Nurses' perception of primary nursing in a day hospital for the elderly

Abstract

The aim of this exploratory study was to explore nurses' perceptions of primary nursing in a day hospital for the elderly. This was conducted in a day unit of a rehabilitative geriatric hospital. A sample of 7 nurses took part in the study. Data was collected through semi-structured interviews, which were tape-recorded. The interviews were later transcribed and analyzed using thematic analysis. Results from this study showed that nurses had positive views on the primary nursing system. The respondents perceived their primary nursing role as having total responsibility for individual patients from the first visit until discharge. Several advantages of this system were identified, mainly, closer therapeutic nurse-patient relationships and greater in-depth knowledge of patients. Nurses also perceived continuity of care as central to primary nursing. This study also revealed that primary nursing offered an individualized approach to care, where patient advocacy, trust, better communication with patients and their families and clearer identification of patients' needs were enhanced. Primary nursing also helped nurses to achieve greater satisfaction with their role and greater personal and professional worth. Some difficulties, inherent either to this organizational system or to the setting in which it is implemented were also highlighted. Primary nursing was found to foster patient- dependency on one's primary nurse. The out-patient nature of the day hospital appeared to restrict the nurses to some extent from providing the truly holistic care that primary nursing is said to offer, due to the limited time that the patients spend in the day hospital. Moreover, the continuity of care that patients and nurses enjoy as a result of primary nursing also seems to be disrupted to a certain degree by the fact that patients are cared for on an out-patient basis. As a result of this study, limitations and recommendations for practice were noted and suggestions for further research were given. Since this was a small-scale study no conclusions can be drawn.