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Functional Nursing
This kind of nursing modality is task-oriented in which a particular nursing function is assigned to each worker. One
registered nurse may be responsible for giving medications, another nurse for admission and discharges while nursing attendants
change linen, provide hygienic care or do simple procedures for which they have trained. This method divides the work to be done
with each person being responsible to the Head or Senior Nurse. It is the best system that can be used when there are many patients
and professional nurses are few. It is suitable only for short-term use. If continued, it fragments the care of patients to tasks only.

The advantages of functional nursing are that:

1. It allows most work to be accomplished in the shortest time possible;
2. Workers learn to work fast;
3. Workers gain skill faster in a particular task because of repetitive task;
4. Greater control over work activities and it is aimed at conservation of workers and cost.

The disadvantages are:

1. Fragmentation of nursing care and therefore wholistic care is not achieved;
2. Nurses accountability and responsibility are diminished;
3. Patient’s cannot identify who their “real nurse” is;
4. Nurse-patient relationship is not fully developed;
5. Evaluation of nursing care is poor and outcomes are rarely documented; and
6. It is difficult to find specific person who can answer the patient’s relatives’ questions.

B. Primary Nursing
The following are the characteristics of the primary nursing modality:
1. The primary nurse has the responsibility for the nursing care of the patient 24 hours a day, from admission through
2. Assessment of nursing care needs, collaboration with the patient and other health professionals, and formulation of
the plan of care are all responsibilities of the primary nurse.
3. Execution of the nursing care plan is delegated by the primary nurse to a secondary nurse during other shifts.
4. The primary nurse consults with nurse managers.
5. Authority, accountability, and autonomy rest with the primary nurse.
Primary nursing, as a form of assigning responsibilities for patient care, is an extension of the principle of decentralization
of authority. Each registered nurse is responsible for the total care of a small group of patients from admission to discharge. The
primary nurse assesses the patient’s needs for care, sets care goals, writes a nursing care plan, administers care according to that plan,
evaluates the outcomes of care, and makes the necessary changes or adjustments as necessary. He/she provides pre-discharge planning
and teaching.
Marram, Schegel, and Bevis state that “primary nursing is the distribution of nursing so that the total care of an individual
is the responsibility of one nurse, not many nurses”. They describe autonomy as the key to the development of professional nursing.
Since the primary nurse assumes a 24-hour responsibility for nursing care, secondary or associate nurses execute the nursing care plan
to assign the two- or three-worker team full responsibility for a case load of 8 to 12 patients in a particular section of the nursing unit.
Again, as in primary nursing, another group of nurses will care for the patients on alternate shifts and during their day offs.
The greatest responsibility falls on the registered nurse who assesses the patient’s needs, plans, implements care, and
assesses outcomes including guiding and instructing her partners. It may therefore be observed that the role of the nurse in the modular
form of assignment is more difficult than in primary nursing.
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To Whom It May Concern:

This is to certify that Mr. / Mrs. / Miss ___________________________________

was examined by the undersigned last ___________________________________
with a chief complaint of______________________________________________
with a diagnosis of ___________________________________________________

I therefore advised him/her:


___________________________, M.D.
Attending Physician
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PTR. No. ________________________