The synergy model is used as a framework in nursing in the CCRN exam. The exam is used to test nurse on how well they are equipped to develop relationships with their patients. The model majors on the individual nurse and patients. Normally, the program is used to demonstrate and educate on the role of advanced practice nurses in the course of the contemporary practice. The model aids in the understanding of the roles of the nurse in the contemporary modern society. However, divergent views have been propagated by various people on the specific roles of the CNS. In some quarters, the nurses are viewed as researchers or experts in the field. To help us understand the nurse- patient’s interactions we shall consider the various the various dimensions in the synergy model. The model provides a framework that guides in understanding the contemporary roles of the nurse. The dimensions that we are going to address are namely, the clinical inquiry, facilitator of learning and clinical judgment. All this are aimed at improving the overall efficiency of the nurse to the patients (Brorsen, 2014). Additionally, it ensures only the top notch and qualified staff are picked. Additionally, the model ensures that the people entrusted with the responsibility of taking care of patients are well versed in all spheres.


Clinical enquiry is one of the dimensions in the synergy model used by CNS. The clinical enquiry entails using research-based method to determine the patient’s illnesses. Additionally, the research leads to the proper description for the illness to be made. The data obtained enables the decision-making process to take place smoothly paying close attention to the obtained. The advantage of this model is that it prevents the misdiagnosis of ailments occurring. Furthermore, this prevents wrong prescriptions being made informed by wrong diagnosis. After, data is collected it is evaluated and used to make an informed decision based on the correct facts. The right program to help the patient is established that that will enable the CNS to communicate easily to the patient (Kaplow, 2010). Additionally, the program development enables the coordination between the various nurses involved in the treatment. Furthermore, the CNS can coach the other nurse on various medical conditions. The other nurses can learn from the more learned colleague, and it provides an opportunity to pass on the knowledge. The other nurses are guided on how to collect the data, analyze and make an informed decision. The model on this dimension provides a great opportunity to pass on the knowledge the rest given the stringent conditions one is required to meet. The CNS shares all the critical leads to the other nurses by analyzing and articulating every research finding to make them understand the importance of the each decision taken. Additionally, the nurses are also taught on how to use such health records for future reference to help solve similar cases.

Furthermore, the clinical enquiry enables the nurse to compare note in the future that may lead to development innovations. The innovations may provide better and easier way to treat medical conditions. Additionally, the conditions can be used to benchmark among CNS’s in the system. Moreover, this will allow them to compare notes on various research findings enabling them to discuss the various upcoming developments in diagnosis that may be new to the system. This development is critical to the achievement of the whole system growth and development since through clinical enquiry records kept by each party the Clinical nurse specialist can compare notes and agree on the best remedies. It provides an opportunity to brainstorm and come up with best ideas on the market. It also leads to gross development in the sector. The specialist can recognize the major ailments that are affecting the society. Additionally, it creates an opportunity to sensitize the population against certain conditions that predispose them to health problems (Alspach, 2006). Furthermore, the specialists can advise the state’s management on the relevant programs to be rolled out to reduce mortalities and recurrent expenditure on health. This provides a great opportunity to influence the sectors decision-making apparatus and funds allocating bodies to make the requisite considerations. This will greatly help in the reduction of catastrophes that result in great loss of lives in the countries due to failing to foresee the lying dangers ahead due to upcoming trends.

An ideal example in clinical enquiry is case I came about when a patient pressed an alarm, and the staff failed to respond. This was two weeks prior to me opening my clinical. The patient had a tracheotomy Brady down. The alarm had been coded by the patient. My preceptor the CNS guided me to come up with a tool that would be used to monitor the alarm. The tool was a survey tool that monitored all the action generated from the alarm. More importantly, the survey tool was used to measure the level of training the staff had acquired as far as the alarm usage is concerned. This would help the management to come up with the necessary measure to mitigate such occurrences in the future.


The other dimension in the synergy model is the facilitator of learning. The facilitator of learning implies that the CNS can guide various parties to learn on the requisite programs that enable them to be better informed. The nurse specialist can get into collaboration with the family members of the patient and decide on the appropriate medical training they would require I order to reduce the intensity of such incidences (CCRN: Certification for adult critical care nurses, 2010). Additionally, the nursing staffs are taught on the handling of the special cases. This contributes to the mitigation of special health conditions that may cause severe damage to the afflicted persons. The patient together with their family is taught on the important basics to the development of their skills (Kaplow, 2010). This will enable them to gain necessary skill that will help reduces the incidences of cases if they are preventable. Additionally, the nursing staff is involved in a continuous development program whereby they handle in assistance of CNS complicated cases to earn a hand on experience. This allows for staff development to be a continuous program that presents them with a great opportunity to deputize in the absence of the CNS. Additionally, the nurses can offer better quality services in addition to being responsive due to development of diverse skills. The facilitator to learning dimension is important to the development of quality health care in the state since most of the nurse’s skills are sharpened continuously. Additionally, through the integration into the system the CNS can build confidence in their medical and nurse staff making them better positioned to improve the health well-being of the patients greatly. Furthermore, through the facilitation the Clinical nurse specialist can discover the talent in the various medical and nursing personnel.

