Patient Experience: Reflecting on Patient Care and Outcomes

This essay examines the patient experience through the case of Mr. William Taylor, a 75-year-old man who experienced a fall and subsequent healthcare encounters. The essay reflects on his experiences, focusing on falls prevention, e-health records, and the importance of patient-centered care. It utilizes the Gibb's reflective cycle to analyze the case study, exploring themes of falls and patient care information. The essay highlights the significance of respectful communication, therapeutic interaction, and the need to address the unique needs of elderly patients, drawing upon Erikson's stages of psychosocial development. It identifies instances of both adequate and inadequate care, emphasizing the importance of dignity, empathy, and active partnership between healthcare providers and patients. The conclusion proposes action plans for future nurses, including sensitive communication techniques and patient-focused interactions to enhance the overall patient experience. The essay references relevant research and standards to support its analysis and recommendations, ultimately advocating for holistic and patient-centered care.

Running head: PATIENT EXPERIENCE
Patient experience
Name of the student:
Name of the University:

1PATIENT EXPERIENCE
The position statement for the essay is that respectful and active partnership with patient
is important to satisfy holistic care needs of client and provide positive care experiences. The
essay is based on the case scenario of Mr. William Taylor, a 75 year old client who is reporting
to Natasha Reddy about his experience of fall and his past experience of visiting a health clinic
following kidney stones. He sustained a fall six years ago which has affected his overall
functioning even today. Mr. Taylor’s narrates his overall experience about fall, the consequences
of the injury and the care that he received following the fall incident. The essay will provide a
reflection on the case study scenario using the six stage of the Gibb’s reflection cycle and utilize
the theories related to nursing philosophy of care, nursing standards of care and the partnering
with consumers standards to reflect on his care experience. The Gibb’s reflective cycle supports
people to think systematically about an experience and this is important for nurse as engaging in
regular reflection is important for their professional development (Husebø, O'Regan & Nestel,
2015) The essay will explore two themes of fall and care information of patient (related to my e-
health record).
This section provides an overall description of Mr. Taylor’s case scenario and his overall
care experience. Mr. Taylor reports about his experience of fall which he has sustained six years
ago. He fell down and injured his right shoulder after tripping over a piece of concrete. Instead of
rushing to the public hospital, he preferred visiting the GP who did some x-rays and referred him
to the surgeon. He reported long waiting time in hospital as a major drawback as in the past he
had to wait for 11 hours to get relief. He was in intense pain due to kidney stone. However,
despite this, he had to endure the pain because of priority system. He also reported about his poor
functioning after the fall as he had to be dressed and showered by his wife and he depended on
his wife for driving too. However, the care that he received following GP assignment was

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satisfactory for him as he was referred to the best physiotherapist and he was satisfied by the care
received. The main theme of care coming out from the case description is related to fall
experience and falls prevention and e-health record of patient. The main rationale for taking fall
prevention as a theme of focus is that fall was a major event in Mr. Taylor’s life which affected
his functioning. He sustained fall twice. Hence, the fall interventions received would help to
evaluate what factors influence quality of life in patients with fall. In addition, e-health record
has been prioritized because William gave many important suggestions for future nurse while
providing care to elderly client. Nurse can use electronic health record (EHR) to capture unique
care needs of elderly client and engage in active interaction with patient too (Migdal et al.,
2014).
Based on the review of Mr. Taylor’s experience, I feel empowered to provide holistic
care to elderly client, respect their dignity and unique care needs at this stage. This is because
according to the Erikson’s stages of psychosocial development, individuals from the mid 60s to
the end of life come under the integrity vs despair stage. As Mr. Taylor is 75 years old, he comes
under this stage. People at this stage are aware about their unique lifestyles and they feel a sense
of integrity based on their past achievement. However, who are not successful at this stage suffer
from feelings of despair (Malone et al., 2016). Hence, to provide patient-centred care to him, I
will have to seek out information regarding his interest, his challenges and concerns. I feel for
the rights of elderly because of Taylor’s statement regarding how nurses should provide good
care. His statement of ‘She never left my side..’, ‘get past the nonsense..’ sums up his interest
and overall expectation from nursing staffs and the need to treat elderly patient with empathy and
respect. The values and beliefs that made me accept Taylor’s opinion about nursing care is my
personal value of empathy towards elderly people and the presence of professional standards to

