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Nurse Education in Practice 12 (2012) e30
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Nurse Education in Practice
journal homepage: www.elsevier .com/nepr
Book review
Synergy: The Unique Relationship between Nurses and Patients,Martha A. Q Curley. Sigma Theta Tau International, Indianapolis,IN (2007).
The Synergy Model for Patient Care was developed in the 1990’sby and for critical care nurses, but its extensive application asdescribed in this clearly written book speaks to the practical impactof this model even while its empirical validation is still in progress.
The Synergy model’s theoretical overview and its components:patient characteristics and nursing competencies, describe a recip-rocating interaction among patient, family and nurse in which allparticipants work together to facilitate optimum patient outcomes,defined as what patients and families consider important. Theseoutcomes are best achieved when knowledge of client characteris-tics match nursing competencies, and result in patient and families‘safe passage’ through health care events and transitions.
Three levels differentiate optimum patient outcomes: patientand family, unit, and system. In chapters 3–13, these three levelsorganize the Synergy Model’s broad application as a framework:to define and promote progressive levels of nursing practicethrough certification and peer review processes, to clarify advancepractice and preceptor roles, to implement a unifying patient caredelivery model within complex health care systems, to developundergraduate nursing students’ clinical reasoning, and to concep-tualize a baccalaureate curriculum. Such examples provide a lucidtemplate for nursing administrators and educators to establishexpected levels of nursing competency.
This broad application illustrates this model’s value – it illumi-nates the actual practice of nursing in response to and respect forthe patient, and it establishes a framework for institutional stan-dards for nursing competencies. Synergy’s basic premise, thatpatient well being is fostered through nursing competencies, willresonate with nurses practicing world-wide. The unit and system
doi:10.1016/j.nepr.2012.01.002
level, while varying in different countries, might spur contrastingideas or guide variations consistent with international institutionsand cultures. Further research to validate and refine the genericnature of patient characteristics and nursing competencies wouldenhance its applicability on a more global scale.
Research to develop tools tomeasure outcomes and evaluate themodel’s conceptual basis, is clearly addressed in chapters 14–16.The reader is given an inside view of both quantitative and qualita-tive analysis of individual studies and the results from an expertpanel’s review of the model. Positive conclusions noted the model’sadequacy and feasibility in the acute and critical care areas. Majorcriticism focused on the lack of empirical testing and evidence tosupport improved patient outcomes resulting from implementa-tion of the Synergy Model. Some suggestions for improvementincluded amplifying the model’s family component, and clarifyingthe model’s relevance in healthy populations and primary care.The cultural congruence of the synergy model in other culturesand underserved rural areas were stated points of concern forfuture research.
Most chapters focus on the Synergy Model’s use to developnursing practice and education. While patient characteristicspurportedly drive the nursing competencies, they are yet insuffi-ciently developed in proportion to nursing competencies. Examplesof both match and mismatch between patient characteristics andnursing competencies might develop a more balanced view, and,consistent with Synergy’s subtitle, focus attention on the twocomponents’ unique relationship.
Mary Tod GrayDepartment of Nursing, East Stroudsburg University,200 Prospect Street, East Stroudsburg, PA 18301, USA
E-mail address: [email protected]
