RORY’s Values
Putting patients and carers first
© 2013 MA Healthcare Ltd
D
uring my career, I have had many fantastic opportunities afforded to me. One of these was working with babies, children and young people and their families/carers across the UK and Ireland. One of the big things I learnt at a very early stage during my experiences with children and their families was the positive impact nurses and the multidisciplinary team have when working in partnership with children and their families/carers. Family-centred care is a philosophy that is used within children’s nursing to describe a particular method of care delivery. It embraces ideas such as parental/carer involvement in care, partnership and care by parents/carers (Coyne, 1996). This philosophy means that parents/carers are involved in the ongoing care of their child and are encouraged to undertake duties traditionally considered to be nurses’. In the integrated arena, family/carer-centered care can be an approach to the planning, delivery and evaluation of health and social care that is grounded in mutually beneficial partnerships among health and social-care providers, patients and their families/ carers. Nurses and the multidisciplinary team already recognise the vital role that families/carers play in ensuring the health and wellbeing of all ages of our patients.We should acknowledge that emotional, social and developmental supports are integral components of health and social care. Nurses will promote the health and wellbeing of individuals and families/ carers, and restore dignity and control to them. There is emerging evidence that this leads to better health outcomes and wiser allocation of resources, and greater patient and family/carer satisfaction. Historically, our patients have not always been given the opportunity to influence the design of services to meet their needs and their families or carers are not acknowledged as being users. But now we have an opportunity to use the model of familycentred care to make this more of a reality. If we are to implement the main elements of patient and their family/carer-centred care across adult and social care, however, we must first: ■■ Recognise the patient’s family or carer as a constant in the patient’s life ■■ Facilitate family/carer-professional collaboration at all levels of health and social care ■■ Honour the racial,ethnic,cultural and socioeconomic diversity of patients and their families/carers ■■ Recognise patient/family/carer strengths and individuality, and respect different coping methods ■■ Share complete and unbiased information regularly with patients and their families/carers ■■ Encourage and facilitate family-to-family support and networking ■■ Respond to patient and family/carer developmental needs as part of health and social-care practices
British Journal of Nursing, 2013, Vol 22, No 14
■■ Adopt
policies and practices that give patients and their families/carers emotional and financial support ■■ Design health and social care that is flexible, culturally competent and responsive to patients’ and their families’/carers’ needs. I believe that all nurses working in adult services across health and social care must move to a family/ carer-centred approach to nursing all our patients and their families/carers. This will be a transformational change. But with the engagement of our patients and their families/carers, it will truly put our patients and those who care for them first, and always ensure they are at the centre of all we do. In my experience, nurses have the ability to affect directly how well patient and family/carer-centred care is implemented in both the health and social-care environment. Nursing can lead the way on familycentred care and take it into the multidisciplinary team, both in health and social care. I would now ask all nurses to look at when they achieved a patient and family/carer-centred approach. What was the impact? How do you continue to maintain this approach in yourself and the team you work with? Nurses can be empowered to implement this model, particularly when our views are listened to as well. I would suggest that to practise in a family/carercentred manner requires a shift in the orientation of health and social-care services from a standard model to a collaborative model that recognises family/ carer involvement as central to our patients’ care. Within this view, the health and social-care provider is an equal partner and facilitator of care, and families are invited to participate in the decision-making, planning and provision of our patients’ care to the extent they choose. It is expected that the development, implementation and outcomes of a family/carer-centred model of health and social care may differ according to the population and setting. For example, the needs and outcomes for families/carers of a patient with a chronic condition will look different from those who do not have a chronic condition. Also, many of our patients will have a greater awareness and understanding of the reasons for their care or treatment. Models of care may reflect increased participation of our patients and their families/carers in their care. In my experience, family/carer-centred care models are seen as making a difference and are advantageous in their own right. Reliable reassurance that they result BJN in more good than harm should be sought.
Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division
Coyne IT (1996) Parent participation: a concept analysis. J Adv Nurs 23(4): 733–40
The views expressed in this column are those of the author
853
British Journal of Nursing. Downloaded from magonlinelibrary.com by 147.188.128.074 on November 14, 2015. For personal use only. No other uses without permission. . All rights reserved.
