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Learn MoreBy Janet Weaver, MSN, RN, NE-BC, Consultant at Creative Healthcare Management
I have to admit that I am dumbfounded by the resistance I’ve encountered from direct care providers, right up to the CNO, to Primary Nursing. The first time I heard a colleague share an example of a Primary Nurse explaining his or her role to a patient, I remember thinking, “This is great; I would really feel safe as a patient or family member if my nurse spoke those words.”
It sounded something like this:
Hello, my name is Janet Weaver, and I am your Primary Nurse. I will be responsible for you during your stay in this department [episode of care]. I will listen to what is important to you and communicate with others what we agree on for how best to deliver your care. I will make sure you understand how to care for yourself before you go home.
I once had the good fortune to have a nurse speak very similar words to a family member of mine. She was my mother’s hospice nurse. I had total trust in her because it was evident that she was making an authentic effort to know my mother, that she would ensure that my mother’s needs were met, and that my mother would not experience harm from anyone’s lack of knowing. This nurse had my mother’s back. Why would any nurse not want to provide this type of care for patients and their loved ones?
The Primary Nurse Becomes a Care Partner
Primary Nursing is a care delivery system that puts the responsibility for decision-making for a set of patients in the hands of one nurse for the patient’s episode of care. The Primary Nurse partners with the patient to develop a plan of care that will best meet the patient’s needs, and communicates this plan with others caring for the patient. The Primary Nurse may delegate some tasks as appropriate, but the Primary Nurse coordinates all care provided to the patient.
Safe quality care is on the mind of everyone delivering healthcare these days. Primary Nursing provides the necessary structure for RNs to function to the height of their licensure and education. What better way could there be to positively impact Nurse Sensitive Indicators (NSI), those components of care for which nurses have direct control, than a Primary Nurse coordinating and following a patient’s care?
Improved Patient Care Experiences
Adopting Primary Nursing is not an easy transformation to implement; it challenges staff on many levels. They must become skilled at managing their interpersonal relationships, establish trust and respect with one another, and open lines of honest communication. Accepting responsibility for the development and management of a patient’s care can concern nurses for a variety of reasons. Still, what I have repeatedly experienced is that nursing staff members, despite their initial misgivings, find that Primary Nursing makes possible a higher degree of professional nursing practice, and they witness patients having an improved experience of care.
In discussions I have with organizations contemplating a change to Primary Nursing, along with the inevitable resistance, I’ve also seen people’s faces soften as they begin to get a clearer vision of what Primary Nursing makes possible. As they experience the rewards of a responsibility relationship, they realize that Primary Nursing has little in common with the often unsatisfying way they currently practice; instead, it puts a structure in place that makes it possible for them to practice in the way they’ve always hoped to. Nurses engage and become enthusiastic when they’re shown the vision of an infrastructure that actually makes room for knowing the patient as a person and really being able to tailor care to his or her unique needs and circumstances.
With the support of an expert guide, staff creatively (and often eagerly) overcome the initial challenges and misgivings and successfully implement Primary Nursing. Staff I have worked with have shared improved patient outcomes, such enhanced patient communication and partnerships when in the role of a Primary Nurse. I suspect and hope that you’re now thinking of the ways you too will impact patient care as you implement Primary Nursing.
As a clinical nurse, Janet connected with her patients and felt great compassion for them. As her career evolved and she moved into leadership roles, something she’s done for nearly 30 years, Janet brought that same sensitivity to her teams. As a consultant for CHCM, Janet’s areas of focus include Primary Nursing, orchestrating the implementation of Relationship-Based Care (RBC) and facilitating Re-Igniting the Spirit of Caring (RSC). jweaver@chcm.com
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
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View All ProductsIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream's solutions allow your healthcare workforce to be confident and competent with the knowledge they are upholding the highest of standards.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
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View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
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