The traditional Chinese medicine (TCM) nursing round model is an important way of learning a patient’s condition through TCM four diagnostic methods and taking nursing measures for the patient in the daily life, emotions, diet,care, medication, and rehabilitation after making dialectical nursing based on the theory of TCM.[1]The implementation of the TCM nursing rounds is conductive to improving the quality of TCM characteristic nursing, alleviating the suffering of patients, promoting patient satisfaction, and optimizing the relationship between nurses and patients.[2]It highlights the characteristics and advantages of TCM and requires the nurses to have a certain basis in TCM and the ability to implement dialectical nursing. The improvement of the ability of dialectical nursing is based on the thinking of TCM while the rounds with teachers are a better way to exercise the thinking of TCM.[3]

TCM nursing teaching rounds, also named rounds with teachers, establish a relationship between teachers and students through the master-apprentice system.[4]Students follow TCM nursing experts in TCM nursing clinics to learn and summarize their TCM thoughts and clinical experience.[5]The study of TCM treatment and nursing is relied on real cases.At the bedside of a patient, nursing experts teach students to collect the patient’s condition information through inspection, smelling and listening, inquiry, and pulse-taking,explain the basic theoretical knowledge of Chinese medicine around the disease, analyze the etiology and pathogenesis of Chinese medicine, and clarify the type of syndrome and the diagnosis finally to develop a dialectical care plan from the aspects of daily life, diet, emotions, medication, health preservation, and rehabilitation. The focus of TCM nursing teaching rounds is to show the inheritors the whole process of TCM clinical thoughts, and exercise the thinking of TCM through interactive questioning and discussion.

In 2016, Beijing Administration of TCM set up 3 studios and 1 workstation, namely “Wang Min TCM Nursing Inheritance Studio” “Gui Meifen TCM Nursing Inheritance Studio”“Feng Yunhua TCM Nursing Inheritance Studio” and “Feng Yunhua TCM Nursing Inheritance Workstation” to inherit TCM nursing. As the inheritors of TCM nursing inheritance studio, students delved into and sorted out experts’ clinical nursing experience, academic thoughts and humanistic TCM nursing concept by making nursing rounds, listening lectures, studying TCM classics and academic exchanges.Combining teaching rounds with famous veteran nursing experts and clinical practice in departments, a TCM“doctor-nurse-patient” rounds model has been established,a round model focusing on highlighting the characteristics of TCM and emphasizing the participation of doctors, nurses as well as patients.

The TCM “doctor-nurse-patient” rounds model lays emphasis on preparation before making nursing rounds and rounds’process. First, the department sets up a ward round team,which is composed of a department director, a head nurse,doctors, and nurses of the department and is responsible for the selection of cases for ward rounds, communication with patients and their families, arrangement of ward round personnel, and other work. Before making nursing rounds,the doctor in charge, the nurse in charge, and the patient shall jointly complete the collection of medical records information and formulation of treatment plan and nursing measures,and make PowerPoint presentation for explanations 3 days before the rounds, report the materials to the nursing department, and distribute them to the staff participating in the ward rounds. The second is rounds’ procedures,including three steps: (1) Physical examination: The patient complains the history of present illness, past history,current symptoms, and treatment expectation. The doctor in charge makes supplementary inquiries and specialized physical examinations for the patient. The responsible nurse carries on the overall evaluation to the patient depending on four TCM diagnostic methods and nursing physical examinations to make clear TCM nursing diagnosis and formulate the dialectical nursing plan in combination with the doctor’s diagnosis and the patient’s will. (2) Explanation of ward rounds: In the department classroom or office, the department director, the doctor in charge, the head nurse,the responsible nurse, and medical staff of the department and the patient participate in the lecture. The doctor in charge explains the etiology and pathogenesis, clinical symptoms, dialectical thinking, key points of diagnosis and treatment, and treatment plan of the disease with the help of computers and projectors. Subsequently, the responsible nurse explains the related TCM nursing diagnosis and nursing measures of the disease, especially explanation of dialectical thinking based on four TCM diagnostic methods (inspection,smelling and listening, inquiry, and pulse-taking), and nursing physical examinations. For example, the common symptom of clinical orthopedic disease is pain, the responsible nurse should explain how to make syndrome differentiation from the nature, location, and course of pain as well as tongue manifestation, and then develop a nursing plan containing nursing technology, TCM diet, health education, health preserving, and efficacy evaluation after taking nursing measures. The other participants make analyses and discussions on syndrome differentiation, treatment, and care of the case, to supplement and optimize treatment and nursing plan if there is any problem. (3) Summary of ward rounds: The patient expresses his/her satisfaction after completing nursing plan, the head nurse and department director will make a summary comment on the ward rounds,expound academic disputes and prospects on the treatment and nursing of the disease, inspire team member as well as put forward queries and requirements for the next ward rounds.

From the TCM “doctor-nurse-patient” rounds model, there are two main points of experience summarized. First, the thinking ability of TCM of students can be well cultivated through the TCM nursing inheritance. At present, TCM nursing ability of nursing staff is insufficient, and the number of TCM nursing professionals is not enough to meet social requirements either.[6]However, with the help of TCM nursing inheritance workstations, the academic thoughts, nursing technology, and noble character of famous TCM nursing experts are explored, sorted out,and inherited.[7]By following experts’ nursing rounds,the inheritors can master how to make evaluation of a patient’s condition as a whole through the four diagnosis of inspection, smelling and listening, inquiry, and pulse-taking,and how to clarify TCM nursing diagnosis through syndrome differentiation,[8]consequently cultivating TCM thinking ability, syndrome differentiation, and nursing ability.[9]Second, the TCM “doctor-nurse-patient” rounds model highlights the characteristics of TCM. The emphasis of concept of patient-centred conforms to the overall concept of “man-oriented” and “harmony between man and nature” in TCM, which is beneficial to create the culture atmosphere of TCM nursing. Based on the model of nursing rounds, the formulation and implementation of individualized TCM nursing plan for patients from the nursing techniques, diet, health education, and health preserving depending on syndrome differentiation coincides with modern precision medicine.[10]In addition, under the guidance of experts of workstations, students also can make fully use of advantages of nursing rounds with the famous veteran experts to improve the nursing ability of nurses in difficult cases and provide more high-quality nursing for patients.[11,12]In the process of ward rounds, attention should be paid to the patients’ past medical history and feelings,respect the wishes of patients, and enable patients to join the rounds team, which fully reflects the humanistic TCM nursing concept.

In conclusion, by applying TCM nursing rounds from the superficial to the deep, the teaching concept based on TCM clinical thoughts has been strengthened, the clinical thinking of TCM nursing has been broadened, and the nursing quality and the level of teaching practice have been improved simultaneously.[13]With the inheritance of the academic thoughts of well-known nursing experts, the improvement of the TCM nursing rounds model has played a vital role in promoting the improvement of the quality of TCM special nursing.[14]Therefore, how to better integrate TCM nursing rounds into nursing practice and formulate a more scientific and effective TCM nursing round model will be the research content of the next step.

Xue?Jian ZHANG1, Ling TANG2, Jing ZHANG3,Yue TANG11Department of Spine, Hand and Foot, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing,China,2Department of Nursing, Dongfang Hospital of Beijing University of Traditional Chinese Medicine, Beijing,China;,3Traumatic, Minimally Invasive Joint Department,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing, China

Address for correspondence:Prof. Ling TANG,Department of Nursing, Dongfang Hospital of Beijing University of Traditional Chinese Medicine, Beijing, China.E?mail: tangling9101@163.com