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The Nurse User
Published in William C. Beck, Ralph H. Meyer, The Health Care Environment: The User’s Viewpoint, 2019
Primary nursing is the most recent system for the delivery of nursing care. The professional nurse plans nursing care for a small group of patients 24 hr a day from admission to discharge from the hospital. This system of nursing care is more efficient when there is decentralization of drugs, supplies, food, and communication. The nurse can spend time meeting patient needs rather than traveling to the pharmacy, passing food trays, or getting supplies from a distribution point. One method of decentralization is the “nurse server”. The “nurse server” is a cabinet that has access from both the corridor and the patient’s room. Both sides may be locked, and those persons needing access have a key. Within it clean areas hold routine supplies, there is a medication drawer, a space for linen, and any equipment the nurse requires to meet the needs of the patient. Soiled items, such as linens, food trays, and trash are placed in another area for collection. Dietary, pharmacy, or other technicians and aides bring the supplies, drugs, and equipment to the point of use. The nurse is free to care for the patient because the nurse’s activity is centered in the patient’s room. Treatments, administration of medications, and charting are all done at the point of origin — the patient’s bedside. There is less travel for the nurse and she becomes less involved in nonnursing activities.
Method: ethnography in clinical situations and rigour of the study
Published in Steven J. Ersser, Nursing as a Therapeutic Activity, 2019
The fieldwork settings are listed according to fieldwork stage and the informants from that site in Appendix 1. All wards were located in a provincial county in the South of England. The neurology ward was the speciality ward used for stage I. It is based in an acute hospital and operated a system of team nursing. Both general medical wards (one in each stage of fieldwork) are situated in the main district general teaching hospital. The general ward used for stage I operated a system of team nursing and had a high patient turnover compared to national averages. The general ward used in stage II was led by an innovative senior sister operating within a lecturer-practitioner role. Nursing was organised according to a system of primary nursing. The ward was known to have a high average patient dependency relative to other wards in the hospital. The speciality ward used for stage II was the district dermatology unit. This unit was geographically isolated from the site of the acute unit. The unit provided inpatient and outpatient services and patients were nursed in individual rooms or in a treatment area. The unit was at an early stage of using team nursing.
Mixed feelings
Published in Nigel Malin, Professionalism, Boundaries and the Workplace, 2002
Examples of how emotionality finds expression in organisations now abound and, not surprisingly, many of these accounts concern the medical professional (Smith 1988, 1992; James 1989, 1992, 1993; Dent et al. 1991; Phillips 1996). The acknowledgement of emotion as a valuable ingredient of organisational life is clearly reflected in changed nursing practice. Traditionally, nursing work was structured around specific tasks. This served two purposes: it gave nurses a claim to base their practice on medical-scientific knowledge, while also allowing them to remain less involved with the patient as a person. Recently, however, ‘primary nursing’ (Smith 1992; Porter 1994; Savage 1995) has been introduced, which promotes a patient-centred, rather than task-centred, approach to nursing. The ‘new’ nursing process is said to counter the previous authoritarian relationship between patient and nurse and allows the patient much more participation in their own healthcare while hospitalised. This is said not only to act as a ‘reaffirmation of the full humanity of people requiring health care’, but also serves to improve the occupational status of nursing by ‘rationalising’ the concept of care (Smith 1992; Porter 1994). The change in the nurse–patient relationship has been greeted with enthusiasm by nurses, and yet, no matter how ‘rationalised’ the new process may be, it does require nurses to invest more of themselves emotionally into the job and, despite claims of increased professional status for nurses, many initiatives appear to be management driven.
Discharge nurse intervention on a pediatric rehabilitation unit: Retrospective chart review to evaluate the Does it impact on number of unmet needs during the transition home following neurological injury
Published in Developmental Neurorehabilitation, 2021
A focal point of the inpatient rehabilitation process is a plan of care developed by an interdisciplinary team, in collaboration with the family. Weekly team review of the plan of care ensures coordination during the inpatient stay. The inpatient rehabilitation primary nursing team focuses on helping the child and family understand and perform the physical care needs required after discharge. At discharge, coordination of the plan of care and provision of care falls to families. Our T1 data indicated there was room for improvement in the preparation of families of children with newly acquired neurological injury during the transition from hospital to home. The discharge nurse intervention was designed to bridge this gap for families and streamline the discharge process for staff. The success of the role is reflected in significant reduction of post-discharge needs from T1 to T2 regarding equipment and supplies, the general transition to home and transition back to school and understanding the child’s new condition and commonly associated problems.
Multidisciplinary attentive treatment for patients with chronic disorders of consciousness following severe traumatic brain injury in the NASVA of Japan
Published in Brain Injury, 2019
Jun Shinoda, Yoshihide Nagamine, Shigeki Kobayashi, Masaru Odaki, Nobuo Oka, Kazushi Kinugasa, Hirohiko Nakamura, Takafumi Ichida, Ritsuko Miyashita, Hiroji Shima, Takashi Hama
In Japan, the National Agency for Automotive Safety and Victims’ Aid (NASVA), which is a national governmental agency specializing in automobile accident measures, has been providing medical support since 1984 to patients with chronic DOC resulting from automotive accidents (33). Currently, NASVA officially operates four NASVA medical centers (with 230 beds) and four affiliated medical sections (with 60 beds) for the treatment of these patients in regional core hospitals which are administered by non-national organizations other than NASVA (33). These medical facilities provide multidisciplinary attentive treatment (MAT) specialized for chronic DOC including rehabilitation, medication, surgery as necessary, and best nursing care using a primary nursing system in which a single nurse has continuous charge of a given patient throughout their hospitalization for 3 years (33). Generally, patients with chronic DOC are spread throughout many different types of medical facilities including acute hospitals, rehabilitation hospitals, geriatric hospitals, mental hospitals, care hospitals, nursing and care homes, or are cared for at home. The NASVA medical facilities provide long-term hospitalization for medical treatment and care. To the best of our knowledge, NASVA is the only nationally organized, large-scale medical system specializing in the treatment of patients with chronic DOC following severe TBI due to automotive accident, and is unprecedented worldwide.
Implementing physical exercise and music interventions for patients suffering from dementia on an acute psychogeriatric inpatient ward
Published in Nordic Journal of Psychiatry, 2019
Anneli Pitkänen, Hanna-Mari Alanen, Olli Kampman, Kirsti Suontaka-Jamalainen, Esa Leinonen
All participants in both study groups received treatment as usual including medication and multidisciplinary treatment negotiations in which patients’ relatives were also asked to participate. The primary nursing model, where every nurse was responsible for a small group of patients from the time of admission to the time of discharge, was used on the ward [39]. Multidisciplinary team meetings took place daily. Moreover, treatment, as usual, included some recreational activities in the ward’s living room such as reading newspaper, painting, playing games, singing songs, listening to music, and exercise training. These activities were carried out infrequently based on nurses’ individual interests and if they were not busy with routine work. On some days during a week, there was also a possibility to walk outdoor in a group with a nurse. Patients’ willingness to take part in different activities were asked separately each time.