Person-Centred Care: Principles and Nurse-Patient Partnerships Essay

This essay delves into the concept of person-centred care (PCC) within the nursing profession, emphasizing its core principles and practical application. The essay begins by defining nursing according to the ICN, highlighting the broad scope of nursing practice and the various roles within the field, including the importance of professional competence. The main body of the essay focuses on PCC, exploring its definition, which involves treating patients with dignity and respect and including them in healthcare decisions, and its link to patient rights. It discusses the core elements of PCC and how nurses can partner with consumers to improve safety and the quality of care. The essay also examines the four pillars of competence as defined by the ANMC, including the importance of practicing in accordance with legislation and ethical guidelines, the role of research in evidence-based practice, the significance of comprehensive nursing care planning and assessment, and the establishment of therapeutic relationships with patients. The essay provides real-world examples of legal and ethical dilemmas nurses may face and emphasizes the importance of cultural competence. Finally, the essay concludes by summarizing the significance of evidence-based knowledge and skills in achieving professional competence in nursing and highlights the role of the ANMC competency standards in guiding nursing practice.

PERSON-CENTRIC CARE
1. Introduction
According to the ICN (International Council of Nurses), “Nursing encompasses
autonomous and collaborative care of individuals of all ages, families, groups and
communities, sick or well and in all settings. Nursing includes the promotion of health,
prevention of illness, and the care of ill, disabled and dying people. Advocacy,
promotion of a safe environment, research, participation in shaping health policy and in
patient and health systems management, and education are also key nursing roles” (ICN -
International Council of Nurses, 2010).
This statement clearly defines the scope of a nurse's practice. But there are several types
of caregivers in the field of nursing. It includes registered nurses, licensed nurses,
midwives, enrolled nurses and nurse assistants. It is a fact that nurses play a crucial role
in the provision of health services. The lives of people are at stake and, therefore, it is
necessary to practice it in a competent way. Professional competence is indispensable in
the practice of nursing (Numminen et al., 2013). This essay will explore what is
competence and what it means to be a professionally competent nurse.
2. The Body
In this essay, I will discuss person-centred care (PCC) (Kitson et al., 2012) focused on
the principles of PCC and different ways to improve the safety and quality of service
provided as a nurse. I will also discuss the three aspects of PCC for the patient, the client
or the consumer and the role in the improvement of safe and quality nursing care as a
care provider or as a care recipient.
Person-centred care consists of treating dignity and respect for a person who receives
healthcare and involves them in all decisions about their health. This is also referred to
as "patient-centred care" (Kitson et al., 2012). This is an approach linked to a person's
1

PERSON-CENTRIC CARE
health rights. When a patient receives attention focused on the person of healthcare
professionals and services, he places himself in the "centre" of healthcare to obtain
treatment with dignity, respect and compassion, communicating and coordinating the
patient's attention between the appointments and the different Services.
The ANMC characterizes competence as the mix of learning, aptitudes, attitude, values
and capability that support effective as well as better performance in profession or work
area (Nursingmidwiferyboard.gov.au, 2010). All healthcare institutions perceive and
expect a lot of competition in nursing. The institutions desire an overall improvement of
the ability of their nurses.
The rules of competence of the ANMC applicable to registered nurses are based on four
pillars which are practice of proficiency, skill on critical thinking and investigation,
coordination and arrangement of health care and the practice of joint collaboration and
therapy (Nursingmidwiferyboard.gov.au, 2010).
In the first pillar, an important area related to the practice includes the need to practise as
per legislation that influences the act of nursing and medicinal services, just as the need
to practise within a professional framework and nursing ethics
(Nursingmidwiferyboard.gov.au, 2010).The good and legitimate conflicts regularly
muddle taking decision in the practice of nursing. For example, managing a patient who
rejects any kind of treatment is a kind of legal situation encountered by the nurse
(Griffith and Tengnah, 2013). This is genuine on account of the fact that the ANMC
standardises the competencies that the nurses need to perceive and acknowledge the
rights of others. The nurse wants to fulfil his professional obligations to help the patient,
whereas, legal morals establishes that the patients can opt to reject the treatment. There
are some cases, as for example, some religions do not permit transfusion of blood which
2

PERSON-CENTRIC CARE
creates a dilemma for the nurse (Tschudin, 2010). In this specific situation, the nurse has
to either convince the patient through education or acknowledge the rejection of the
treatment. In this case the patient needs to confront the conceivable outcomes of
rejecting the treatment.
Additionally, there is a necessity to practise in a way that perceives pride, culture,
qualities, convictions and privileges of people or groups. Belief in religion is especially
auspicious for patients amid times of a medical emergency. Unfortunately, this religious
conviction does not generally outcome in a positive result. It may frustrate the patient's
receptiveness to treatment and care. This type of issues require a different type of
expertise to solve that is based on understanding cultural diversity. Fundamentally,
cultural capability is significant to nursing. A nurse is simply proficient in case of
dealing with patients having different value system, yet at the same time manages how to
set up and keep up a therapeutic relationship that facilitates implementation of nursing
procedure.
Within the scope of the first pillar of professional practice, there is one more significant
issue that suggests the necessity to address as well as clarify decisions or orders which
are not transparent or debatable. Moreover, there is a need to address as well as clarify
interventions that appear incorrect to be members of healthcare group. In following this
request, a nurse may consistently falter to examine the authenticity of a particular
intervention whether it was given by an individual specialist or by some other health care
professional, for example, a doctor. Inter personal conflicts (Brown et al., 2010) have
been documented. For instance, in examining a specialist's instruction, the nurse would
normally enquire the specialist whether the prescription endorsed is appropriate or not.
3

