Primary nursing also has some disadvantages, including:
● It requires excellent communication between the primary nurse and associate nurses. ● Primary nurses must be able to hold associate nurses accountable for implementing the
nursing care as prescribed. ● Because of transfers to different units, critically ill patients may have several primary care
nurses, disrupting the continuity of care inherent in the model. ● Staff nurses are neither compensated nor legally responsible for patient care outside their
hours of work. ● Associates may be unwilling to take direction from the primary nurse.
Although the concept of 24-hour accountability is worthwhile, it is a fallacy. When primary nursing was first implemented, many organizations perceived that it required an all–RN staff. This practice was viewed as not only expensive but also ineffective because many tasks could be done by less skilled persons. As a result, many hospitals discontinued the use of primary nurs- ing. Other hospitals successfully implemented primary nursing by identifying one nurse who was assigned to coordinate care and with whom the family and physician could communicate, and other nurses or unlicensed assistive personnel assisted this nurse in providing care.
Patient
Other health care providers
Primary nurse Charge nurse