Nursing Care Models

NursingCare Models

NursingCare Models

A model can be defined as a way of representing reality. In otherterms, it can be used to represent a simple version of a complexsystem with the aim of developing an understanding regarding how itwould work in a realistic situation. The inception of nursing caremodels followed the increased need to provide a comprehensive view ofnursing, including its objectives, process, as well the differentcomponents of the nursing profession. As a result, various modelswere developed according to different perceptions of nursing. For along time, people had different opinions regarding what nursingshould achieve in the community, how it should be carried out, andwho should be at the forefront of realizing the related goals(Finkelman, 2016). The consensus is that nursing care modelrepresents the actual nature of health care (Finkelman, 2016). Thispaper seeks to identifynursing care models utilized in today’s various health caresettings with the aim of enhancing the knowledge of how they impactthe management of their influence on care and delegation of duty inhealthcare settings.

Observationof a Staff in the Delivery of Care

Iobserved a staff making rounds in a small hospital to check theconditions of the inpatients. What stood out in this observation isthe passionate nature in which the nurse handled her job. Despitehaving the previous information regarding the diagnosis of patientsas well as what was required as part of their treatment procedures,the nurse still engaged the patients who were able to talk inexplorative discussions. Most of the questions he asked sought todiscover other hidden aspects of the patients’ lives which were notcaptured previously. For instance, he asked them whether they hadbeen treated before using the drugs he was about to administer tothem. It was apparent that the nurse was concerned with knowing whythe treatment procedures did not work previously. He also wanted todetermine whether clients have had allergic reactions as a result ofsome drugs. These pieces of information were critical in ensuringthat all the clients` issues were resolved. It was also essential inensuring that the patients received the right treatment. Lastly, Ialso observed that the nurse preferred to deal with the issues ofpatients comprehensively, even those which may be regarded asirrelevant in the typical healthcare setting.

AReview of the Sources

Inthe book, “Leadership and Management for Nurses,” Finkelman(2016) provided a modern perspective regarding leadership andmanagement process in nursing. The book discusses what it takes fornurses to provide quality healthcare to the community. The authorreflected the framework developed by the Institute of Medicine tofacilitate clarity in her discussion and support the relatedarguments. The delivery of quality care is pegged on five essentialelements: patient-centered care, interdisciplinary teamwork,evidenced-based processes, periodical improvement of quality, and theuse of informatics.

Thebook, “Nursing Theorists and their Work” by Martha Alligood isprimarily a guide through 31 nursing theories, includingmulticultural nursing model. The author provided the historicalcontext of each theory, how they have been used, and their importanceto the contemporary nursing practice. She used case studies toprovoke the critical thinking of the readers.

Ina different literature, “The Essence of Nursing,” Suzie Kimportrays nursing as a concept and discipline rather than anaggregation of specific skills and techniques to facilitate theprovision of care. She developed a five-level framework to justifythe need to perceive nursing from a holistic perspective. The authorbases her arguments on several nursing care models, including carefulnursing theory.

Additionally,Meehan (2013) conducted a deep analysis of careful nursing model withthe aim of fitting within the structure of contemporary nursingprocesses. The methodology of the study included content analysis ofprimary sources, mainly those which were developed at the time of thedevelopment of the model. The exercise revealed that careful nursingis portrays nursing as a holistic and multifaceted process.

Inthe book, “TransculturalNursing Education Strategies,” Sagar (2014) offers a comprehensiveguide to the integration of transcultural nursing education to thein-service and academic sector. The author acknowledges thathealthcare has increasingly been challenged by the cultural diversityin the society. The literature offers a deeper analysis oftranscultural nursing model in the process.

CarefulNursing Conceptual Model

Followingthe observation described in the previous paragraph, I concluded thatthe nurse operated within the careful nursing conceptual modelbecause of his holistic approach to care when making rounds oninpatients at the hospital. Although it is still widely used in thecontemporary healthcare setting, the careful nursing conceptual modelwas developed in the 19thCentury by Catherine McAuly in Ireland during the Crimean War(Meehan, 2013). It is widely regarded as the legacy of Irish nursesbecause they used it to deliver health services to the Britishsoldiers who were wounded in the war between 1854 and 1856.

Thismodel sought to re-establish the social service aspect of nursing. Atthe time of its conception and development, Ireland was experiencingan increase in chronic illnesses, epidemics, and war (Meehan. 2013).It became apparent to McAuley and a group of other nurses that peoplewere in need of physical, emotional, and psychological supportfollowing the devastating effects of the diseases which affected thesociety. McAuley and her colleagueshadreceived a complete and modern version of training in nursingprocesses. This education coupled with their experience taught madethem realize that as social service providers, sometimes they had totake their services to sick people rather than wait for them to cometo hospitals. In the observation described in the previous paragraph,the nurse seemed to deal with issues which otherwise would not havebeen thought as relevant in the modern healthcare setting. Not onlydid he demonstrate having an interest in the patients’ physicalconditions, but also assessed their emotional and physical conditionsand helped them deal with their concerns.

McAuleyalso emphasized on getting the right and adequate training beforeembarking on nursing procedures. For instance, she was well equippedwith the scientific and medical practices at the time of thedevelopment of this model. Correspondingly, she consulted thepublications of former nurses such as Catherine of Sienna and John ofGod among others. She perceived nursing as a concept, an area ofstudy, and practice.