Putting patients and carers first
© 2013 MA Healthcare Ltd
D
uring my career, I have had many fantastic opportunities afforded to me. One of these was working with babies, children and young people and their families/carers across the UK and Ireland. One of the big things I learnt at a very early stage during my experiences with children and their families was the positive impact nurses and the multidisciplinary team have when working in partnership with children and their families/carers. Family-centred care is a philosophy that is used within children’s nursing to describe a particular method of care delivery. It embraces ideas such as parental/carer involvement in care, partnership and care by parents/carers (Coyne, 1996). This philosophy means that parents/carers are involved in the ongoing care of their child and are encouraged to undertake duties traditionally considered to be nurses’. In the integrated arena, family/carer-centered care can be an approach to the planning, delivery and evaluation of health and social care that is grounded in mutually beneficial partnerships among health and social-care providers, patients and their families/ carers. Nurses and the multidisciplinary team already recognise the vital role that families/carers play in ensuring the health and wellbeing of all ages of our patients.We should acknowledge that emotional, social and developmental supports are integral components of health and social care. Nurses will promote the health and wellbeing of individuals and families/ carers, and restore dignity and control to them. There is emerging evidence that this leads to better health outcomes and wiser allocation of resources, and greater patient and family/carer satisfaction. Historically, our patients have not always been given the opportunity to influence the design of services to meet their needs and their families or carers are not acknowledged as being users. But now we have an opportunity to use the model of familycentred care to make this more of a reality. If we are to implement the main elements of patient and their family/carer-centred care across adult and social care, however, we must first: ■■ Recognise the patient’s family or carer as a constant in the patient’s life ■■ Facilitate family/carer-professional collaboration at all levels of health and social care ■■ Honour the racial,ethnic,cultural and socioeconomic diversity of patients and their families/carers ■■ Recognise patient/family/carer strengths and individuality, and respect different coping methods ■■ Share complete and unbiased information regularly with patients and their families/carers ■■ Encourage and facilitate family-to-family support and networking ■■ Respond to patient and family/carer developmental needs as part of health and social-care practices
British Journal of Nursing, 2013, Vol 22, No 14
■■ Adopt
policies and practices that give patients and their families/carers emotional and financial support ■■ Design health and social care that is flexible, culturally competent and responsive to patients’ and their families’/carers’ needs. I believe that all nurses working in adult services across health and social care must move to a family/ carer-centred approach to nursing all our patients and their families/carers. This will be a transformational change. But with the engagement of our patients and their families/carers, it will truly put our patients and those who care for them first, and always ensure they are at the centre of all we do. In my experience, nurses have the ability to affect directly how well patient and family/carer-centred care is implemented in both the health and social-care environment. Nursing can lead the way on familycentred care and take it into the multidisciplinary team, both in health and social care. I would now ask all nurses to look at when they achieved a patient and family/carer-centred approach. What was the impact? How do you continue to maintain this approach in yourself and the team you work with? Nurses can be empowered to implement this model, particularly when our views are listened to as well. I would suggest that to practise in a family/carercentred manner requires a shift in the orientation of health and social-care services from a standard model to a collaborative model that recognises family/ carer involvement as central to our patients’ care. Within this view, the health and social-care provider is an equal partner and facilitator of care, and families are invited to participate in the decision-making, planning and provision of our patients’ care to the extent they choose. It is expected that the development, implementation and outcomes of a family/carer-centred model of health and social care may differ according to the population and setting. For example, the needs and outcomes for families/carers of a patient with a chronic condition will look different from those who do not have a chronic condition. Also, many of our patients will have a greater awareness and understanding of the reasons for their care or treatment. Models of care may reflect increased participation of our patients and their families/carers in their care. In my experience, family/carer-centred care models are seen as making a difference and are advantageous in their own right. Reliable reassurance that they result BJN in more good than harm should be sought.
Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division
Coyne IT (1996) Parent participation: a concept analysis. J Adv Nurs 23(4): 733–40
The views expressed in this column are those of the author
853
British Journal of Nursing. Downloaded from magonlinelibrary.com by 147.188.128.074 on November 14, 2015. For personal use only. No other uses without permission. . All rights reserved.
