Person-Centred Practice in Nursing: Patient and Staff Stories

This assignment explores patient and staff stories that highlight the importance of person-centred practice in nursing. It discusses the impact of compassionate care, understanding of cultural beliefs, and the role of leadership in providing holistic care. The stories emphasize the need for nurses to treat patients as individuals and create a supportive and respectful environment.

Synopsis of Patient story
One morning, Mr. Ali met with an accident while riding his bike to work with a friend.
His friend had minor scratches while Mr. Ali fell unconscious and had a leg injury. He and his
friend were hurried to a nearby hospital and treated in the Emergency Department. Mr. Ali was
transferred to an inpatient ward for further observation. Upon waking in hospital, Mr. Ali was
anxious as he noticed he was in a hospital bed with an intravenous drip in his hand, and his right
leg was covered with plaster of Paris (POP). It was painful when he tried to move himself off the
bed. The doctor in charge was alerted by the charge nurse and came to meet Mr. Ali. Dr. Max
introduced himself and explained to Mr. Ali that he had been admitted to an orthopedic ward
under Dr. Max’s care due to a fracture of his right leg. Mr. Ali understood and complied with the
prescribed treatment while he was in hospital. He was referred to a Muslim cleric for his routine
prayers as he was unable to stand to perform prayers independently. Mr. Ali was touched by the
health care staff’s caring and supportive gesture to him during his ward stay. He was discharged
with follow up treatment and a POP on his right leg. Everyone including his family had been
very supportive throughout his stay in hospital. Mr. Ali had to use the crutches to walk in the
house until the plaster cast was removed.

Synopsis of staff story
This story was narrated by a nursing supervisor named Agatha, who encountered challenges
while no special bed was available and she had to assist a patient’s admission in the hospital. As
the patient was eligible for a “Very Important Person” (VIP) room, the patient and her husband
refused to stay in an ordinary ward. Until there was a discharge in the special ward they insisted
on special treatment. This made Agatha feeling anxious as she had to intervene to calm the
situation when she was called into her office by the nurses. The patient had early contractions
and diagnosed pre-labor of ruptured membranes (PROM) with high risk due to her age as she
was 43 years and having a second child, after 23-year gap since the birth of the first daughter. In
order to admit the patient, Agatha decided to keep the patient in a room alone in the post-partum
unit until the special room became available. However, the patient’s husband was unhappy and
contacted the hospital director to express his distress. Fortunately, the hospital director had
already been alerted to the situation by Agatha and arrangements were made to accommodate the
patient in a single room, with special care set up, with the hospital director’s acknowledgement.
Luckily, there was a discharge next morning, and patient was transferred to the VIP ward by
afternoon. When Agatha met the patient during rounds, the couple thanked Agatha for immense
effort to understand the patient and her husband situation during the special ward hunting in the
hospital.

Table of Contents
INTRODUCTION...........................................................................................................................................4
Patient Story - Being sympathetically present........................................................................................5
Patient Story – “Existence of Healthful Culture”....................................................................................6
Staff Story – “Prerequisites”...................................................................................................................6
Prerequisites - Knowing “Self”................................................................................................................7
Outcome ................................................................................................................................................8
CONCLUSION...............................................................................................................................................9
References.................................................................................................................................................10

