Observation of Clinical Practices in Mayo Clinic Rochester
In mayo clinic Rochester, a single nurse is usually appointed to provide comprehensive care to a patient especially after admission into the hospital as an inpatient. After which the patient receives individualized attention throughout the stay period, and this is given by the same nurse until the duration of stay is over. In the same clinic also, a single nurse may be appointed to provide care and health services to a group of patients, especially those who have common needs for care. In such a case, the nurse is usually responsible for monitoring the progress of the group of patients, which is often through constant assessments and evaluation of treatment outcomes. In general, patients in Mayo clinic are engaged in a direct relationship with nurses as part of a utility management program, and according to the management, this helps in maximizing the levels of care provision to both in patients and out patients, while at the same time minimizing the provision of unnecessary care. By attending to specific patients, nurses in the clinic are accorded rightful duties depending on the patient’s condition, and on the number of nurses available for health care service provision. Mayo clinic may therefore be seen as having adopted an economic strategy of utilizing its nurses. For instance, nurses at the clinic usually report for duty periods that run for a 24 hour duration, and within which the nurses direct all their efforts towards giving the patient(s) all their care requirements.
In Mayo clinic Rochester, the nurses not only provide individualized care to patients as they deem necessary, but also refer to a primary nurse who gives general directions about the treatment and health care service they should provide to their patients. The primary nurse in this case monitors on the progress of all patients, and supervises the operations of all nurses in the clinic. The clinic may therefore be seen to be seen as practicing a primary model of operation by the way the nurses are appointed duties. For instance; the management of the clinics is seen as one that emphasizes that its nurses engage in a close relationship with its patients; the nurses consult the primary nurses frequently as a basis for responsible service delivery; through its utility management program, it provides evidence based treatment to patients; there is some element of autonomy in the way the nurses operate; communication among nurses and with patients is also well facilitated because they are often on duty for long durations of time, which enables them to interact, bond and collaborate; and also because leadership is well exercised in the operations of all staff in the health care facility.
The Primary Model in Nursing
According to Howatson-Jones et al (2015), the primary model of nursing is one that relies on a nurse-patient relationship in health care service provision, and that the nurses working under such a model are accorded some element of autonomy. With the primary model of nursing, treatment and health care service provision is based on empirical evidence, which means that the patients have to be diagnosed to determine their actual health care requirements, which is unlike other models of care that provide treatment acoording to the patient’s perceived health care requirements (Finkelman, 2012). This model of nursing is evident in the Mayo clinic Rochester, and this is mainly evidenced by the constant nurse therapeutic presence that patients experience in the clinic. The nurses may also be seen as having some element of autonomy, this is so because; one single nurse is given the responsibility of attending to a patient or a group of patients exclusively, in addition, the nurses in Mayo clinic also report and refer to a primary nurse for consultation and directions regarding how certain patients are to be given care services, this implies that the nurses often collaborate as a basis for service delivery.
Farrell (2015) also asserts that; the primary model of nursing is one in which the following features are observed. These are; an elaborate nurse-patient relationship that is exercised throughout the patient’s duration of stay; individualized judgement and decision making by nurses regarding the scheduling of treatment and health care services to a patient or a group of patients; Assignment of responsibilities to a particular nurse once a patient is admitted into the hospital; and finally, a centralized leadership system in which the primary nurse(s) oversees the functions of each nurses under his or her team (Farrell, 2015).
All these features are evident in Mayo clinic Rochester. For instance, the nurses at the clinic are engaged on a one on one relationship with patients throughout the patient’s duration of stay, the nurses are also allowed to make individual judgement and decisions regarding treatment or health care service provision to patients in the clinic. This implies that the nurses in Mayo clinic Rochester have autonomy (Farrell, 2015). However, this is subtly limited by the roles of the primary nurses, who often monitors and supervises the nurses while on duty. In addition, the fact that nurses are allocated the responsibility of attending to patients on a direct basis exclusively is evidence that the clinic has adopted the primary model of care.
Howatson-Jones et al (2015) also see the primary model of care as one that is comprehensive in nature. This is seen where the nurses are tasked with two responsibilities, these are; the nurses are responsible for accountability of their conduct at work, this implies that the nurses has to document a patient’s progress from admission to when the patient recovers, and also do the same for all the treatments and health care services scheduled from the time the patient is admitted to when he or she is discharged; the nurses are also tasked with the responsibility of exercising authority in the health care facilities in which they work, this is seen where a nurse is required to make judgement and decisions regarding the type and duration of treatment a patient should receive in the hospital (Howatson-Jones et al., 2015). In Mayo clinic this features are evident whereby; the nurses in the surgery and substance abuse departments are seen attending to patients from the time they are admitted to when they are discharged. Meanwhile, the nurse provides health care services to patients individually and on a direct fashion, by providing them with care and treatment and at the same time assessing and evaluating their progress. Indeed, Mayo clinic has adopted the primary model of nursing in its healthcare facility located in Rochester.
