TASK: Discuss each of the following nursing care modalities and how the nursing manager can apply them while organizing nursing care:
1. Total nursing care
2. Functional nursing
3. Team nursing
4. Primary nursing
5. Case management
Total nursing care:
Total nursing care involves a single nurse providing all care for a group of patients over a shift. The nurse assesses, plans, implements, and evaluates care for each patient. This allows for continuity of care but can overburden the nurse if the patient load is too large. A nursing manager can apply this by assigning one nurse to care for 4-6 patients maximum to avoid burnout.
Functional nursing:
In functional nursing, care tasks like medications, treatments, and procedures are divided among nurses. Each nurse focuses on a specific function rather than individual patients. While this increases efficiency, it risks fragmentation of care and lack of oversight. A manager can mitigate this by designating one nurse as the primary contact for each patient to coordinate all aspects of care.
Team nursing:
With team nursing, a group of nurses, nursing assistants, and technicians work together under a registered nurse to care for a patient unit or group of patients. Each member has defined roles and works interdependently. This promotes collaboration but requires strong leadership. A manager should clearly outline all team member roles and ensure the team lead facilitates communication.
Primary nursing:
Primary nursing assigns one primary registered nurse to each patient who oversees, plans, and implements the entire plan of care. Other nurses and staff provide support. This fosters continuity and holistic care with a single point of accountability. Managers should limit each primary nurse’s workload to 8 patients maximum to allow for comprehensive care.
Case management:
Case management involves coordinating all care aspects from admission to discharge and beyond. A case manager assesses patient needs, develops care plans, monitors outcomes, and facilitates discharge. This provides streamlined transition of care but requires significant coordination. Managers must support case managers with adequate resources and workload limits of 15-20 patients.
