How well is patient-centred care applied in practice?

Headnote

Patient-centred care is an ideal of nursing practice. How well is it applied in practice? A group of students share their thoughts and experiences.

Patient-centred care (PCC), as defined by the Institute of Medicine, provides care that is responsive to, and respectful of each patient's needs, values and preferences, to ensure the individual's values guide all clinical decisions^ This is a crucial health-care concept as it separates disease (characterised by pathophysiological aspects, such as symptoms, diagnosis and treatment) and illness (describing the overall patient experience, including the effect on individual wellbeing, feelings, ideas and lifestyle).2 Understanding these differences enables the health-care professional to understand the disease and work alongside patients as they experience illness, to increase patient-centred decision-making.2

To highlight the importance of this health-care model, this article explores cultural safety, family/patient support networks, active patient involvement and participation in care, and the nursepatient relationship. It incorporates personal experiences from our clinical placements to demonstrate how these concepts are utilised in health care from the perspective of a student nurse. We also include practices we feel can be improved to ensure the best patient outcomes.

* Cultural safety: Cultural safety has been defined as: "An outcome of nursing education that enables a safe, appropriate and acceptable service that has been defined by those who receive it."3 This encompasses, but is not limited to, differences in ethnicity, religious beliefs, sexual orientation, gender, age, socioeconomic status and disability.4 It is enacted by the nurse, but allows the recipient of care to determine whether their care was safe.5 Safety is a subjective term that is deliberately used to give the person receiving health care the power.5 Cultural safety is also included in the Nursing Council's Code of Conduct (the code). Principle two is: "Respect for the cultural needs and values of health consumers". 4 Failure to fulfil this principle would breach the standards registered nurses (RN) are expected to uphold.

Cultural safety is a vital component of the undergraduate nursing curriculum and is in the forefront of many student nurses' minds during clinical placements. However, this concept was only developed in the early 1990s and therefore differences exist in its implementation^

An experience recalled by a secondyear student nurse demonstrates the contrast between the concept of cultural...