Chapter 2:The Theory and Advantages of Primary Nursing
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Description
Dr. Summers gives an overview of “primary nursing” and its development as a central concept in nursing. She also discusses its advantages for clinical practice and care of patients.
Identifier
SummersB_01_20140123_C02
Publication Date
1-23-2014
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Barbara Summers, PhD, Oral History Interview, January 23, 2014
Topics Covered
The Interview Subject's Story - OverviewOverview Definitions, Explanations, Translations The Researcher The Clinician The History of Health Care, Patient Care
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
And what does that mean, “primary nursing”?
Barbara Summers, PhD:
Well, that was in those days. In those days, primary nursing was a model for nursing care delivery that was developed by Marie Manthey. And the fundamental guiding principle of primary nursing is that when a patient is admitted to the hospital, there is one registered professional nurse who is responsible and accountable to that patient for planning, organizing, overseeing the delivery of and evaluating their care outcomes. It was lovely because it allowed nurses to develop strong relationships with individual patients and to be able then to see the impact of their practice on the outcomes of those patients’ experience.
Tacey Ann Rosolowski, PhD:
This leads to a question that I wanted to ask you, because I noticed that you’ve done some publishing and presenting on the theory of nursing. And one of the questions I hope we’ll talk about is how nursing has changed over the course of your career. So what were you beginning to understand at the time? What was nursing really about? I mean, you’ve talking about this very interesting model, one person responsible for a patient. What’s the theory of nursing involved in that kind of model?
Barbara Summers, PhD:
Well, you know, there are nursing theories and theoretical frameworks, and then there are nursing care delivery models, and then there are nursing Professional Practice Models, and Professional Practice Models are always grounded in a nursing theory. Nursing care delivery models should be in support of a Professional Practice Model. So there has to be consonance and harmony across all of them. When I was in my nursing program, it was at a pivotal point in the profession when nurses were transitioning their care delivery models from something called team nursing to something called primary nursing, and I graduated right at the cusp when primary nursing was getting started. In the old team nursing model, there would be a team that would include a nurse who would have been a professional registered nurse who would have been a team leader, who would have worked with perhaps another R.N. and an L.V.N. and a nursing assistant. And that team together might be responsible for fifteen patients, and the team leader would assign various aspects of care for these fifteen patients to the team members, but there was no single nurse who had responsibility for a particular patient.
Tacey Ann Rosolowski, PhD:
Now, does that—the advantage—I mean, I’m trying to think of what the advantage is, but I should just ask you what the advantage is of having one person responsible.
Barbara Summers, PhD:
Well, I think the advantage is that you have consistency in approach and you have continuity of care, because one of the challenges with team nursing is that there was discontinuity in care because there could be a different member of the team assigned to address care needs of a particular patient on any given day. The benefit of team nursing is that there was this tremendous sense of camaraderie among the team members because they were all in it together. So with primary nursing, the benefit to the patient was consistency and continuity in care. The benefit to the nurse was seeing the outcomes of his or her nursing practice, that one could observe “Was I effective or not in providing the care planning and the delivery of care to the patient?” The disadvantage is that nurses were not practicing in a context of the team, so they lost that sense of teamwork and camaraderie that was so strong in team nursing. But that was mitigated somewhat by the fact that then in those olden days nurses worked eight-hour shifts and worked five days a week, and so you were working with the same group of people and seeing them five days a week, you know, spending more time with them than you were your own family. So there was still a very strong sense of community among nurses at that time.
Recommended Citation
Summers, Barbara PhD and Rosolowski, Tacey A. PhD, "Chapter 2:The Theory and Advantages of Primary Nursing" (2014). Interview Chapters. 1239.
https://openworks.mdanderson.org/mchv_interviewchapters/1239
Conditions Governing Access
Open