TheDescription and Implementation of the Model

The careful nursing conceptual model views health as an experience ofharmony, self-dignity, contentment, and harboring a sense of purpose(Kim, 2015). It claims that people can only have such experienceswhen they are free from diseases. It further connects with religiousteachings by maintaining that the process of healing is a divine planof restoration. The concept of careful nursing occurs when peoplelove the life of others and would want to be competent when dealingwith them. Nurses should love the life of their patients irrespectiveof their characteristics. The observed nurse demonstrated this aspectby taking his time with patients and exploring their issues furtherthan expected. From the observation, it was apparent that the nursehas a holistic perspective on health care. McAuley pointed thatnurses should be able to remain calm and transfer the same to peoplein their surroundings, including their patients (Kim, 2015).

Themodel has four interrelated categories with subcategories whichrepresent the dimensions of the model. The first dimension is thetherapeutic milieu with five dimensions. The second group includespractice, competence, and excellence which have eight dimensions.Nursing management and influence in health systems has threedimensions. Lastly, the professional authority has two dimensions(Kim, 2015). The dimensions in the first category are attributes of acompetent nurse. They include the ability to feel and express love,maintain calmness, intellectual engagement, and capacity to care forself and others, capacity to maintain a safe physical environment forpatients. The second category comprises of the specific processeswhich should drive nursing interventions. They include being tenderin approach, inspiring safety and comfort, assessments, engaging inclinical reasoning before decision making, encouraging patients toparticipate in self-care, diagnoses and outcome interventions,establishing family and community support, and providing healtheducation.

Thethird category entails the skills needed to be a careful nurse. Theyinclude the ability to develop trustworthy collaboration with otherhealth-related agencies, adopting a participative and authoritativeapproach to management, and capacity to recognize and support a givennursing practice. The last segment includes aspects which facilitatethe trust between health care providers and patients. They compriseof visibility, self-confidence, and responsibility. This model is aprocess which promotes the development of self-awareness regardinghow patients should be treated. The central factor, in this case, isthe provision of comprehensive quality care to people. It forms thebasis for understanding the holistic nature of health care.

Recommendationof a Different Model

Whereasthe previous model contextualizes nursing practice on the religiousprinciples and the general attributes that people should possess tobe competent nurses, the transcultural nursing model is particular inredressing the challenges that arise from increased culturaldiversity in the contemporary society. The development of the theoryin the 1950s was underpinned by Madeline Leininger’s her experienceas a child psychologist (Kim, 2015). She realized that children’spattern of behavior were largely underpinned by their culturalpractices. She understood that her service delivery process wascompromised by the lack of cultural knowledge. After a successfulstudy of cultural anthropology, Leininger concluded that nursingdeals with a lot of issues relating to cultural diversities.

Therefore,it is important for nurses to discover, document, interpret, explain,and predict the various cultural factors which affect the delivery ofa holistic and conclusive health care to the culturally diversecontemporary society. According to Leininger, it is possible todevelop a comprehensive transcultural nursing framework becausevarious cultural practices have similar aspects (In Alligood, 2014).Leininger developed three approaches which could be used to plan andachieve the objective to provide health care that aligns with thecultural needs of various people. They include being culturallycompetent by acquiring knowledge and continually engaging inself-assessment. The second approach entails conducting a culturalassessment by studying and understanding the beliefs, values,meanings, and the behavior of people. Thirdly, nurses should be ableto overcome cultural dissonance by listening and understandingpatients` cultural context, perceptions, and behaviors beforeoffering professional insights into issues which hinder the provisionof a comprehensive health care.

Thismodel highlights three approaches which nurses can use to provideservices which acknowledge people`s cultures. Firstly, nurses aretasked with the responsibility of finding ways of preserving andmaintaining the cultural elements of individuals while receivingholistic care. Secondly, it is the obligation of nurses to exploreand negotiate with patients regarding their cultural practices toprovide the best care services (In Alligood, 2014). Lastly, nurseshave the obligation of determining cultural influences on people’sbehaviors. Later, nurses can re-pattern and reconstruct patients`ways of life following the successful determination of culturalpractices which affect their behavior. A cultural practice caninfluence a behavior in a way that positively or negatively affectspeople`s health and perceptions of health care.


Throughoutthe exercise, I was able to learn that there are specific attributesthat define the nursing profession. It is not just enough for someoneto undergo training to become a competent nurse. People have topossess the ability to express genuine sympathy and love human life.These attributes will drive healthcare professionals towards actingethically, inclusively, fairly, and competently to alleviate people`ssuffering. I have also learned that cultural diversity is one of themajor issues affecting the delivery of complete health services tothe community. Cultural competence is essential for understandingthat various practices can compromise health processes.


Finkelman,A. W. (2016). Leadershipand management for nurses: Core competencies for quality care.Boston, Pearson.

InAlligood, M. R. (2014). Nursingtheorists and their work.St. Louis Missouri

Kim,H. S. (2015). Theessence of nursing practice: Philosophy and perspective.

Meehan,T. C. (2013). Careful nursing: A model for contemporary nursingpractice. Journalof Advanced Nursing,44(1),99-107.

Sagar,P. L. (2014). Transculturalnursing education strategies.Springer Publishing Company.