Patient Experience & Partnering in Care: Raelene Ward Case Analysis

This report examines the case of Raelene Ward, a 40-year-old Aboriginal woman diagnosed with gestational diabetes, to analyze the application of patient-centered care principles in nursing practice. The report critiques the healthcare decisions made for Raelene, highlighting violations of patient-centered care and nursing standards. It explores how a patient-centered approach, emphasizing patient involvement and education, could have improved her care. The analysis also considers the impact of her diagnosis and the loss of her sister, and the role of various healthcare professionals like endocrinologists, midwives, and dieticians. The report emphasizes the importance of teamwork and adherence to patient-centered care guidelines for effective and holistic nursing care, ultimately arguing for the critical need to prioritize patient preferences and values in healthcare delivery to avoid complications and improve patient outcomes. The case study uses Erikson's stages to understand the patient's experience.

Running Head: PATIENT EXPERIENCE & PARTNERING IN CARE 1
Patient Experience & Partnering in Care
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PATIENT EXPERIENCE & PARTNERING IN CARE 2
Patient Experience & Partnering in Care
As it has been attested by many healthcare workers, nursing care approaches which
prioritizes the opinions and decisions of the patient involved as well as that of the family
members tend to be the most fruitful. A case scenario of a 40-year-old female Aboriginal woman
by the name Raelene Ward who has been diagnosed with gestational diabetes after giving birth
to her third child will be scrutinized on the basis of her treatment from the time she falls a victim
of diabetes through her care process. Her discussion with the interviewer reveals that most of the
decisions regarding her treatment were entirely made by the healthcare workers involved and
were full of assumptions. Based on this fact, this paper will frame the experiences of this woman
under the Patient-Centered Care theory in order to emphasize the importance of patient-centred
care approach in nursing practices. In addition, the case scenario of Raelene Ward will be
analyzed in relevance to how patient-centred care approach would have helped in her case.
There are a number of weaknesses which are clearly evident in the case scenario of
Raelene Ward because most of the nursing care decisions did not follow the guidelines of a
patient-centred Care (McCormack & McCance, 2016). For instance, it has been revealed that
Raelene Ward did not get a detailed explanation as well as the cause of what she was suffering
from. Also, despite the fact that her condition (Gestation Diabetes) had other approaches of
treatment like diet approach and exercising approach, the healthcare worker in charge went
ahead to make the decision of insulin treatment without involving or consulting her. There are a
number of nursing standards which were violated in the case scenario of Raelene Ward. First,
violation of quality of practice when Raelene Ward went for maternity services can be attributed
to her developing gestation diabetes (Halcomb et al, 2016). This is in consideration of the fact
that she was not receiving ongoing support as it should be. Secondly, collaboration standard was

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also violated in this case because, in most of the cases where decisions were made regarding her
treatment, she was not consulted (Fisher, 2017).
Patient-centred care is basically a nursing care approach which emphasizes partnerships
between patients and the healthcare professionals as far as nursing care is concerned. This theory
acknowledges the preferences and the values of the patient with the aim of promoting flexibility
when providing healthcare services and moving beyond paternalistic and traditional approaches
to healthcare (Rathert, Williams, McCaughey & Ishqaidef, 2015). Also, this approach
acknowledges the beliefs and values of a patient in regard to health and wellbeing. The quality of
practice standard requires a professional healthcare worker to systematically enhance the
effectiveness and quality of nursing practice. On the other hand, collaboration standard requires
all the healthcare workers to collaborate with patients, family and other stakeholders when
conducting nursing care. When mapped on Erikson’s 8 stage framework, the case scenario of
Raelene Ward fits under stage one because it raised issues of Trust and Mistrust for failing to
involve Raelene Ward in decision making (Kropf & Greene, 2017). Failure to adhere to the
guidelines stipulated above saw the entire nursing care process proceed with many faults.
From the case scenario, the first fault has been identified as the lack of ongoing support
when Raelene Ward was going through the gestation period. It is through this fault that she
developed gestation diabetes. This can be supported by the fact that Raelene Ward had given
birth to two other children without any problem. The loss of her sister has also been identified as
another reason which worsened the case of Raelene Ward. This would have been avoided if there
was ongoing support through counselling. This is based on the fact that stress worsens the
condition of diabetic people (Delaney, 2018).

