The medical Internet of Things (IoTs) can bind intelligent sensing devices with urinary nursing recipients and integrate information into various hospital information systems through network communication, so as to realize the intelligent perception, data collection, remote monitoring, information sharing, and other functions of urinary real-time nursing recipients. The urinary real-time nursing model can complete the expansion of hospital information system data to the bedside and the instant exchange of terminal data with the system through the medical IoTs and wireless local area network. Based on the summary and analysis of previous research results, this paper expounds on the research status and significance of the urinary real-time nursing model, elaborates on the development background, current status, and future challenges of medical IoTs, introduces the methods and principles of medical IoTs level evaluation system and transformation rules-based optimization algorithm, conducts urinary real-time nursing model design based on medical IoTs, analyzes model hardware design based on medical IoTs, performs model software design based on medical IoTs, proposes the urinary real-time nursing model optimization based on medical IoTs, explores the front-end function optimization of the urinary real-time nursing, implements the system program optimization of the urinary real-time nursing, discusses the hierarchical architecture of the urinary real-time nursing model, and finally carries out the role function analysis of the medical IoTs in the urinary real-time nursing model. The study results show that the urinary real-time nursing model based on medical IoTs can accurately and efficiently identify, manage, and integrate clinical nursing procedures and data such as patients, diagnoses, drugs, and can optimize nursing workflow, strengthen quality control, and improve nursing efficiency and provide patients with more convenient nursing services. The research results of this paper provide a reference for further research on the design and optimization of urinary real-time nursing model based on medical IoTs.