| Nursing Models | 'Care' Models |
| Nursing models have a theoretical base underpinned by well-documented and validated clinical research. | Care models do not have any theoretical base and are not underpinned by any clinical research. |
| The focus is on health needs - nursing models have a holistic focus, based on the total health care needs of a resident. | The focus is on social needs Care models fail to recognise the real health care needs of residents - they concentrate on residents needing 'a cup of tea and to be taken for a walk'. |
| Nursing models acknowledge that nursing practice occurs in a home-like environment and maintain that domestic care and the living environment can have an impact on health. | Care models place emphasis on the 'home-like' environment and treat health needs as a separate issue. |
| Nursing models require the development of a comprehensive nursing care plan dealing with the promotion and maintenance of health; injury and disease prevention; maintenance or attainment of optimal well-being; or the achievement of a peaceful death. The plan is holistic in nature and can include traditionally non-nursing work as long as it contributes to health and well-being. | The focus is on 'domestic' care such as a roof over their heads, food, clean surroundings and companionship. Promotors of this model seek to limit the influence of nurses over the total care provided. |
| Nursing care plans are developed by a registered nurse taking into account the total needs of residents. They must be developed in accordance with professional practice as determined by nursing regulatory bodies. | Where required by law nursing care plans are developed; however, there is a concerted push by employers to limit these plans to the current technical nursing needs of residents - separating 'domestic' care needs from other health needs. |
| Registered nurses may delegate work identified under the nursing care plan. By law, the registered nurse remains professionally responsible for the work that is delegated and is required to ensure that any person performing work identified by the plan is competent to discharge the task or role in a manner that is consistent with professional nursing standards. Professional and ethical standards apply equally to all care provided including 'domestic' care such as bathing. | There are no professional standards or code of ethics associated with the care provided under these models. |
| Action can be taken through nursing regulatory bodies over care provision which falls outside of the ethics and standartds of professional nursing practice (this is what protects the public from the potential for abuse, unethical or unprofessional care). | There is no regulatory body, professional standards or code of ethics associated with care provided under these models. Standards are determined by each individual worker. |
| Registered nurses who delegate the work performed under a nursing care plan are required to monitor the care of residents to ensure that it continues to meet professional standards. Nurses must act to rectify unsafe or unethical practice | As there are no professional standards or code of ethics associated with the provision of care, there can be no on-going monitoring of standards under 'care' models. |
| Nursing care plans do not include service provisions such as laundry, regular cleaning, cooking or the like. This work is undertaken by dedicated staff and allows nursing staff to direct nursing care time to the resident. | Under these models workers are expected to perform a range of tasks which do not directly involve care of the resident, such as cooking, cleaning, mowing and the like which takes them away from the direct personal care of residents. |
| Nurses are trained to monitor the on-going health status of residents. Any deterioration in a resident's health is detected early and treated promptly. | Non-nursing staff may not recognise the early symptoms of certain illnesses. Many ailments suffered by the elderly (particularly where a difficulty to communicate may be present) may not show obvious symptoms until damage has already been done or treatment is more difficult. No requirement for regular direct reporting to nursing staff contributes to this problem. |
| Preventative health care is a focus of a nursing model. | Preventative health care is rarely achieved as a problem has to arise before action is taken. |
| There is a recognition that the health of residents in nursing homes often deteriorates over time and constant monitoring ensures the level of care provided to a resident can be modified quickly. | There is an assumption of a degree of 'health and well-being' that is simply kept stable by good domestic care when facts show that residents in nursing homes are indeed sick, disabled and in need of preventative health care. |
| The environment is premised on meeting the holistic health care needs of residents. | The emphasis is on 'custodial' care. |
