nursing model vs. medical model - page 2

Hi all, I'm doing more research about the NP and PA professions and have read a lot about both. The only thing I'm not sure of is the type of training each one receives, either the "nursing model... Read More

  1. by   KrisGi
    medical model,
    the traditional approach to the diagnosis and treatment of illness as practiced by physicians in the Western world since the time of Koch and Pasteur. The physician focuses on the defect, or dysfunction, within the patient, using a problem-solving approach. The medical history, physical examination, and diagnostic tests provide the basis for the identification and treatment of a specific illness. The medical model is thus focused on the physical and biologic aspects of specific diseases and conditions. Nursing differs from the medical model in that the patient is perceived primarily as a person relating to the environment holistically; nursing care is formulated on the basis of a holistic nursing assessment of all dimensions of the person (physical, emotional, mental, and spiritual) that assumes multiple causes for the problems experienced by the patient. Nursing care then focuses on all dimensions, not just physical.
  2. by   zenman
    Professional schools = theory driven

    Trade schools = no "fluff," no theory, just hands on stuff

  3. by   CRF250Xpert
    DItto Zenman. My employer doesn't care about holistic anything or any theory implimentation. They want that pt out of the room as fast as possible so I can see more and more. The old nurse in me still tries to teach, but if I am in particularly chatty teaching good spirits - I notice I get way too far behind (a place I loathe). I agree with the reitree model too. I hope to get a part time job after retirement and see maybe 10 instead of 18 or 20. That would allow for much more time and info exchange - rewarding for the PT and the NP.
  4. by   Frozen08
    Having worked with medical teams on interdisciplinary rounds I would say that we've lost the "whole patient" battle. MDs do treat nutrition, spiritual health, social issues, etc.. They often are not the ones doing the care, but they were on top of recognizing when RD's Chaplains and social work needed to see patients for various issues and asking/ordering those providers consults.

    At the end of the day it's an individual thing. not a profession thing. We can all choose to treat the whole patient or just focus in on specific issues to get through the day.
  5. by   ronit_3232
    I don't know much about Nursing model or medical model. I just did a search on google and this website came up. I think nursing models are somewhat models that help students to make functionality of certain parts clear.
  6. by   Skippydog
    The medical model could be used to arrange nursing curriculum. I know selecting nursing model for course works well to focus nursing education on relevant nursing practice but it is hard to pull away from the medical model when hospitals and text books are written with medical model.
  7. by   nomadcrna
    Not sure where you get "on the fly". I had basic hard science as well.
    Gasp, I had chemistry, organic chemistry, microbiology etc. Both masters level and doctoral level biochemistry, pharmacology, physiology.

    So again, I'm not sure where you get your information but it is not correct.

    Quote from Josh L.Ac.
    Another way to look at it:


    Medical model - heavy didactic foundation in basic sciences before any patient contact. Problem focused.
    Nursing model - more focus on the interaction with the patient and clincal experience while attempting to learn the scientific rationale "on the fly". Patient focused.
  8. by   almost_done2012
    maybe medical model = scientific method? take hypothesis and investigate it with H&P, labs, imaging -> result

    nursing model = ?

    comparing the NP and PA curriculum, seems very different especially in clinical training. PAs have inpatient/outpatient Internal Medicine, Pediatrics, OB/Gyn, Surgery, Psychiatry, Primary Care, Neurology clerkships, but nowhere in the NP curriculum shows that, how do NPs do clinics?
  9. by   nomadcrna
    You have to remember a couple of things. NPs are building on previous experience. Even though many PAs have previous medical experience, the program assumes they start from scratch. Good or bad, agree or disagree, this is how it is.
    Even though a PA rotates through those areas, they are not proficient in treating patients in that area. There is still a large measure of mentorship and OJT. Of course the same goes for NPs.
    I personally like the basic generalist education the PAs get and wish our NP programs would start with that and then specialize. Is it better? Depends on the person. I've found that PAs and NPs are pretty much interchangeable. I've seen good and bad in both specialties.
    As an RN before I went to school. I have 13 years of critical care, ER and a couple in med surg when I was a new RN. No matter what anybody tries to tell you. That experience is invaluable.
    A PA I knew had pretty much the same background as I did. She was excellent but she choose the PA road because it would be quicker for her. She had an ADN and would have had to finish her BSN and then go to grad. school. Was there a difference between her and I? Not at all, we both had our strong points but really not any difference.
    The only difference was she had to have her charts reviewed, signed and had to have a collaborative agreement. I practiced independently.