It is also important to note that it is through the facilitator of learning dimension that the CNS can contribute to the community development. The nurses can make educative publications guiding the public on the Dos and don’ts to achieve good health. The specialist nurses can clearly illustrate the given points using the data collected from the clinical enquiries. The public is sensitized on avoiding programs that predispose them to becoming ill. For those that pay head to the educative programs rolled out they can mitigate their risk of getting ill. Moreover, parents are sensitized on the ways to protect their children contacting various ailments (Curley, 2007). The specialist nurses are also able to make a contribution to their professional bodies meeting whereby they chiefly brainstorm on emerging issues. In addition to emerging issues follow up studies are carried out providing an opportunity for the CNS from different parts of the state to exchange ideas (Peterson, 2009). The exchange of ideas becomes a platform for learning on new methods of diagnosis. Moreover, the community is empowered to educate their fellow colleagues on the various predisposing factors to illnesses and the possible remedies. To a greater extent the initiative contributes to freeing up of the resources channeled to the medical sector to be used in some other development projects in the country (Peterson, 2009).

An ideal example was when my preceptor came to learn of a situation that a nurse had administered 4 IV bolus containing the diltiazem for rapid afib. Additionally, the afib was accompanied by an RVR though positive response was unattained. The Hr of the patient was in the 150’s.In the situation, the nurse that had diagnosed the patient with the dialtizem was unaware of the pre-existing protocol about its drip remedy the situation the CNS organized and facilitated a learning opportunity for the staff. The staffs were empowered with skills by the CNS in addition to the patient responding well to treatment without their transfer to the ICU. The above case provides a classic example that a CNS sizes to teach their medical staff on the existing diagnostic techniques hence empowering them by making them skillful. The example demonstrates the CNS as a facilitator to learning to one to one of the parties directly under their command.


The clinical is a dimension of the synergy model that aims at achieving accurate decisions based on the collected data. The collected data may be conflicting. However, the CNS is required to closely scrutinize each detail and make accurate decisions (Hardin, 2005). The scrutiny may involve revisiting the research material collected at the enquiry stage to identify the possible source of conflicting ideas and hints. The accurate clinical judgment is important to all the stakeholders in the process ranging from the patients, the other nurses and medical staff as well as the entire nursing system. The importance of a complete synthesis of the collected data before recommending a diagnosis is key since all the process are dependent on the clinical judgment (Hardin, 2005). A wrong clinical judgment would lead to other successive medical attendants administering a wrong diagnosis on the patient. This negatively affects the quality of medical services being offered to the hospital’s clients. Additionally, the patients’ health is put at risk of deteriorating further given the administration of a wrong diagnosis

It is important to note that the subsequent coaching and mentorship programs are dependent on the collect clinical judgment being made. Failure to make a correct clinical judgment would render the whole process null and void. To precipitate the issue the nurses modeling and benchmarking with the actions of the CNS will model on the wrong thing (American Association of Critical-Care Nurses. 2007). This will lead to incompetence that will be noted by fellow colleagues in a professional. The given illustration is

Meant to underscore given the important role it holds in the heart of the treatment process of the patient in addition to mentoring the nurses under the CNS. However, if correct clinical judgments are made the society would improve as whole given that all them medical diagnosis done on a well-founded basis hence aiding to improvement of the health services offered

It is also important to note that health care programs are drawn dependently on clinical judgment. Moreover, the decision trees, algorithms based research are all developed based on the clinical judgment. The given illustrations underscore the importance to paying greater concentration to the clinical judgment process. An ideal example arose when Mr.xx got transferred from the ICU, and he became extremely non-responsive. A cebellar bleed was revealed by A CT scan. The CNS applied clinical judgment through ordering an anesthesia to the patient to protect their airway. More the patient got intubated the right way and later transferred to the ICU due to change in the health conditions.


Hardin, S. R., & Kaplow, R. (2005). Synergy for clinical excellence: The AACN synergy model for patient care. Sudbury, Mass: Jones and Bartlett.

Curley, M. A. Q., Sigma Theta Tau International., & American Association of Critical-Care Nurses. (2007). Synergy: The unique relationship between nurses and patients, the AACN Synergy model for patient care. Indianapolis, IN: Sigma Theta Tau International.

Peterson, S. J., & Bredow, T. S. (2009). Middle range theories: Application to nursing research. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

American Association of Critical-Care Nurses. (2007). Advanced Hardin,

  1. R., & Kaplow, R. (2010).Cardiac surgery essentials for critical care nursing. Sudbury, Mass: Jones and Bartlett Publishers.critical care nursing. Philadelphia, Pa: Elsevier Saunders.

Alspach, J. A., & American Association of Critical-Care Nurses. (2006). Core curriculum for critical care nursing. St. Louis, MO: Saunders Elsevier.

Brorsen, A. J., & Rogelet, K. R. (2014). PCCN certification review. Burlington, MA: Jones & Bartlett Learning.

CCRN: Certification for adult critical care nurses. (2010). New York, NY: Kaplan.


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