Patient-Centered Care: Embracing All Nursing Stories
In 2009, African novelist, Chimamanda Adiche gave a TED Talk in which she addressed the danger of a single story. She warned that if we hear only a single story about another person or country, we risk a critical misunderstanding.
Like Adiche, I believe that there are many stories of nursing care and that if we hear only a single story, we risk a critical misunderstanding of our possibilities as nurses. To that end, it is important to listen to each patient’s story and keep it in mind during care.
What is patient-centered care?
Patient-centered care focuses on the active involvement of patients and their families in the design and decisions surrounding their options for treatment. It is about more than educating patients about a diagnosis, potential treatment and healthy behavior. It recognizes that patients want guidance from their care providers, but that they expect that guidance in the context of full and unbiased information about options, benefits and risks.
Moreover, at its core, patient-centered care is about considering patients’ cultural traditions, personal preferences and values, family situations, social circumstances and lifestyles. In essence, listening to their personal story and providing care accordingly. In addition, acting with these considerations in mind can lead to improved outcomes for patients.
While the modern healthcare industry depends on nurses far beyond the bedside, enhanced patient engagement remains nurses’ strongest tool for improving a patient’s well-being. Enhanced direct patient care helps maximize patients’ time in the hospital, and ensures their families are equipped with the knowledge and support they need when discharged.
I once helped a patient who suffered from depression. As part of her treatment, we put a focus on helping her tell her story. We encouraged her to write down her experiences and share her thoughts and feelings around all that she had been through. By relating and documenting her story, she came to appreciate the depth of the strength she had in order to have gone through it all and keep going. She ended up finding her own source of healing through discovering her strength.
It is important to keep in mind that nurses benefit from the patient-centered care model as well. They are able to forge a deeper connection with each patient when all aspects of their story are considered. This connection can help nurses to better care for their patient and nurses can take pride in the improved patient outcomes because of their efforts.
Incorporating patient-centered care
Referring back to Adiche, she said, “I've always felt that it is impossible to engage properly with a place or a person without engaging with all of the stories of that place and that person. The consequence of the single story is this: It robs people of dignity. It makes our recognition of our equal humanity difficult. It emphasizes how we are different rather than how we are similar.”
As the health care landscape continues to evolve, the significance of the connection between nurse and patient, the significance of understanding a patient’s story, is more important than ever.
As the largest segment of the U.S. health care workforce – more than 3 million – nurses possess the unique perspective to treat the whole person and not just a specific illness or injury. This patient- and family-centered care extends beyond the limits of the physical body to a person and family’s social, mental and spiritual needs.
Patient-centered care creates a style of nursing effectiveness founded in the answers to these questions:
1. Have I seen underneath the disease or the condition I have been educated to diagnose, the person who exists struggling to deal with this disease?
2. To what extent have I appreciated and embraced the role I play in bettering the lives of others and my own life?
3. How much time have I devoted to listening to the story that my patient longs to tell in contrast to the time I required him or her to answer my health history questions?
4. Finally, how often have I remembered that my heart is as great a guide to action as is my brain?
Take time to consider these questions daily in order to better understand each individual patient’s needs and how you can better care for them.
So where do we go from here?
According to an article published in the Annals of Family Medicinein 2014, healthcare providers who used decision support tools with patients, such as healthcare report cards or personal counseling, saw a consistent improvement in patients’ knowledge and more accurate perceptions of risk, leading to increased confidence in decisions regarding their own treatment.
In some instances, patients decided not to undergo elective surgeries after becoming better informed. Other patients improved in their ability to self-manage long-term conditions and adhere to their medications.
It’s these types of outcomes that can become more commonplace with the application of patient-centered care.
I understood when I was 16 years old that something was happening to me that created a love for nursing before nursing had a name or place in my consciousness. I spent half of 10th grade and half of the 11th grade volunteering at the local hospital. I loved being a part of what was going on there. I believe what I experienced was the essence of nursing as caring. I came to see healing as appreciating wholeness and caring as an avenue for this appreciative praxis.
Much of what I learned in those early days of my experience has shaped the way I think about nursing education and leadership. This strong connection to the people we serve inspired me to look beyond my role as a clinician and consider these areas. I felt a natural connection to people because of nursing, and that easily translated to forming positive relationships with students and colleagues.
In particular, the appeal of influencing the education for the next generation of nurses was more than intriguing; it felt like what I was meant to do. I felt that contributing to the education of nurses would fulfill the responsibility and accountability to society that has since shaped every choice in my career.
Nurses have the power to change the course of the human condition, and nurse leaders have the responsibility to affect change through decisions that ripple throughout the profession and support the next generation of nurses. The extraordinary nurses we have helped educate now have the same sense of exploration and dedication to lifetime learning that brought us to our calling.