The Team Model of Nursing
This type of model is one in which the nurses and a team or group of nurses is tasked with the responsibility of giving health care services to a group of patients, and especially to a group of patients with common treatment and health care service requirements (Howatson-Jones et al., 2015). The functioning and operation of the nursing team is often overseen by a single leader who provides the rest with advice and a venue for consultation as when they encounter challenges in provision of care and health services to patients. In addition, individual nurses who make up the team are often specialized in providing different types of services, but in most health care facilities that practice the team nursing model, the team members are given tasks according to necessity and the patient’s needs (Farrell, 2015). For instance, one nurse may be tasked with the responsibility of cleaning and clothing the patients, while another is tasked with the responsibility of providing the patients with physical care, for example, giving drugs and medication. Meanwhile, the team leader supervises as the nurses go about their business of providing the patients with care and treatment.
Through the team nursing model, nurses with different levels of experience and varied fields of specialization may be tasked with providing care to a single patient. In the long run, some nurses may be over utilized while other are less utilized. This implies that the model is not economical, and most often than not, fragmentation in care provision could occur (Howatson-Jones et al., 2015). This is so because, the nurses do not get time to bong with patients as they have been given a common duty in providing care services to different patients in the facility. Also, the nurse who performs the assessments may not necessarily be the one to provide the recommended care services of treatment to the subject patient. This implies that the mode may not be entirely effective in as far as provision of high quality, need and evidence based services are concerned to patients, especially those who are admitted in the health care facility for long durations of time.
According to Middleton et al (2015), a team nursing model is one in which a patient’s or a group of patient’s health care requirements are distributed to different nurses, and who work together to ensure that all the identified needs are met. These team on average comprises of 5 nurses who have different specialties and whose main objective is to provide the patient with high quality need based care (Middleton et al., 2015). This is often achievable since the team members have different abilities and have specialized in different fields. The fact that the team works towards meeting a common object implies that effective and maximized monitoring and assessments of the patient’s progress can be achieved. This is because the nurses make direct contact with the patient on a daily basis, and are prone to making different observations that could imply different assessment outcomes. The advantage of this is that the most effective treatment is unanimously given to the patient by all the patients (Middleton et al., 2015).
According to Walker et al. (2007), the gradual increase in the number of inexperienced nursing graduates and other levels of nurse including assistant nursing and enrolled nurse calls for rethinking concerning the perfect model for healthcare provision. The team model of nursing was found out to be effective in improving the skills of the inexperienced nurses as being placed in a team of experienced nurses forced them to level up. The team model was also found to be effective in redistribution of certain aspects of care so that they can be used effectively at each nurse level. This implies that, if well-orchestrated and effectively managed, fragmentation of care may not take place and that the system may prove to be more effective than the primary nursing model as observed in Mayo clinic.
Recommendations
For Mayo clinic Rochester to provide high quality care and treatment services to its patients, it should adopt a nursing model that makes maximum utilization of its medical staff, and this should most probably be the team nursing model. This as described above is due to the fact that; for any clinic to develop and implement an effective facility utilization management plan, it needs to identify the most suitable model of nursing depending on the characteristics of its personnel and facility. However, the following key features should be observed in the type of nursing model that is chosen as a basis that guides the operation and functions its personnel. These are;
The model should enable the nurses to and patients to engage in a direct relationship. This would enable the nurses to be able to monitor the progress of the patients more closely, and therefore adjust appropriately depending on the health care and treatment requirements of the patient.
The model should also enable the best suited medical staff to attend to particular care requirements by the patients. For instance, if the team model of nursing is adopted by Mayo clinic Rochester, nurses should be allocated duties depending on their specialization.
All treatment and health care services given to patients should be evidence based and in accordance to the outcomes of assessments. By having different nurses attending to one patient or a group of them, this could easily be achieved as different nurses would perform assessment and unanimously agree on the best care and treatment services to be given to individual patients.
Conclusion
Mayo clinic has adopted a primary nursing model. This is seen where a single nurse is tasked with the responsibility of attending to and providing health care services to a group of patients. This model is effective if the best suited nurses are accorded the responsibility. However, the model is expensive as it does not make maximum utilization of nurses and medical staff. It is therefore recommendable that the clinic adopts the team nursing model.
References
Finkelman, A. W. (2012). Leadership and management for nurses: Core competencies for quality care. Boston: Pearson.
Howatson-Jones, L., Standing, M., & Roberts, S. (2015). Patient assessment and care planning in nursing. Learning Matters.
Farrell, C. (Ed.). (2015). Advanced Nursing Practice and Nurse-led Clinics in Oncology. Routledge.
Middleton, S., Grimley, R., & Alexandrov, A. W. (2015). Triage, Treatment, and Transfer Evidence-Based Clinical Practice Recommendations and Models of Nursing Care for the First 72 Hours of Admission to Hospital for Acute Stroke. Stroke, 46(2), e18-e25.
Walker, K., Donoghue, J., & Mitten-Lewis, S. (2007). Measuring the impact of a team model of nursing practice using work sampling. Australian Health Review, 31(1), 98-107.