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maintain dignity and active engage with patient during care delivery. The NMBA Code of Ethics
for Nurses in Australia mandates nurse to value respect, dignity and kindness for others. To
preserve dignity, recognizing the vulnerability of individual client is important and the same has
been expressed by Mr. Taylor too ((NMBA, 2014).
My feelings of empathy and respect towards Mr. Taylor is influenced by my own
personal values of respect and compassion for elderly client and my professional experience of
witness of agony of elderly client with falls. Compassion and respect towards elderly client is
important for nurse because the registered nurse standards for practice in Australia states that
communicating effectively and respecting dignity, culture, values and beliefs of patient as
important professional responsibility for nurse (NMBA, 2017). As Mr. Taylor reported that he
did not received immediate attention and expected care during visit to the public hospital, it is
reflective of the fact that patient dignity is often compromised. Cairns et al. (2013) mentions
dignity as important part of personalization of care and according to older people opinion,
dignified care includes not only active communication, but also fulfilling basic and vital aspects
of care such as personal hygiene needs, nutrition and toileting needs.
Based on the analysis of Erikson’s stage of integrity vs despair, I identified inadequate
care experience for Mr. Taylor by collecting details regarding his challenges and concerns
related to past care experiences. From the review of Mr. Taylor’s lifelong care experience, it has
been found that he received inadequate care in the past evidenced by long waiting time, no staff
coming to check him and suffering from terrible pain while visit to a public hospital for his
kidney stone. During the visit to the surgeon too, he did not received adequate care as he used
derogatory terms to explain his treatment. Elderly patient are very sensitive about the
information they receive from health care staffs and staffs must be sensitive to avoid catastrophic

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thoughts and feelings about physical problem which was experienced by Taylor (Holm, Lyberg
& Severinsso, 2014). The fact that he received no attention from the staffs during pain is in
violation of the values of respect, compassion and dignified care for elderly client.
The above experience went against the NSQHS standard 2 of partnering with consumers
which encompasses treating patient with dignity and respect and communicating in a manner that
supports effective partnership (ACSQHS, 2017). Even if Taylor had to wait because of priority
system, it was the duty of the staffs at the hospital to pacify Taylor and assure him that his pain
will resolve. To increase his comfort, he should have been given a comfortable place to lie down.
The significance of giving attention and therapeutic communication to patient in such situation is
that it gives positive perception to patient that their problem is of utmost importance for nurses.
Therapeutic nurse-patient communication and partnership has been found to improve patient
satisfaction level (Negi et al., 2017). However, Mr. Taylor did not received similar attention
from the staff and lack of person-centered care was the reason for him to never visit hospitals
again.
The review of Mr. Taylor’s experience gives examples of occasion where he received
adequate care too. For example, after contact his GP following fall, he managed to get proper
referral to the surgeon and physiotherapist. Mr. Taylor was happy with the care received by the
physiotherapist as she helped him to use his arms and use aids to lift objects. The intervention
provided to him following fall is a evidence based strategy in response to fall injury as . In
addition, another experience where Taylor received adequate is the care that he received from a
nurse during iron infusion she used distraction strategies to keep his mind off from tension and
she never left his side. This is in relevance with the NSQHS standard 2 which requires nurse to
engage in respectful partnership with patients ((ACSQHS, 2017) Therapeutic communication

