As a professional nurse who is responsible for the care of Mr. R., a 58-year-old patient who has recently underwent surgery. Mr. R. had colon cancer that resulted in a temporary colostomy. The first area of focus is to select a nursing theory that best suits Mr. R. situations. The second priority is to provide professional nursing care based on the theory. Providing the basic plan of care requires nurses to consider the theory or model that best suits their patients need.
Basic Content and Terminology of the Theory or Model
The selected model is the team nursing model of patient care. The team nursing model is “where teamwork is practical nurses stay in nursing, they are more productive, errors are reduced, quality is improved and “patients are more satisfied” (Kalisch, Weaver, and Salas, 2009, p.1). Team nursing was established in the 1950s in response the patients needing mixed skills for their care. The model requires excellent communication and strong leadership skills of groups of nurses who work cooperatively and collaboratively to provide better care than individuals nurses can provide alone. The team model typically has a team leader for the group.
The team members work closely and interact in a way that fosters cooperation and trust among each other. The patient then benefits from a combination of skills provided by the team. In a functional system, the needs may not be recognized; however they may be identified in a team environment. The patients receive better care and are more satisfied. The team model used and recognized the different skill levels that each team member can offer. Managers have continued to outline the success that they have found with team nursing. The prior model of patient allocation did not provide the same quality of care as team nursing. The team nursing model also gives an opportunity for less experienced nurses to learn from their peers.
The team nursing model provided nurses a complete picture of the patient’s needs. Having a full overview of the patients allows for better facilitation for covering breaks or days off. It also establishes a platform for independence within the staff while holding the seniors of the team with greater responsibility for supervising their team. Patients reported that there was more contact with their nurses, a safer environment, and better quality of care. More than one nurse can help the patients and is familiar with the patient’s case, so there is always continuous care.
The leader or senior member of the team nursing group is responsible for setting the goals. Goals can change based on the situation. “A person’s performance and productivity are affected by the nature of the task and by his or her ability, experience, and motivation” (Bessie and Huston, 2011, p40). The leader needs to consider what strategy will work best for each case; no single leadership strategy will be useful in every situation. The team leader will aid in keeping the team motivated and focused on the patients need and providing the best care possible.
The team nursing model of patient care has proven to increase employee satisfaction and the care given to the patient. The model fosters an environment where nurses more readily willing to help others. There is no stating ‘that’s not my patient’, the model has several members who are available to assist the patient’s needs. The model has also proven that employee satisfaction has increased because they are working together. The team nursing model also allows for an expanded mentoring opportunities where experienced nurses can share their knowledge with new nurses. The team nursing model of patient care is a common practice in hospitals today. It allows for the patients to get the best care possible and the nurses to work together and share their knowledge and responsibilities.
Providing Professional Nursing Care Based on the Theory
Providing profession nursing care based on the team nursing model of patient care will allow Mr. R to get the best care possible. The head of the team nursing model is the Nurse Manager (or DON) who is in charge of the entire nursing unit. The Director of Nurses supervises the nursing staff; however she is not as involved with the patient as the other nurses in the group. The Registered Nurse and the Licensed Practical Nurse does review the patient’s plan of care with the DON to ensure they are treating the patient in the best manner possible.
The next member of the team nursing model of patient care is the Registered Nurse. An RN, who manages the care of 4-5 inpatients, does the assessments, care plans and delegates work to the team. The RN makes clinical decisions and instructs which actions will best suit the patient. “The nurse must always have sound reasons behind clinical decisions and procedures and be able to communicate the purpose well” (Hood, 2014, p.6). The RN can provide on the job training to the other nurses on the team by explaining why the care plan would best suit the patient’s recovery. The registered nurse is responsible for changing Mr. R’s care plan if the assessment shows the recovery is not going in the direction that it should.
On the team is the Licensed Practical Nurse, who is responsible for wound care, treatments, and PO medications. The LPN would create the plan for the Mr. R’s management of his temporary colostomy. The patient needs to understand the procedures and how he will be able to self-care for himself. The LPN encourages all nurses to build his self-esteem and allow him to know he has control over his recovery. The LPN will teach Mr. R and his family how to change the pouch and keep the area clean. When the bag is one-third full, the patient will need to empty or replace the bag. The LPN is responsible for allowing the patient to learn to do it on his own while she is supervising to ensure he can do it on his own at home. If Mr. R is in pain, the LPN can request pain medicine to keep him more comfortable.
The next member of the team is the Patient Care Technician (PCT) who completes the vital signs. In implementing the necessary care, one of the biggest challenges in patient care is updating the charting. It needs to be a priority to document immediately after every interaction, task, and intervention performed. The PCT can also aid in educating Mr. R with the best diet for the individual. The ADLs (hygiene) are responsible for turning and repositioning of the patient, and they apply the TED stockings for postoperative circulation. The ADL ensures the patient in changing positions when needed to increase movement and get him back on his feet as soon as possible. The final members of the team are the unlicensed assistive personnel. It includes nursing assistants or transporters. These members will bring the patient food, fill Mr. R’s pitcher with ice and water, or transport him internally with a wheelchair or stretcher. All members of the team nursing model of patient care are vital to the care and recovery of Mr. R.
- Bessie L. Marquis, Carol J. Huston. (2011). Huston Leadership Roles and Management Functions in Nursing Theory and Application, Seventh Edition.
- Hood, L. J. (2014). Leddy & Pepper’s conceptual bases of professional nursing (8th ed.). Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins.
- Kalisch, B.J., Weaver, S.J. and Salas, E. 2009. What does nursing teamwork look like? A qualitative study. Journal of Nursing Care Quality, 24(4):298–307