Hospital:

Nursing Care Delivery System

Theorists 

Florence Nightingale and Jean Watson are the theorists upon which our practice model is built.  Nightingale, the first nursing theorist, identified that good health is linked to the Five Environmental Factors: fresh air, pure water, efficient drainage, cleanliness, and light.  In addition, warmth, quiet environment, and nutrition were key aspects to improving health.  Nightingale was the founder of hourly rounding, carrying her lamp as she rounded on her patients. She identified that nursing is both an art and a science.  These components remain the cornerstone of the nursing profession.

Jean Watson’s Theory of Caring takes the basic aspects of Nightingale and builds upon it to incorporate caring, faith, and hope.  The major components of her theory infuse the 10 Carative (Caring) Factors: 

  1. Embrace altruistic values and practice loving kindness with self and others.
  2. Instill faith and hope and honor others.
  3. Be sensitive to self and others by nurturing individual beliefs and practices.
  4. Develop helping-trusting caring relationships.
  5. Promote and accept positive and negative feelings: authentically listen to another’s story.
  6. Use creative scientific problem-solving for care decision-making.
  7. Share teaching and learning that addresses the individual needs and comprehension styles.
  8. Create a healing environment for the physical and spiritual self which respects human dignity.
  9. Assist with basic physical, emotional, and spiritual human needs.
  10. Be open to mystery and allow miracles to happen.

Caring is the essence of nursing and focuses on the nurse-patient relationship.  The essence of nursing care can be experienced in the moment when one person connects to another.  Compassion and care are conveyed through our relationships with others.  This is the core of nursing practice.

Relationship-Based Care

The framework used to provide nursing care at Jefferson New Jersey is the Relationship-Based Care Model.  Relationship-based care is built upon principles that encourage engagement of healthcare providers and leaders throughout the organization and promote exemplary performance.   Relationships are patient centered, grounded in mutual respect and encompass patients, families, the healthcare team, and one’s self.   The Relationship-Based Care Model includes three crucial relationships: 

  1. The relationship between caregivers and the patients and families they serve.
    1. The clinician understands that individual experiences will determine how a patient will face their illness.
      1. The clinician strives to understand what is most important to the patient and actively engages the patient in their care to promote safety, quality, and satisfaction.
  2. The caregiver’s relationship with self.
    1. This relationship is nurtured by self-knowing and self-care.
  3. The relationship among members of the healthcare team.
    1. Quality care occurs in environments where the standard among members of the healthcare team is to respect and affirm each other’s unique scope of practice and contribution to promote a culture that supports caring and healing.

Nightingale’s and Watson’s theories are congruent with Relationship-Based Care and visibly align with the philosophy of nursing and the mission, vision, and values of the organization.  Through this model, Jefferson New Jersey nurses serve as patient advocates, putting the patient and family at the center of our work.  We strive to make a difference in the lives of those we touch each day.

Resources

Koloroutis, M, Felgen, J., et. al (2004).  Relationship-based care:  A model for transforming practice.  Minneapolis, MN:  Creative Health Care Management.
Watson Caring Science Institute& International Caritas Consortium (2013).  Caring science (definitions, processes, theory).  Retrieved April 28, 2014 from http://watsoncaringscience.org/about-us/caring-science-definitions-processes-theory/.