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style like conversing with client in empathetic fashion, acknowledging their health problem and
being attentive to patient reduce frustration for patient and empowers them too (Gupta, 2015).
From the evaluation of Mr. Taylor’s case scenario, it can be said that elderly patients are
in need of dignified and therapeutic care as they already suffer because of their physical
problems and effective therapeutic communication is a form of empowerment that gives them
new hope about recovery. The new meaning that can be drawn from Taylor’s experience of fall
is that respecting dignity of patient and therapeutic communication are two positive indicators of
future change in patient care. In addition, violation of dignity and lack of sensitivity towards
patient during communication are two negative indicators that can guide nurse to avoid such
practice in the future.
Based on the above conclusion, two action plans that future nurse should implement to
provide positive care experience to elderly patients included learning about sensitive
communication styles with patient and putting emphasis on active patient communication instead
of health records to identify holistic care needs of patient. Patient sensitive communication style
is important to address stigma and issues of ageism in the health care system and avoid negative
emotional experience for older patients during care (Wyman, Shiovitz-Ezra & Bengel, 2018). In
addition, active patient communication with patient is crucial to avoid misunderstandings about
care and facilitate nurse to express about their health concerns freely Kourkouta, L., &
(Papathanasiou, 2014).
From the analysis of the care experience of Mr. Taylor, it can be concluded that
reaffirmed that respectful and active partnership with patient is important to provide holistic and
patient-centred care and improve their overall care experience. The essay identified occasions of

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adequate and inadequate care received by Mr. Taylor. Inadequate care episodes were linked to
use of insensitive comments by surgeon and lack of therapeutic communication during pain.
Adequate care episodes were linked to active engagement with patient and fulfilment of holistic
care needs of patients. The experience of Mr. Taylor gives the implication to future nurse to treat
elderly patient with respects and be sensitive to their unique care needs instead of stigmatizing
them during care and communication process.
References:
Australian Commission on Safety and Quality in Health Care (ACSQHS) (2017). National
Safety and Quality Health Service Standards. Retrieved from:
https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-
Quality-Health-Service-Standards-second-edition.pdf
Cairns, D., Williams, V., Victor, C., Richards, S., Le May, A., Martin, W., & Oliver, D. (2013).
The meaning and importance of dignified care: findings from a survey of health and
social care professionals. BMC geriatrics, 13(1), 28. https://doi.org/10.1186/1471-2318-
13-28
Gupta, A. (2015). The importance of good communication in treating patients’ pain. AMA
journal of ethics, 17(3), 265-267.

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Holm, A. L., Lyberg, A., & Severinsson, E. (2014). Living with stigma: depressed elderly
persons’ experiences of physical health problems. Nursing research and practice, 2014.
http://dx.doi.org/10.1155/2014/527920
Husebø, S. E., O'Regan, S., & Nestel, D. (2015). Reflective practice and its role in
simulation. Clinical Simulation in Nursing, 11(8), 368-375.
https://doi.org/10.1016/j.ecns.2015.04.005
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia
socio-medica, 26(1), 65. doi: 10.5455/msm.2014.26.65-67
Malone, J. C., Liu, S. R., Vaillant, G. E., Rentz, D. M., & Waldinger, R. J. (2016). Midlife
Eriksonian psychosocial development: Setting the stage for late-life cognitive and
emotional health. Developmental psychology, 52(3), 496. doi: 10.1037/a0039875
Migdal, C. W., Namavar, A. A., Mosley, V. N., & Afsar‐manesh, N. (2014). Impact of electronic
health records on the patient experience in a hospital setting. Journal of hospital
medicine, 9(10), 627-633. Retrieved from:
https://www.journalofhospitalmedicine.com/jhospmed/article/126949/ehr-impact-patient-
experience
Negi, S., Kaur, H., Singh, G. M., & Pugazhendi, S. (2017). Quality of nurse patient therapeutic
communication and overall patient satisfaction during their hospitalization
stay. International Journal of Medical Science and Public Health, 6(4), 675-680. DOI:
10.5455/ijmsph.2017.0211522112016

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NMBA (2017). Registered nurse standards for practice. Retrieved from:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx
Nursing and Midwifery Board of Australia (NMBA). (2014). Code of Ethics for Nurses in
Australia. Retrieved from: https://www.nursingmidwiferyboard.gov.au/News/2018-03-
01-new-codes-of-ethics-in-effect.aspx
Wyman, M. F., Shiovitz-Ezra, S., & Bengel, J. (2018). Ageism in the health care system:
Providers, patients, and systems. In Contemporary perspectives on ageism (pp. 193-212).
Springer, Cham. Retrieved from: https://link.springer.com/chapter/10.1007/978-3-319-
73820-8_13