INTRODUCTION
Person-centred practice has provided nurses with an opportunity for enhancing the
quality of patient care within holistic and theoretical dimensions. In today’s world, nurses have
tried working towards the main goal of providing person-centred care and treat patient as a
“person” rather than as a bed number or part of the daily assignment while delivering care.
According to McCormack and McCance, (2017, p.1) there is evidence of inadequate patient
management where nurses and health care professionals have not delivered person-centred care
while attending the patients. Evidently, nursing has become more technical and less personal,
with nursing care provided to most patients based on technology, such as by reviewing
laboratory results and patients’ medical records, instead of communicating face to face with the
patient or the carer in person (World Health Organization, 2015).
According to McCormack & McCance (2017, p3) the word “person” has been debated and
defined by learners in multiple perspectives. While some argue, that animals can meet the criteria
for person-hood, but others are disagree and consider that humans are the highest authority to
define as a person (McCance, 2017, p4). A patient who comes to a healthcare service to seek
treatment is defined as a person and has the right to respectful and dignified treatment, regardless
of their sex, race, social status or economic background. Person-centred practice focuses on each
patient as an individual, with a care plan designed according to the needs of the patient.
Therefore, health care personnel need to be trained according to the department they provide care
in. (Moore and et.al., 2017, p662). Moreover, person centred practice are those which focus on
the each person i.e. mother or any person. At this time, nurses should be consider when caring
for their patients. McCormack & McCance (2017) argues that nursing care should be provided
to patients based on person-centred practice in which the nurse role, as a primary care giver,
should enable the patient to feel comfortable to confide in and receive care from, someone who
is skilled and can be trusted. The aim of this assignment is to explore the patient and the staff
stories using person-centred practice principles in the nursing profession, based on McCormack
& McCance’s framework.
The Person-centred Practice Framework (McCormack and McCance 2017) is in line with
World Health Organisation (WHO, date needed here), which aims to understand more about
people and how their illness affects them, to support them as an individual who has right to live
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with respect and dignity. The focus not only relies on the patient but also supporting the people
surround them including health care professionals, families, friends or the community in the area
in a professional manner (World Health Organisation, 2015). The empirical research completed
on the nursing care for older people by McCormack (2001) and redefined by McCormack and
McCance (2006, 2017) have positively contributed to the PcP framework development, where
the design illustrates four key points: “Prerequisites” which consist of the the skills and attributes
of the healthcare professional, Care environment in the context of is all about to keep the patient
safe, but it is influenced by the policy, practice as well as team. “person-centered process,”
which is treating the patient with care and respecting their rights and “person-centered
outcomes” which are the main goals of the framework with evaluation of the care received by the
person (McCormack and McCance, 2017).
Patient Story - Being sympathetically present
In the interest of confidentiality, all real names have been replaced with a pseudonym.
Mr. Ali was old, anxious and feeling disorientated on the hospital bed as he had intravenous
drips attached with a cemented plaster on his leg. For this nurses are sympathetically presented
because she was able to determine that Mr. Ali was anxious. Therefore, both doctor and nurse
may took action to ensure that MR. Ali is needs were care for. Having a positive attitude, being
emotionally available and not being judgmental is the greatest thing one can offer a person who
is feeling vulnerable and needs care and support (McCormack & McCance, 2010). The treatment
Mr. Ali received was not compromised with his culture and belief during his ward stay. The
impact of good care provided by health professionals affected him physically and mentally. In
contrast, a large mixed method qualitative research conducted in London, 2014, shows that
Unless Mr Ali was an older gentleman, and you have not said that he was, this reference is not
helpful. Your argument should be that Mr Ali was respected for his values and beliefs (care
processes), regardless of whether or not they were the same as the professional staff, and they
cared for him holistically (care processes). This enabled him to feel less anxious and get well.
(Williams and McCormack, 2017).
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Patient Story – “Existence of Healthful Culture”
Based on the physician assessment, Mr. Ali was transferred to an Orthopedic ward for
further treatment. In the ward, he received professional and compassionate care from all the on-
duty ward nurses and other health care professionals to assist him in daily activities (Slater,
McCance and McCormack, 2015). In another occasion, patient’s religion faith was also taken
into concern via observation and nursing assessment that Mr. Ali was confused and showed signs
of being helpless about performing prayers correctly with an injured leg. He was referred to a
Muslim cleric which attend to patient ‘s faith issues during their stay in the hospital. With the
presence of family support to assist him walk again and nutritional fruits and spending time with
Mr. Ali, motivated for a speedy recovery in hospital. Health professional’s intuition going an
extra mile to care Mr. Ali human being within the context of spirituality, physical, mentally and
sociocultural, it has promoted Mr. Ali’s overall health (McCormack & McCance, 2017). To
better adapt, a study conducted in year 2017 on the healing experiences of patients illustrates that
feeling loved and wanted promotes healing of which bonding with family, friends, spirituality
beside receiving the holistic care from the health professionals contributes towards the goal of
person-centered outcome (Scott et al., 2017).
Staff Story – “Prerequisites”
For the purpose of this assignment, the person-centred practice framework sub-domains
of being professionally competent and interpersonal skills has been taken into consideration to
narrate the story. The nurse supervisor, Agatha, carried out her duty with the competence
outlined in the prerequisites component of the Person-centred Practice Framework while
attending to her patient for admission. The prerequisites component shown in Agatha’s gesture
