Nursing Care Delivery Models: Pros and Cons

Holistic Nursing

Holistic nursing (HN) is a type of nursing practice that focuses on curing the whole person rather than just treating the biomedical problems. HN pays much attention to the relationships with the patient, caring for their “interconnectedness of self,” as well as their ties to “others, nature, and spirituality” (Dossey & Keegan, 2016, p. 3).

There are numerous advantages to HN. These include:

  • Better patient health outcomes. Because nurses devote attention not only to biomedical aspects of the patient but also to their psychological condition, it allows them to help overcome the psychological concerns that the patients have.
  • Better satisfaction of patients. Patients feel that they are cared for, and usually appreciate the effort that nurses put in them.
  • More satisfaction for the nurse. The nurses delivering holistic care form relationships with the people they are caring for, and gain more joy from helping them.

However, there are also certain disadvantages to HN, some of which are:

  • HN can be emotionally draining for the nurse. Nurses are required to devote much attention to each patient, to take into account their personal needs, relationships, opinions and perceptions, and help them to achieve harmony, which might take much personal and emotional effort.
  • HN is time-consuming. The need to devote much attention to every single patient requires much time and effort, which is especially hard if not impossible if nurses are overloaded with patients.
  • HN requires additional knowledge and expertise. Nurses delivering holistic care need to be able to understand the patient’s psychological concern, as well as to take into account their biomedical condition in its wholeness.
  • HN may not be well-understood by patients. Some patients might perceive holistic nursing as prying into their personal affairs.

Team Nursing

Team nursing (TN) is a model that was developed during World War II to ease the shortage of nurses by involving auxiliary personnel in patient care. In TN, staff is divided into teams, and each team is assigned to a group of patients. The team is led by an RN, who provides coordination and supervision for the rest of the team, and is responsible for the delegation of tasks to them. Teams usually consist of RNs, LPNs and NAPs (Kelly, 2012, p. 358).

Some of the advantages of this model are:

  • Decreased workload of RNs. Because it is possible to delegate certain responsibilities to the rest of the staff, RNs can focus their advanced knowledge and skills where they are needed most.
  • Nurses work in teams rather than alone, which allows them to use “collective knowledge”; they can always consult with one another in case of uncertainty, and, because all the members of the team are involved in caring for patients, they know them more deeply, and the advice will be more in-depth as well. This reduces the risk of making mistakes while delivering care.
  • TN provides collaboration and camaraderie among the nursing staff, lets them learn and practice skills needed for teamwork. Less experienced nurses gain more opportunities to learn quickly.

However, there are also certain disadvantages to this model, such as:

  • Communication in TN is rather complex; additional discussions need to take place, and the time for decision-making increases. RNs need to have highly developed supervision and delegation skills.
  • Nurses share responsibility and accountability, which may cause the lack of both, and lead to confusion.
  • The patients may receive fragmented, depersonalized care, because each nurse deals with a greater number of patients, thus having to devote less time to each one of them (Kelly, 2012, p. 359).

References

Dossey, B. M., & Keegan, L. (2016). Holistic nursing: A handbook for practice (7th ed.). Burlington, MA: Jones & Bartlett Learning.

Kelly, P. (2012). Nursing leadership & management (3rd ed.). Delmar, NY: Cengage Learning.

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