PERSON-CENTRIC CARE
It is an incredibly uncommon case when the nurse advises the doctor to change his
prescription. Reference is made to this kind of specific interaction between doctor and a
nurse as doctor-nurse game. There should be such kind of communication between
doctors and nurses without hurting sentiments of each other. This is part of healthy
practice in health care scenario.
The second pillar based on the ramifications of research for evidence based practice.
This pillar additionally describes the commitment to partake in the ongoing professional
improvement of self as well as other people (Dalheim et al., 2012). In one's very own
practice with regards to nursing, proceeding with professional education has been one's
primary objectives. It is an approach to engage oneself to keep updated with the latest
advancement in nursing. Attending seminars, presentations, conferences would update
the knowledge and exposure in this field. Attending training is a requirement to keep the
healthcare professionals with the latest developments in this scientific field. With the
advancement in technology and the increase in demand for quality care, the nurses have
to update their skill and knowledge to be at par with the latest developments (Nash,
2012). The high level of competence required by the nurses is a necessity as nurses are at
the frontline of health care service. Nurses who are well informed about the latest
developments can deliver competent and quality care to their patients.
The prominent part of the third pillar correlates to the importance of the nursing care,
which includes the implementation of an extensive and efficient appraisal, planning and
implementation of safe and efficient evidence based nursing and after that assessment of
the expected outcomes (Joseph and Huber, 2015). To simply depict it, the nursing
procedure is a critical thinking and problem solving method. It is a well ordered
methodology used by the nurses to take care of patient issues that exist in the nursing
field. In its own nursing care, the problem area of the nursing procedure is the nursing
4

PERSON-CENTRIC CARE
evaluation. Nursing evaluation can be characterized as the efficient and consistent
collection and investigation of patient information. It is very difficult to declare that a
patient is thoroughly assessed. This is because many factors need to be considered.
Patient care is dependent on the nurses' competence in assessing the signs and symptoms
related to the patient's medical condition.
For the fourth domain, what is most relevant to one's practice is to establish and maintain
therapeutic relationships with the patients and the need to cooperate with other
healthcare professionals in the field of comprehensive care (Birks et al., 2016). It is the
first step in gaining patient confidence and trust. It is an important part of nursing. In an
effective therapeutic relationship, the patients feel genuine support from nurses, while
the nurses feel some degree of satisfaction in his or her role. Maintaining a therapeutic
relationship with patients is as per the requirement of ANMC (2006) to make
assessments as per the needs of individuals or groups. The standards for competency in
this field include the ability of a nurse to address the patient's psychological, physical,
emotional, and spiritual needs as well to optimize the environment (Andre and Barnes,
2010).
3. Conclusion
The accumulation of evidence-based knowledge and skills are the main resource to
acquire competency in professional nursing. It also involves understanding cultural
diversity and how it affects the kind of care to be given. Competence is also related to
genuine care. The ANMC competency standards are crucial to managing the way nurses
need to think and act. The competency standards can be idealistic, but it is certainly
realistic and achievable if only nurses devote more time in reflecting their own practice
and in trying to incorporate through actions to achieve these competency standards.
5

PERSON-CENTRIC CARE
References:
Andre, K. and Barnes, L. (2010). Creating a 21st century nursing work force: Designing a
Bachelor of Nursing program in response to the health reform agenda. Nurse Education
Today, 30(3), pp.258-263.
Birks, M., Davis, J., Smithson, J. and Cant, R. (2016). Registered nurse scope of practice in
Australia: an integrative review of the literature. Contemporary Nurse, 52(5), pp.522-543.
Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T. and Kasperski, M. (2010). Conflict
on interprofessional primary health care teams – can it be resolved?. Journal of
Interprofessional Care, 25(1), pp.4-10.
Dalheim, A., Harthug, S., Nilsen, R. and Nortvedt, M. (2012). Factors influencing the
development of evidence-based practice among nurses: a self-report survey. BMC Health
Services Research, 12(1).
Griffith, R. and Tengnah, C. (2013). Maintaining professional boundaries: keep your
distance. British Journal of Community Nursing, 18(1), pp.43-46.
ICN - International Council of Nurses. (2010). Regulation and Education. [online] Available
at: https://www.icn.ch/nursing-policy/regulation-and-education [Accessed 27 Apr. 2019].
Joseph, L. and Huber, D. (2015). Clinical leadership development and education for nurses:
prospects and opportunities. Journal of Healthcare Leadership, p.55.
Kitson, A., Marshall, A., Bassett, K. and Zeitz, K. (2012). What are the core elements of
patient-centred care? A narrative review and synthesis of the literature from health policy,
medicine and nursing. Journal of Advanced Nursing, 69(1), pp.4-15.
Nash, M. (2012). Critical appraisal to support evidence-based practice. Dental Nursing,
8(10), pp.662-665.
Numminen, O., Meretoja, R., Isoaho, H. and Leino-Kilpi, H. (2013). Professional
competence of practising nurses. Journal of Clinical Nursing, 22(9-10), pp.1411-1423.
Nursingmidwiferyboard.gov.au. (2010). Nursing and Midwifery Board of Australia -
Professional standards. [online] Available at:
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards.aspx [Accessed 27 Apr. 2019].
6

PERSON-CENTRIC CARE
Tschudin, V. (2010). Book review: Benjamin M, Curtis J, Ethics in nursing: cases, principles,
and reasoning, Oxford University Press: Oxford, 2010, 300 pp.: 9780195380224, GBP22.50
(pbk). Nursing Ethics, 17(6), pp.793-793.
7