    In regards to the medical model = scientific model. Do you really think we diagnose differently? Do you really think NPs don't do labs, imaging etc to obtain a diagnosis?
    BTW, H&P is not a tool to diagnose.

    Quote from almost_done2012
    maybe medical model = scientific method? take hypothesis and investigate it with H&P, labs, imaging -> result

    nursing model = ?

    comparing the NP and PA curriculum, seems very different especially in clinical training. PAs have inpatient/outpatient Internal Medicine, Pediatrics, OB/Gyn, Surgery, Psychiatry, Primary Care, Neurology clerkships, but nowhere in the NP curriculum shows that, how do NPs do clinics?
  10. by   kanzi monkey
    Quote from Traveler
    T If a patient has a pressure ulcer the NP will focus not only on the actual wound (and nurses have more experience with chronic wounds and treatments), but also on nutrition and lifestyle teaching.
    I have to disagree w/ this example. If a pt has a chronic wound, the doc/surgeon/nurse/NP/PA all understand that the wound won't heal with an albumin of 1.8 or by sitting on it--even for short periods.
  11. by   zenman
    Quote from kanzi monkey
    I have to disagree w/ this example. If a pt has a chronic wound, the doc/surgeon/nurse/NP/PA all understand that the wound won't heal with an albumin of 1.8 or by sitting on it--even for short periods.
    Yep, and you got to give them a tuna sandwich and pour honey on the wound!
  12. by   kanzi monkey
    Quote from zenman
    Yep, and you got to give them a tuna sandwich and pour honey on the wound!
    ...and I have actually done both of these things.
    ;-)
  13. by   KurtDNP
    The following is by no means exhaustive and is what I've gleaned from my personal observations, education, and reading. The term model is not speaking of some specific step-by-step process but, rather, a philosophical paradigm that undergirds the values, assumptions, approach, and practice of a discipline. Thus, I will attempt to differentiate the medical model from the nursing model (where "model" refers to the fundamental underlying approach). Mind you, as society changes, so do disciplines. Some of these are less true now than 30 or 40 years ago but I still think my fundamental points are reasonably accurate.

    Medical model
    TRADITIONALLY TENDS to emphasize empiricism (cause & effect; objective facts relatively separable from the patient), reductionism (reduces the patient to a disease, body part, problem that can be fixed), paternalism (physician over patient, physician over other providers--hence phrases like "physician's ORDERS")

    Strengths: Aggressive and in-depth treatment of specific disease processes, keen awareness of objective anomalies, often motivates patients through authority (could be a weakness too)

    Weaknesses: Can easily miss the whole-person complexity of humans, less sensitive to subjective evidence

    Nursing model TRADITIONALLY TENDS to emphasize esthetics (experiential knowledge), holism (the interconnected nature of human realities a.k.a. mind-body-etc...), partnerism ([I made that word up but I'm sure there's a legitimate term out there] nurses partner with patients to help them reach self-actualization, doing only for them what they can't do for themselves)

    Strengths: The HUMAN in human being is validated, empirical evidence is utilized but with the purposeful consideration of the subjective reality that is a legitimate part of the human experience, patients feel like partners and not subjects or children (unless they are...indeed...children)

    Weaknesses: Can easily miss more complex physiological anomalies, risk being overly sensitive to subjective evidence

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