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Delivering Care In Nursing

Nursing Care Delivery Model: Functional Nursing Model

Nursing care delivery models details how tasks assignment, authority, and responsibility are structured to achieve patient care. The nursing models describes who is responsible, the one with authority to make informed decisions and which worker is to perform specific tasks assigned. In the delivery models, caregivers are closely matched to the needs of the patient so as to give out quality care in a cost effective way possible (Blais and Hayes 2011). With the functional nursing model there is no individual care to patients as staff members are allocated certain tasks to be done to certain group of patients. The functional nursing method mainly focuses on the provision of physical care by carrying out physician orders through tasks and procedures given out. The staff assignment is given out according to job description of the nurses, type and amount of work that need to be done. The assignment assigned may or may not take into account of the potentials of the nurse and needs of the patient. The personnel utilized here are the nurse managers who are the professional in the sector, the licensed practical Nurses (LPN), registered nurse (RN), and nurse aide and unit clerk (WISE 2013). 

 

The nurse manager is responsible for coordinating of the patient outcome and their care in the hospital. Registered professional nurses are the ones responsible for administering of medication to the patients in all units, others are used for administering the ordered treatments for all the patients and finally there are those used for changing the dressing of patients (Edmunds and Mayhew 2008). The registered nurses are responsible for recording and taking vital signs, they are also used to record the output for patients in all units and others bath the bedridden patient in the units. The nurse aides are responsible for assisting the patients who are mobility impaired to walk in the hospital hall or to move on bed in sides. The unit clerk in the functional model is responsible for delivering messages, answering the telephone, discharges and recording admissions of patients (Giddens 2013).

The nurse manager is the overall of all the personnel utilized in the model. The LPN/LVN, RNs and the Nurse aide all report to the nurse manager who assigns all the work and responsibilities to each of them. The nurse patient relationship does not develop mostly as they are not in touch with the patients (Parsons and Preece 2010). This is because the nurse care is task-oriented instead of patient-centered. The LPNs organize care round scheduled services and treatments performed by other staff members in the healthcare team. The RPNs and RNs coordination is by the involvement of other staff to ensure that the needs of the patients are met appropriately by the healthcare team members. The nurse is the central individual who coordinates and organizes the small teams around the patient to ensure that everybody is doing work properly (WISE 2013). Therefore, the nurse becomes responsible for patient care coordination. The RNs and RPNs also coordinate patient advocacy. They act on behalf of patients. Mediate between the patients and the professionals, update on physicians on patients status, having a role in planning care and result interpretations for patients. RNs and partly RPNs coordinate discharge planning as a care coordination component. The RNs work together to help the patients by way of care coordination to help them return to their highest stage of health for earlier discharge from the health facilities. LPNs their role in discharge is to get everything ready needed by the patient before leaving the health center and to ensure that the charting is current (Blais and Hayes 2011).

The nurse manager in terms of the education needs to be high as compared to the LVN and RNs. She/he has to have a degree in the relevant nursing academic background with a lot of experience. The LVN/LPN and RN can be a holder of a degree or diploma, but mostly the LVN is a degree holder with high competence. The RN, most of them have, diplomas in the relevant nursing area and also others possess a degree. The nurse aide does not possess any academic background in any field of nursing (Wise 2013).

The functional model mainly focuses on division of specific work among the different healthcare workers based on individual knowledge and the complexity tasks assigned. The model therefore heavily relies on protocols, procedures and regulation which makes it cost effective and production line techniques. The method though contributes to lower quality care, poor patient satisfaction and fragmentation (Giddens 2013).

In terms of the resource consideration in the functional model the resources are very few. When the labor market of nurses is very small compared to the needed workforce the functional nursing model comes in in-order to address the issue of shortage. Mostly in this model money has been diverted to the construction of hospitals or the renovation of the hospitals. With no sufficient monetary the government opts to recruit few nurses so that they can be able to meet on their demands. To sustain the wage bill further it recruits the unprofessional nurses whose wage demands are considerably low to reduce the deficit nurse shortage. This creates a lot of saving for the resources to be used in the expansion of the infrastructural facilities. There is also the problem of the limitation by the agencies responsible in accrediting of the staffing in the hospitals (Parsons and Preece 2010).

The model has no minimum staffing regulations and this affects the RNs and LVPs who are qualified. Working with other nurses who have no knowledge on the needs of the patients becomes a problem. This affects the RNs morale who works with the nurse aides and this leads to the dissatisfaction in work (Giddens 2013). There is also the issue of low staffing levels in the hospitals. This is because the professional nurses who are employed are very few compared to the patients numbers. This leads to job dissatisfaction by the professional nurses who have a high patient ratio. The nurse aides with no basic knowledge sometimes opt to leave the work when it becomes hard due to the job dissatisfaction (Parsons and Preece 2010).

The functional delivery model has got some advantages. Nursing staff becomes specialists in tasks expected to be done by them. Unskilled workers who are recruited are able to perform specific tasks assigned to them very well. The care provided in the functional model is economical and efficient as a large number of patients can be attended to by mixing of the RNs and the large number of nurse aides. The limited number of RNs that are required in the hospitals becomes efficient when shortage in the nurse staff is experienced or when there is a shortage in the number of professional nurses. The tasks assigned to each individual nurse are completed very fast. The model is very useful in emergency situations and when there is occurrence of disasters (Edmunds and Mayhew 2008).

The disadvantage with this model is that care given can be fragmented and lead to ineffective communication making the patient to be dissatisfied, confused and frustrated. Though the technical and physical aspects of care are met the spiritual and psychological needs are overlooked and hence less control over the quality of the service. The patient’s overall response to the care given becomes difficult to assess as critical changes in the patients may go unnoticed. There is also the issue of professional nurse dissatisfaction as they feel unchallenged (Blais and Hayes 2011).  

In conclusion, the cost in the functional model is very costly compared to the other delivery model. This is due to the high death rates experienced in the hospitals. Studies have found out that nurses who are more trained have reduced death rates than the untrained ones (Edmunds and Mayhew 2008). Due to the high number of untrained personnel there is increased mortality rate. The richer staffing of the nurses are very cost effective or neutral in terms of the cost which is not in the functional nursing model as few professional nurses are employed. Non valued man power such as the hours spent with the patient is also very low with the functional model and this becomes very costly at the end than even money spent in the professional nurses who are the few employed here. The increased number of nurses with no job experience has a higher rate of causing wound infections to the patient. There is also the issue of higher job turnover by the inexperienced nurses who do not get job satisfaction from what they are doing which they have no relevant job experience hence over ally increasing the costs.

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