Primary Nursing is a care delivery system that supports professional nursing practice. Within Primary Nursing, a therapeutic relationship is established between a registered nurse and an individual patient and his or her family. The relationship is initiated by the RN and is in effect for an episode of care or service.

A defining component of Primary Nursing is clarity of the RN’s acceptance of responsibility for decision-making regarding the nursing care the patient receives during a health event. The primary relationship is known to the patient and family, and the safeguarding of that relationship becomes a priority for other members of the care team. The Primary Nurse does not provide all patient care. In partnership with the patient, the RN identifies the patient’s unique health needs and priorities, establishes an individualized plan of care, provides direct care as appropriate, and communicates the plan to other members of the team. The associate nurses are responsible to follow the plan of care unless a change in patient condition warrants an adjustment of the plan.

Primary Nursing focuses on the nurse-patient relationship, strengthening accountability for care and facilitating patient and family involvement in the planning of care.

Marie Manthey, President Emeritus of Creative Health Care Management, shares her personal experience of knowing when she wanted to become a nurse and how that experience led her to that first unit that implemented Primary Nursing at the University of Minnesota Hospital in 1968.

Program Agenda

This one-day dynamic workshop educates and prepares staff to develop the infrastructure for Primary Nursing. This care delivery system emphasizes nurse autonomy and a responsibility relationship for patient care, which results in nursing excellence and a positive experience for every patient.

Through presentation, reflection, and small-group dialogue, the participants will have the opportunity to explore and deepen their understanding of how Primary Nursing is instrumental in establishing and maintaining a therapeutic relationship with patients and their loved ones. The RN will realize the potential for achieving greater professional satisfaction and pride associated with the responsibility. The program covers the following topics:

  • A brief history of Primary Nursing
  • Elements of a care delivery system
  • Comparison of care models versus care delivery systems
  • Definition and congruence of responsibility, authority, and accountability (R+A+A)
  • Primary Nursing implementation process
  • Relationship-focuses: relationship with self, teamwork, nurse/physician relationships,
  • Establishment and preservation of the therapeutic nurse-patient relationship
  • Staffing and scheduling to create an infrastructure of support for continuity of care
  • Creating a culture of ongoing development as Primary Nursing evolves in your unit over time
  • Leading for empowerment
  • Managing one’s own interpersonal relationships
  • Outcomes measurement

Who Should Attend

  • Direct care nurses, nurse managers, nurse directors, and nurse executives seeking improved patient satisfaction or simply wanting to ensure excellence in patient care
  • Those seeking an opportunity to find greater meaning in their work
  • Those from a facility beginning or desiring to strengthen their Magnet® journey
  • Those desiring a care delivery model that enhances professional nursing

Participant & Organizational Objectives

  • Nurses will achieve a new sense of autonomy and confidence in their ability to truly manage the patient’s nursing care.
  • Participants will achieve a greater feeling of professional satisfaction.
  • Participants will gain new perspectives on teamwork and practical suggestions for how to maximize the interdependence of RNs with LPNs and NAs.
  • Participants will achieve a higher level of professional nursing practice.
  • Primary Nursing promotes a satisfying patient experience as described in the first three questions on the HCAHPS survey.
  • Patients feel better oriented and more secure.
  • Nursing staff is engaged and inspired, finding new meaning and purpose in their work.
  • Nurse/physician collaboration and collegiality are enhanced.

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