of a professionally trained nurse to settle the patient-staff conflicts that were happening in the
Emergency Department and produce a win-win solution for both parties. She took up the role as
a responsible leader, showed professional competency and great interpersonal and
communicational skills when Agatha explained that the patient and her husband’s request was
understandable. A good leader is that person who posses a clear vision and is a courageous and
also has an integrity, honest and must have a clear focus. However, the unavailability of the
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desired room was beyond her control due to high volume of eligible officer admissions in the
hospital during that period.
This situation showed that how the patient was managed was directly impacted upon by the care
environment. Normally, the role of a nurse supervisor is based on administrative and supervising
nursing personnel, while the duty of room allocation falls under the hospital bed management
department. However, in this case, the issue was referred to the on-duty nurse supervisor,
Agatha, by the admission department and the senior doctor in-charge for trauma patients. As
there was no bed available and the conflict was disturbing other patients who were receiving care
in Emergency Department Agatha had to take action. Thus, to manage the conflicted situation,
Agatha had to act as a comforting supporter, to allow the patient and her husband to express their
frustration (Seah and et.al., 2017). Agatha showed an ethical decision-making by notifying the
hospital director and receiving his permission to utilize a two bedded room as a special room in
the post-partum ward. Agatha also showed leadership, this sits under the pre-requisites of the
PcPF. It is further supported by Slater, McCance, McCormack (2015) in which author stated that
midwife also have a clear understanding and caring attitude which reflect that they posses
leadership skills that support them to perform their work in better manner.
This decision was made based on the nurse’s competency, as the post-partum nurse has required
skills and experience to care for obstetric patients. Despite the stressful situation, nurse
supervisor Agatha showed her capability to manage the couple and solved issue in an ethical and
calm manner. With the expansion of person-centered practice framework in various ways, health
professionals are trained to accept the stress level and manage the stress in workplace, and while
that can be difficult, however, staff feel most satisfied when their immense effort towards patient
care has been widely appreciated and acknowledged by their superiors (McCormack, Manley
and Titchen, 2013).
Prerequisites - Knowing “Self”
In this paragraph, the staff story has been addressed based on the person-centred practice
framework of prerequisites with subcomponent of knowing “self”. Agatha had no empty room
but managed the situation with prioritizing and wise decision-making to keep the patient and the
unborn baby in a safe ward. While the couple were delighted to be in the VIP room just in time
to receive their newborn and visitors, thanked Agatha in person to convey gratitude for being an
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understanding person that how important the special room environment meant to the the patient
and her husband based on social status and cultural norms (Messner and Lewis, 1996). It is clear
that Agatha knows self and she had to manage difficult situation and that she also know she
posses a strong leadership skill and also manage the work accordingly (McCormack & McCance,
2017). Further, to know self, it is essential to know about being professional, even when there is
a conflict. While on the other side, Agatha was aware of the need to creates a safe environment
for their family and mum and this shows that care environment creates positive impact on
decision of Agatha. Barr and Dowding (2019) also support this situation by stating that when a
person face an adverse situation, it is requires to adopt best leadership style to cope up the
situation.
Outcome
Both stories have a common ethical point of view, which is based on person-centred
practice. The ethical principle of “beneficence,” which is defined as do no harm (Polit and Beck,
2004), had been taken into consideration where the patient’s story of Mr. Ali’s queries was
answered all the time by health care professionals, received a holistic, caring treatment and his
safety was taken into account. On the other hand, in the staff story, Agatha’s effort paid off when
Mrs. Sara was moved into her desired room, right before receiving the newborn baby, in order to
receive visitors to congratulate the patients for the newborn arrival. The Nursing and Midwifery
Council code, 2015 states that nurses and midwives must uphold in order to be register for
practice in UK, also nurses are professionally committed to safeguard and encourage the person
who been placed under their care with regard of ethical principle of ‘beneficence’. Evidently, a
research study in 2017 identify the effectiveness of person-centred practice across 7 countries in
phase one, in phase two across five organizations in one country, this has provided the insight
that person centred practice has been internationally recognised and integrated within the health
care culture (Slater et al, 2017). The person-centred practice is about respecting the person.
Everyone has right to be treated equally without discrimination on the social status or cultural
background of the person, this is evidenced by the tremendous positive support received by the
patient physically and mentally from the health professional while the staff Agatha demonstrated
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her leadership skills managing the situation and returning to the patient for feedback once the
patient was transferred to VIP room indicates that person centred practice has a huge impact to
empower nurses thus creating a therapeutic environment has been beneficial.
CONCLUSION
The patient story was explained in line with the person-centred practice component of
being sympathetically present and the person-centered outcome subcomponent of prerequisites,
existence of healthful culture, while the staff story utilized the prerequisites component of
professionally competent, developing interpersonal skills and knowing “self”. More generally,
both stories shared a common goal of providing a resourceful and quality person centered
practice in the workplace which was explained using McCormack & McCance person centered
framework. Person centered practice framework can be used by health care professionals to
communicate and maximize the quality of care as this framework helps patients get involve in an
individualized care and good communication skills with listening to patients and speaking
according to their needs to improve healthcare outcome in future.
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