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Primary Nursing tips November 1, 2009

Posted by mariemanthey in Leadership, Professional Practice.
Tags: , , ,

Logistics of assignments complicate Primary Nursing so much that many people feel it is impossible in today’s health care system.

I say Nonsense!   Keep it simple and it works!

Pragmatic not Perfect!

Short term patients need short term goals!

Do nothing that violates your common sense!

Decide in favor of the patient and it will be in favor of the nursing!

Nine times out of ten the problem is either unskilled leadership at the NM level or unhealthy interpersonal relationships among the staff. Both of those need to be solved, then let the staff decide the logistics — of both their schedules and assignment continuity.

It works!  And patients need it more today than ever before.


1. Heidi Orstad - January 10, 2015

Your words echo with truth just short of 6 years later, Marie! Always will. I can remember the faces and names of countless patients in my 27 years as an RN, obviously some more than others, but all because of the Primary Nurse model of care and all because the relationship was the premise of the care that would follow.

I have always found myself drawn to understanding the story behind the patients and families that I served and what might be affecting their physical situation, factors that can’t be measured (grief, trauma, developmental stage, ambiguous loss, family challenge). Understanding those pieces of their puzzle and also unseen strengths helped me to serve the patients and families more effectively.

One book that helped me quite a bit in serving seniors as a Geriatric Care Manager was a book entitled, “How to Say it to Seniors” by David Solie. In his book he wrote effectively about senior’s life journeys, what communication strategies work, and that a senior’s developmental milestone is to leave a legacy. Knowing this key factor, I was intentional in my relationships with seniors that I served to ask the right questions, to hear their life story, to ask the right open ended questions, to practice appreciative inquiry. Reflecting life stories brought such joy and healing often, although at times sadness; but it was necessary. I practiced these legacy visits with patients with memory loss as well, often seeing profound conversations come forth. What an honor to be the one.

One patient in particular saw my role as the person who might collect his “Ed-ism’s”. He was a professional cellist and had no children, but had profound observations about life- poetic in fact. I saw him weekly or biweekly for over a year and it began during one week. He said something profound, “I don’t send flowers to the grave. I tell people when they are across from me how much they mean to me. You mean the world to me” and he gave me a corsage. I said that was so lovely and that i was going to write that in my journal as an “Ed-ism”. From that day forward, he had an “Ed-ism” waiting for me when I came to visit, and he always asked if I would “write it down.” He asked, as his life was coming to an end, if I might read his “Ed-isms” at his funeral. I was honored and his musician friend made a booklet of his verse.

So, I agree wholeheartedly, Marie- in all things, do right by the patient. Sit on the bed, hold the hand, look in the eye, use the name, ask what you can do to help. Connect.

mariemanthey - January 11, 2015

Heidi….once again you hit the nail on the head. Nursing is about a relationship….and it is what makes this such a rewarding profession. Without the ‘story’ of the human being cared for….nursing is just a stress-filled mechanistic unrewrding series of compllicated tasks.
Leadership and teamwork are the two essentials for Primary Nursing. Both are skills we can OWN! and failure to do so puts nurses in roles that lead to burnout and even PTSD! We need to wake up and understand that the kind of experience you describe is worth fighting for! and it is ours to own.

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