Is the Functional Nursing Model Right for Your Facility?
The functional nursing model of care delivery organizes workflow in terms of tasks. Within this model, nurses assume responsibility for the completion of a specific category of patient care duties, such as performing high-level wound care consultations and interventions.
Though this model is sometimes regarded as outdated and ill-suited to holistic, patient-centered care, it still has a place in the nursing profession. The degree that it can benefit patients, your facility, and your staff depends on the way it’s integrated into overall strategies for patient care.
Here’s a closer look at the functional nursing care delivery model, so that you can decide whether it has a place within your facility’s operations. Learn how managers can support personnel engaging in this type of nursing care, and how the model fits in with broader nurse staffing strategies.
What Is the Functional Nursing Care Delivery Model?
Nursing care is always delivered with the objective of supporting and promoting healing, with respect for the patient’s unique needs and values. This is accomplished within the framework of care delivery models that define the responsibilities and distribution of workload. Functional nursing, or task nursing, is a framework that’s oriented around nursing tasks. Within this model, nurses assume responsibility for the completion of standardized, often relatively repetitive duties.
The History of the Functional Nursing Model
This method emerged in World War II as a strategy for maximizing the efficiency of limited nursing resources to meet the needs of numerous wounded soldiers. The model allowed available nursing staff (including many new nurses) to perform standard, repetitive tasks for entire wards. For example, one nurse may have been responsible for distributing medications while another bandaged wounds.
Is the Functional Model Obsolete?
Critics of the functional model argue that it doesn’t contribute to person-centered care, which is increasingly considered a core purpose of modern nursing. This is because when it’s implemented incorrectly, or for the wrong reasons, it can lead to fragmentation of care and a lack of patient trust. However, task nursing does have a place in healthcare today when used correctly.
How the Functional Nursing Model of Care Is Used Today
Here are the most common situations where task-oriented care delivery has a positive impact on the patient experience.
1. As a Secondary Model
In acute care environments, the functional model can supplement the main nursing care models used (usually team nursing or total patient care nursing).
Example: At a large hospital, a med-surg unit primarily uses a team nursing model to organize the workflow. In addition, a wound care nurse and several IV nurses, all of whom organize their work according to tasks, visit the unit to assist with patient care on a case-by-case basis.
2. To Efficiently Process a High-Volume of Patients
When a situation requires nursing resources to provide care to a high volume of patients, the workload can be divided within the framework of functional nursing.
Example: At a community vaccine clinic, a nurse is responsible solely for checking health histories for drug allergies and delivering vaccines to all incoming patients over the course of an eight-hour shift.
3. As a Crisis Management Strategy
The functional nursing care model can be used temporarily, as a method for getting through a crisis, such as a sudden staffing shortage, pandemic, or mass casualty incident. In these instances, there may not be enough resources for total patient care or team nursing. A unit leader may choose to organize care delivery by task to ensure critical interventions are performed efficiently for the highest number of patients possible.
Example: Due to a sudden influx of patients following a building collapse, emergency department staff nurses move away from their typical team model and begin using a task model of care delivery to ensure patients are swiftly triaged and treated. A nurse who usually performs a wide variety of interventions as a part of a team is now assigned solely to initiating oxygen therapy for all patients with oxygen needs.
How Is the Functional Nursing Care Model Distinct?
To better understand the model, let’s look at how it differs from the other common methods of care delivery.
Functional Nursing vs. Primary Nursing and Total Patient Care Nursing
The primary difference here is scope of responsibility. In functional nursing, the nurse is responsible for completing tasks. In the primary nursing model and total patient care model, the nurse assumes responsibility for the patient.
This difference impacts all areas of the nurse’s workflow, especially the nurse’s objectives per shift and time management strategy.
Functional Nursing Model vs. Team Nursing
The biggest difference here is the degree of independence. Nurses delivering care under the functional care model can work independently of other personnel, moving from task to task according to their own proficiency and speed. In many facility types this will also involve regular interactions with an interprofessional team, but even when engaging with the team they have some autonomy with regard to their workload.
Nurses delivering care under the team model, on the other hand, are far more integrated with a team and their progress through tasks will be dependent on the team’s efficiency.
Strengths of the Functional Model of Nursing Care Delivery
Task nursing allows certain personnel to become experts in critical, challenging tasks, which can be an important advantage for patients with complex needs. Overlooking this method of care delivery can create treatment delays and negative patient outcomes.
Consider a team of IV nurses serving an entire facility. Thanks to the task-oriented nature of their workflow, these nurses insert thousands of challenging IVs, gaining insights and knowledge that those performing the task infrequently never acquire. This level of expertise can make all the difference for patients with difficult access requiring IV medications, sometimes urgently.
Here are some other important benefits to consider:
- Increases efficiency of task completion
- Provides nurses with a sense of autonomy and flexibility
- Can improve patient outcomes when used correctly
Weaknesses of the Functional Model of Nursing Care Delivery
Despite these clear benefits, there are also drawbacks to the method, especially when used in the wrong situation or without appropriate respect for the patient as an individual.
When used inappropriately as a unit’s only care model (to cut down on labor costs, for example), this method can have a negative impact on the patient experience. Patients may feel alone in the system, without a clear advocate. Care delivery may become disorganized, and patient needs can fall through the cracks — particularly emotional and psychosocial needs which aren’t easily quantified. If nurses become too task oriented, they may think of patients in terms of piecemeal duties (“another lab draw”) rather than a whole individual.
Here are other potential weaknesses of the model to consider:
- Repetition of tasks leading to career dissatisfaction
- Stunted professional development due to the narrow scope of tasks performed
- Poor rapport building between patients and nurses
- Lack of accountability for patient outcomes
- Fragmented care leading to missed signs of patient decompensation
How to Support Staff Who Are Delivering Task-Oriented Care
Understanding these strengths and weaknesses can help you support your staff. Guide nurses to avoid pitfalls, such as becoming overly task focused. Encourage staff to continue to put the patient first and engage on a whole-person level.
Standard best practices like addressing patients by name, establishing rapport, and respecting cultural differences should always apply. Empower nurses using this model in non-emergent situations to build time into their schedule for patient engagement, even in the midst of working through a long task list.
Looking for More Management Strategies?
Integrating the functional nursing model into your existing staffing strategies is a great way to give nurses a chance to develop their expertise. Our healthcare leadership insights and guidance can help you ensure your nursing team is functioning optimally and delivering high-quality patient care.