Models of nursing care

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Introduction

Models of nursing care are all based on nursing human patients and they are an attempt to address the definition of what nursing care needs to provide for the patient, how this care is actually provided and how a patient is affected by their illness in the context of how this would effect the nursing care that is required. Models attempt to organise the process of providing nursing care so that there is consistency in understanding what care is required when patients are unable to provide for their own needs, and how this care should be carried out. There are numerous models of nursing care that have been formulated over the years to quantify the nursing process, and a few of the more widely known ones are detailed below. Despite being a human nursing phenomenon they are useful when considering the question 'what is nursing care?'

‘Activities of Living’ model (2002)

Roper, Logan and Tierney are three British nurses who formulated the model now known as the ‘Activities of Living’ model, which defines the ‘activities for living’ in order that a nurse can systematically assess a patient's ability to them carry out independently or with intervention by the nurse. The model is a guide to use when formulating a care plan to ensure all bases are covered: The ‘Activities of Living’ are:

  • Breathing
  • Eating and drinking
  • Eliminating
  • Controlling body temperature
  • Mobilising
  • Sleeping
  • Maintaining a safe environment
  • Communicating
  • Personal care and dressing
  • Working and playing
  • Expressing sexuality
  • Dying

The model has become widely used in human practice and has been praised for addressing the differences between the doctors' and the nurses' interpretation of a patient's needs. It has received some criticism for being unspecific particularly in the context of pain management.

Orem’s Self Care deficit model (2001)

This model starts with the premise that the disease process that affects an individual creates an inability or deficit when caring for yourself which nursing care must address. Orem, and American academic, has defined the needs that are likely to be affected in the following ‘Universal Self Care Requisites';

  • Sufficient intake of air
  • Sufficient intake of water
  • Sufficient intake of food
  • Satisfactory eliminative functions
  • Activity balanced with rest
  • Prevention of hazards to human life, human functioning and human wellbeing
  • Balance between solitude and social interaction
  • Promotion of human functioning and developing within social groups in accordance with human potential, known human limitations and the desire for ‘normalcy’

This model has been praised because it fits many human nursing situations which can be very diverse, from psychiatry to surgical nursing care. The slightly academic language has, however, been subject to some criticism.

Both of these models will not appear to be particularly relevant to veterinary nursing care; however they can be a useful starting point to consider the question of how to achieve consistently high standards of nursing care that is specific to the needs of an individual patient.