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The NurseLink Model of Care

Joy Nugent
Founder, NurseLink

Article Text

About the founder

Joy Nugent has been a pioneer in private nurse practice since 1987. She was a foundation executive member of NIPPSA (Nurses in Private Practice South Australia). The focus of her practice is gerontology and palliative care in the home setting. Team nurses, counsellors and home care assistants assist Joy in providing fee for service nursing and supportive care. The company has ISO 9000 accreditation and is supported by a custom written computer programme and provides holistic education – the basis of the model. Joy has a commitment to self-directed education and travels internationally in her quest for insights and learning.

About the model

The NurseLink motto is The Patient First – always and experience in the delivery of care confirms that individuals and families in the private sector seek patient –centred care in their own environment, surrounded by the people and the things they know and love. Rewards for those providing the service go beyond the financial and include experience and insights into another person's way of life and the opportunity for developing compassion and personal growth. Self awareness as to how attitude, knowledge and skills affect caring excellence is a fundamental NurseLink teaching. Joy is responsible for the initial assessment and case coordination. The model provides personal and flexible 24 hour care that includes an on-call Helpline. This means that the patient and family are empowered to self care and Joy's team members are there to fill in any gaps in the self-care with education and practical help.

About the practice

The model recognises the multi layers of a person's needs and strives to support not only a person's physical and intellectual needs but also emotional and spiritual needs. It acknowledges that all these areas are interrelated and need equal attention. This requires time: for some patients, a few hours a week; for others 24-hour a day care. The NurseLink Portfolio is the assessment tool. It contains health information, invites the patient and family to explore their own needs and with the case coordinator form mutual goals. The role of the case coordinator is to put into place care that supports individual preferences with consideration to costs involved in providing that care. The patient and family are encouraged to live their lives in ways that are meaningful for them. Choice is always an option and trusting relationships underpin choice.

About the team

The Patient Portfolio is kept in the home to provide effective team communication for all those involved. The case coordinator maximises known resources and the role includes advocacy as well as education. If further resources are needed in one of the identified areas these are facilitated through the case coordinator who is trained in palliative care, bereavement counselling, basic wound management and many of the complementary therapies. The case coordinator provides direct and indirect supervision and credentialling. Documentation encourages the team member to consider the whole person when writing a report for the period of care. A Weekly Work Schedule advises who is coming and the time and contract of care. This document is signed and becomes an input document for the NurseLink computer system for the generation of accounts to the patient and pays to staff. The model provides scope and satisfaction for the nurse case coordinator.

Sandakan Hospice – NurseLink training in practice

For the past seven years a group of committed nurses, doctors and allied health professionals have travelled to Sandakan, Sabah, East Malaysia from Australia to give educational and moral support to the volunteer doctors, nurses and carers from Sandakan Hospice who have achieved leadership in the hospice movement in Malaysia. Malaysia is a Muslim country that is tolerant of all religions and the participants in this year's International Training Program demonstrated the connectedness of all people in the common goal of supporting dying patients.

The Group is led by a dynamic nurse, Margaret Lieu. There is a shortage of trained hospice nurses in Malyasia. Margaret runs an 18 hour training programme for lay volunteers twice a year. Sixty people attended her last training – this is spreading the word and gaining support in the community. The community from the beautiful Buddhist temple in Sandakan supports Margaret with a regular donation. Margaret has just been awarded a community honour for her work.

The spirit of a person is honoured in many ways in Malaysia. However, this year a great lesson was given to me as I talked to the mother of a 17 years old boy who was severely brain damaged. When I arrived as a guest for high tea I was introduced to the boy who was lying on a bed in a prominent position in the home and being moved and attended to by several caring maids. The mother said; 'This is our eldest child. We don't hide him – my husband says that he was given to us because we are good people and will take care of him.'

I felt this was a far cry from my Western culture who, I felt, would have blamed and asked 'Why me? Why am I being punished?' rather than to have thanked God.

Location

NurseLink is located at 2/196 Hutt St Adelaide, SA 5000. Phone (08) 8232 0511, Email nurselink@tpg.com.au, Facsimile (08) 8232 3923.

Figure 1: The core model and a guide to holistic care

Practical considerations: These are all interrelated

Figure 2: The NurseLink model

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