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The case scenario also reveals a lot of presumptions made by the healthcare workers who
were taking care of Raelene Ward. For instance, there was no explanation about what she was
suffering apart from the name. It was assumed that as a nurse she was aware of the disease
whereas in real sense it was not the case (Zaccagnini & Pechacek, 2019). This approach violated
the principle of patient-centred care which advocates for the education of patients before being
exposed to any kind of treatment. Violation of patient-centred care theory is also evident from
the fact that Raelene Ward was not consulted before the prescription of insulin as a treatment to
her gestation diabetes (Jakimowicz & Perry, 2015). The healthcare worker went ahead to
prescribe this treatment approach on her despite there being alternatives like exercising and diet
approach.
However, despite the faults identified above and which rendered the nursing care process
of Raelene Ward ineffective, there were other approaches which played a key role to neutralize
her condition. For instance, the available healthcare workers practiced teamwork to ensure that
Raelene Ward received all-round healthcare services. Among the experts who were present, an
endocrinologist ensured her diabetic condition was under control, adrenal and endocrine
disorders addressed as well as heart problems (Gabrielsson, Sävenstedt & Zingmark, 2015). A
midwife was also present to provide the array of healthcare services which could arise in the
labour ward such as labour and delivery care, gynecological examination, contraceptive
prescription and counselling. A dietician was also present to alter the nutrition of Raelene Ward
based on her medical conditions and individual needs.
The nursing care given to Raelene Ward can, therefore, be said to have been both
ineffective and effective as well. It was ineffective because the principles of patient-centred care
like consulting the patient on decisions touching healthcare service provision and educating them

PATIENT EXPERIENCE & PARTNERING IN CARE 5
on their conditions were not observed. On the other hand, it can be said to have been effective
because the experts who took place adhered to the principles of teamwork. This ensured that the
nursing care was an all-round activity.
If the principles of patient-centred care were fully adhered to, Raelene Ward would not
have developed gestation diabetes complications. This is in consideration of the fact that the
condition emerged because of the lack of ongoing support during her gestation period. Also, her
condition would not have worsened if she received counselling after losing her sister. On the
other hand, if the nurse in charge of her would have explained to her on her condition and the
reason behind choosing insulin medication approach, she would not have been shocked by the
decision which worsened her condition (Neuss et al, 2016). Adherence to the quality of practice,
on the other hand, would have minimized the ineffectiveness observed in the case study. For
instance, Raelene Ward would not have developed gestation diabetes if the nurses presented
were committed to providing her with ongoing support. Consequently, her condition would not
have worsened if she was counselled after losing her sister. Collaboration standards would have
enhanced the quality of care given to Raelene Ward. This is in consideration to the fact that most
decisions on care services did not involve Raelene Ward who was the patient. It is as a result of
such negligence that we get to know that she was shocked to hear that she would be injecting
herself with insulin.
In summary, this paper has scrutinized the importance of patient-centred care when
providing nursing care. Framed in reference to the case of Raelene Ward who got gestation
diabetes due to the negligence of healthcare workers during her gestation period, this confirms
the importance of patient-centred care in ensuring effective nursing care. it is also as a result of
negligence to the principle of patient-centred care that the condition of Raelene Ward worsens

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after losing her sister. Standards of nursing care have also been violated in the case scenario of
Raelene Ward leading to ineffective nursing care. The paper has proved violation of quality of
practice standard to have led to the development of gestation diabetes when Raelene Ward
lacked ongoing support during her gestation period. Lastly, violation of collaboration standard
worsened the condition of Raelene Ward through increased stress.
References
Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in
Australia. Collegian, 25(1), 119-123.
Fisher, M. (2017). Professional standards for nursing practice: How do they shape contemporary
rehabilitation nursing practice?. Journal of the Australasian Rehabilitation Nurses
Association, 20(1), 4.
Gabrielsson, S., Sävenstedt, S., & Zingmark, K. (2015). Person‐centred care: clarifying the
concept in the context of inpatient psychiatry. Scandinavian journal of caring
sciences, 29(3), 555-562.
Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency
standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-
10), 1193-1205.
Jakimowicz, S., & Perry, L. (2015). A concept analysis of patient‐centred nursing in the
intensive care unit. Journal of advanced nursing, 71(7), 1499-1517.
Kropf, N. P., & Greene, R. R. (2017). Erikson’s eight stages of development: Different lenses.
In Human Behavior Theory(pp. 75-92). Routledge.

PATIENT EXPERIENCE & PARTNERING IN CARE 7
McCormack, B., & McCance, T. (Eds.). (2016). Person-centred practice in nursing and health
care: theory and practice. John Wiley & Sons.
Neuss, M. N., Gilmore, T. R., Belderson, K. M., Billett, A. L., Conti-Kalchik, T., Harvey, B. E.,
... & Olsen, M. (2016). 2016 updated American Society of Clinical Oncology/Oncology
Nursing Society chemotherapy administration safety standards, including standards for
pediatric oncology. Journal of oncology practice, 12(12), 1262-1271.
Rathert, C., Williams, E. S., McCaughey, D., & Ishqaidef, G. (2015). Patient perceptions of
patient‐centred care: empirical test of a theoretical model. Health Expectations, 18(2),
199-209.
Zaccagnini, M., & Pechacek, J. M. (2019). The doctor of nursing practice essentials: A new
model for advanced practice nursing. Jones & Bartlett Publishers.