Essay Example: Exploring Patient-centred Care from a Nursing Perspective

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University of Richmond
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This assignment will demonstrate the important of professional guidance and how some professional issues influence care for patients and their recovery journey (Dwamena et al., 2012). It will concentrate on consent, effective communication, dignity, and respect as reflected in placement. The assignment will explore the importance of caring at professional standard abide by the regulatory body, Nursing, and Midwifery council code of conduct (NMC,2015).NMC regulates the vision, values, and principles which underpin nursing practice in the United Kingdom.However, professional competence must be updated with current statutory changes, as a nurse dynamic and always changing as noted by Crawford et al. (2006). Names and place mentioned in this assignment will be regarded as pseudonyms upholding Data protection Act(1998) and NMC(2015).

National Institute for Health and Care Excellence (NICE) guidelines (2011) define person-centred care as an equal partnership between people services users, and service providers, respecting their culture, wishes, religion and family. Importantly, they ensure that it must guarantee that individuals are always treated with compassion, dignity, and respect that promote individuality and informed decision making.

The Francis report as indicated by the Department of Health (DH) (2013) stated that the culture of nursing responsibilities must be based on 6cs which includes, compassion, caring, communication, competence, commitment and courage to deliver the best quality care and good working relations. As a student nurse, professional communication will be applied as it is good practice and improves effective teamwork and decision making. The student nurse is aware that patients must be involved in decisions about their care and recovery as highlighted by the Department of Health (DH 2012a) which stated that no decision about a patient should be made without their consent or choice. It is more important that compassion to care is correlated with empathy, respect, and dignity as approved by (DH, 2012a. Is more important that compassion to care is correlated to empathy, respect, and dignity as espoused by (DH, 2012a)

MR Tom is a 70-year-old man referred to the surgical ward at Christ Hospital by A&E as he needed a hip replacement after falling from a ladder.The two student nurses were assigned by their mentor to complete admission paperwork under supervised by a staff nurse.Communication with Mr. Tom commenced by observing the acronym S.O.L.ER as indicated by Egan, (2013). Egan, (2013) describes S.O.L.E as sit squarely facing the patient but not invading personal space, using open posture throughout the conversation showing that you are interested, nodding your head and slightly leaning toward the individual and showing interested to their care, making eye contact and being in a relaxing approach which assures the patient with excellent, caring manner. Maintaining eye contact is considered morally good in some European cultures as well as in nursing profession, but it can be controversial in some cultures especially South Africa as it can be threatening or challenging to look in elderly peoples face when holding a conversation. It is morally acceptable and correct to look on the side of their face when holding a conversation in this culture. However, Egan, (2013) argues that breaking eye contact conveys the message that an individual is disinterested and high levels of eye contact can be misinterpreted as starring and intimidating. Furthermore, Egan (2013) acknowledges communication is not only verbal but also none verbal as some patients might be verbally impaired. Hargie, (2011) argue that none verbal communication can be considered debatable as the gestures and expression in the face do not match body language. Additionally, professional communication should consider paying attention to the rate of speech, the tone of voice and depth of speech as echoed by Egan (2013). It could be argued that different accents can cause few issues of communication failures as individuals may fail to understand different aspects of accent as noted by Hargie, (2011). As a professional student nurse awareness of patronizing during communication is always upheld as talking fast or too slow can present complicity in delivering information. Egan, (2013) echoes the notion that the caring environment should be clear of noise to enhance good communication skills. As a result, the environment was clean of noise.

The student nurse considered a quiet room to be suitable for the nurse- patient to build up a rapport that leads to a therapeutic relationship. Mann and Carr, (2006) highlighted that delivery rapport, and therapeutic relationship minimizes anxiety which may lead to the decrease of pain. Kitson et al., (2013). echoes the notion that when a nurse listens from a patient it indicates that they act as advocates to the patient and they are empathic to the pain. It is the same notion highlighted by the Francis report, (2013) that nurses must develop the mandates of the 6cs in order to provide the excellent care. Mr. Tom seemed to lean towards the student and noted that he was deaf in his right ear and sometimes could barely hear as he was not wearing his hearing aid. Communicating with a patient who hard hearing difficulties can lead to communication barriers and it should be mentioned that if the patient wears hearing aid, it must be checked and fitted properly. Riley (2012) noted communication as more important in the aspects of health and social care as it enabling patient and clinicians to develops the therapeutic relationship. Furthermore, Stein-Padbury (2014) argues that not only basic communication but communication competence, emotional labor, and emotional intelligence should be increased order to meet interpersonal skills for patients needs to be met. Hoschschild (1983) outlines emotional labor as suppressing own feelings and emotion to maintain an outward appearance that reassures other patients that their needs are excellently cared for. Furthermore, Anderson et al. (2002) describe Emotional intelligence as a vital factor which facilitates successful outcomes from stressful events whereas, without good communication, individuals can feel vulnerable and worthless hence their recovery journey compromised (check the formation if more is necessary if not change it)

