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In1860,Florence Nightingale recognized the importance of theory and process in health care,and her message has gotten stronger as the years have progressed.Nurses in the UK today are trained in clinical practice and the importance of following defined methods and practices. Regardless of the specific practice model they follow, first and foremost nurses must adhere to the Nursing and Midwifery Council (NMC, 2004) code of professional conduct: standards for conduct, performance and ethics. The code sets the standards on matters such as patient respect, consent, teamwork, confidentiality, professional competence, trustworthiness, and risk mitigation.
However, the NMC does not specify how a nurse is to embody these standards.Most nurses and health facilities utilise nursing models to guide nursing practice, for example, Roper-Logan-Tierney (1996); Neuman, as cited in Ume-Nwagbo, DeWan, & Lowry (2006); and multiple theories/models as cited in Aggleton & Chalmers (2000). In addition to specific author-developed models, nursing models are delineated as a function of patient care: total patient care, functional, team, and primary (Tiedman & Lookinland, 2004).
The nursing field has long recognized the importance of "innovative practice models" or "structural approaches to nursing practice" (Weisman, 1991).One particular model, the Roper-Logan-Tierney (RLT) model, originally published in 1980 with revisions in 1985, 1990, and 1996, is a commonly used model in the United Kingdom particular at National Health Service hospitals. . 1. Maintaining a safe environment2. Communicating 3. Breathing4. Eating & dressing5. Eliminating6. Personal cleansing & dressing7.
Controlling body temperature8. Mobilizing9. Working & playing10. Expressing sexuality11. Sleeping12. DyingUpon admission to hospital, most patients in an acute care setting have physical problems that impact their ability to satisfactorily complete these tasks, thus the model can be used in multiple clinical settings (Walsh, 1998). The authors (1996) indicate they recognize the influence of non-medical factors including psychological, socio-cultural, environmental, and politico-economic on resources supporting satisfactory completion of AL, however he model is not without its criticisms, which shall be discussed as applied to and following the Case Description.
A nursing model alone is necessary, but not sufficient, to provide nursing care to a patient. The nurse must act, carry out the steps of the model in an organized manner, to provide care meeting the standards of not only the NWC, the hospital, but most importantly, the patient. The National Health Service emphasizes this in its circular model of health care, which places patients and the public in the center of the circle and the providers surrounding them.This organized action involves following the nursing process.
The nursing process generally includes four phases: assessment, planning, implementation, and evaluation. While generally performed sequentially, given the myriad of problems and matters a nurse must monitor for just one patient, let alone a dozen patients, it is not uncommon for a nurse to simultaneously be supporting tasks in each of the four
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