The nursing shortage: dynamics and solutions. A supportive clinical practice model

Area of Science:

• Nursing Care Delivery Models
• Healthcare Management
• Professional Nursing

Background:

• A large VA teaching hospital implemented an all-registered nurse (RN) staff for primary nursing care.
• Initiatives aimed to boost nurse satisfaction amid shortages, highlighting the patient-nurse relationship's value.
• The nursing staff exhibits advanced academic preparation, clinical certifications, and professional organization involvement.

Purpose of the Study:

• To evaluate the success of the primary nursing care delivery model.
• To assess the impact of staffing revisions on nurse autonomy and job satisfaction.
• To examine interprofessional collaboration within the primary nursing framework.

Main Methods:

• The study involved evaluating the existing primary nursing care delivery model and staffing.
• Revisions were made to incorporate licensed vocational nurses (LVNs) as associate nurses.
• Nurse autonomy, job satisfaction, and physician collaboration were key areas of focus.

Main Results:

• The primary nursing model proved successful due to robust support services enabling nurses to focus on patient care.
• Staffing revisions included LVNs as associate nurses.
• Nurses reported affirmed authority and autonomy in clinical decision-making.
• Physicians acknowledged nurses as co-primary care providers in a collaborative environment.

Conclusions:

• The primary nursing care delivery model is effective in a VA teaching hospital setting.
• Support services are crucial for the model's success.
• The model fosters nurse autonomy, professional growth, and positive interprofessional relationships.
• Inclusion of associate nurses (LVNs) was part of the model's evolution.