Nice, (2007 a) stated that as soon as a patient has been admitted to the hospital ward physical observations must be obtained. Mr. Tom was asked for consent to take swabs of an admission procedure as well as checking his weight, height, blood pressure and temperature. NMC, (2015) highlighted that consent could be verbally or given in writing. MR Tom replied by pointing which hand he wanted blood pressure taken from. The NMC (2013) stated that nurses must gain consent from patients before any clinical procedure and the patient has the right to accept or refuse treatment. However, patients best interest can be explored as some patients might not have the capacity to give consent due to mental impairment, for consent to be valid it must be voluntary and informed, the individual consenting must have the capacity to make own decision. It would be unprofessional for a nurse to carry on the producer or active without gaining consent, gaining consent protects both the nurses and patient against legal challenges. It is illegal to put pressure on the patient and carry on the procedure against their wishes (Thorarinsdottir & Kristjansson, 2014). If a person unable to make a decision at that time a health care professionals can carry on with the treatment or procedure if they believe it is the patient best interests. In this instance, the patients best interests are the certain steps or rules that have to be followed so that the patients concrete human community will survive or potentially survive. The decision to sacrifice any patients individual preference for the communal best interest has three concepts. The first concept is that the patient has to be willing to undergo the procedure. Furthermore, NMC (2013) indicated that lasting powers of attorney could authorize by an appointed person if a patient has no mental capacity to consent. A patient is said to have informed consent when they have a clear appreciation and comprehension of the facts, consequences, and implications.

The NMC (2015) code highlighted that nurses should respect patients right to privacy in all of their care aspects. In addition, the DH (2010) respect and dignity was reflected by the student nurse to treat Mr. Tom with the respect that continued to build up an excellent rapport and a therapeutic relationship. Mr. Tom appeared to be happy to go ahead with the observations and admission process.

Henceforth The Royal College of nursing (RCN), 2008 defines dignity as being concerned about how individuals feel about their worthy of honor or how they value others and themselves. It is the same guidelines shared by NICE, (2012) that dignity is concerned with treating a patient with care, compassion, kindness, courtesy, respect, and honesty. Furthermore, the Royal Marden, (2015 p 16) highlighted that body image is highly person and it describes personal worthiness. In additionally, Health Organisation (2012) indicated that dignity is connected to freedom from abuse, autonomy, and inclusivity in decision-making. During the admitting process, the student nurse made sure that doors and curtains were closed as she needed to do a body map and check for any pressure sores. 3 Ps were considered as follows people, place, and process to maintain his confidentiality as all this was carried out in the side room. Transfer Network (2012) sighted Singer (2007) and noted that hospital cubicles are considered less privacy as they are divided by curtains and other people can hear the conversations held behind the curtains. During in the process of doing body map, Mr. Tom asked to used toilet, and a commode was provided. Privacy and dignity are important when using the toilet. As a result, the student nurse provided the commode and went outside to provide Mr. Tom with dignity and respect. Smith, (2001) stated that the nurse has the duty of care ensure to reduce anxiety, distress as soon as possible or any embarrassment caused if they do not understand the language used by the patient when they need the toilet. Moreover, Nazarko, (2007) agrees that the use of freshener and deodorizer to get rid of the smell caused when a patient relieves from the fecal offensive smell is concerned with their dignity and respect.

This assignment has demonstrated the importance of professional guidance and professional issues that influence care for patients and their recovery process whilst in hospital care settings. The summative has explored the effectiveness of communication skills, consent, dignity and respect as core values and principles which help to develop therapeutic relationship care for patients and their relatives. Furthermore, the summative case study has some aspects of tools that are used by nurses to make informed decisions. The case study has followed the professional guidelines laid out by Nursing and Midwifery Council which underpin their practice. Communication continues to improve through meetings, teamwork, MDT, nurses communication book, ward round, handing over to the next shift.

Nice, (2007 a) stated that physical observations must be obtained when a patient has been transferred to the hospital ward or to A&E department. Mr. Lima was asked for consent to check his vital signs blood pressure, temperature, weight, and height



Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of patientcentred care? A...

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