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Nursing models)
Nursing models are conceptual models, constructed of theories and concepts. They are used to help nurses assess, plan, and implement patient care by providing a framework within which to work. They also help nurses achieve uniformity and seamless care.
History of nursing models
The original role of the nurse was primarily to care for the patient as prescribed by a physician. This evolved into the Biomedical Model of nursing care which still strongly influences nursing practice today. The biomedical model focusses heavily upon pathophysiology and altered homeostasis but fails to identify individual differences and whilst it works well for traditional medical and physical care, it focusses solely on the treatment of disease, making little account of psychological, sociocultural , or politcoeconomic differences between individuals. The Biomedical Model essentially views all patients with the same disease as the same problem regardless of their religion, culture, or ethnicity.
The first theorist to clearly articulate a role of nurses distinct from the medical profession was Florence Nightingale. Her theories were developed during the Crimean War and published in Notes on Nursing:What It Is, and What It Is Not in 1859. Nightingale's model is based on the idea that the nurse manipulates the environment to promote the patient's wellbeing.
Nurses quickly realised that treating patients based upon their disease rather than making a holistic assessment was not a satisfactory way of attending patient care.
Universal features of nursing models
All nursing models involve some method of assessing a patient's individual needs and implementing appropriate patient care. An essential portion of each nursing model is measurable goals in order that the process can be evaluated in order to provide better care for the patient in the future. Almost all nursing models are used to produce a document known as a care plan that is used to determine a patient's treatment by nurses, doctors and other healthcare professionals and auxilliary workers. These documents are considered to be living documents - they are changed and evaluated on a daily basis as the patient's condition and abilities change.
Examples of nursing models
The models used vary greatly between institutions and countries. However, different branches of nursing have different "preferred" nursing models. These are summarised below:
Psychiatric nursing
- Roys Model of Nursing
- Tidal model
Children's nursing
Adult nursing
Community and rehabilitation nursing
Generic Model Health, Social & Pastoral Care
Future of nursing models
Nursing models have been criticised for failing to provide holistic care, and preventing nurses from thinking "outside of the box". This has been compounded by many hospitals who have developed "pre-printed" care plans that have been misused by nurses who have failed to customise these generic care plans to the patient. An example of this would be using a standard appendicectomy care plan for an elderly patient with multiple pathology (for instance diabetes, angina pectoris and a history of myocardial infarction). Evidentally, the patient's care needs would be very different from a fit-and-healthy 20 year old male with no previous medical history who neither smokes nor drinks!
Models of nursing have always been accused of being "out of touch" with the harsh reality of patient care, and creating yet more unnecessary paperwork for nurses to complete.
Technological advances may produce software specific nursing models.
See also
External links