NR 500 Week 3: Person-Centered Care

NR 500 Week 3: Person-Centered Care

Sample Answer for NR 500 Week 3: Person-Centered Care Included After Question

Preparing the Assignment 

Introduction 

This graded discussion will explore the concepts of person-centred care and reflective practice. Please provide an initial response to the discussion question by Wednesday at 11:59pm MT and two interactive dialogue responses no later than Sunday 11:59 PM MT at the end of WEEK 3. The discussion is worth 75 points. Please refer to the discussion grading rubric for additional criteria. 

Assignment 

This week’s topic focused on caring and reflective practice in contemporary nursing. In your initial response, provide a definition of what person-centred care means to you. Describe how you will apply principles holistic nursing, cultural humility, and self-reflection in your future role as a nurse practitioner. 

A Sample Answer For the Assignment: NR 500 Week 3: Person-Centered Care

Title:  NR 500 Week 3: Person-Centered Care

Person-centered care means focusing care on an individual’s health needs. It involves ensuring that a patient’s needs, preferences, and values are used in clinical decision-making and delivering respectful care (Santana et al., 2018). Person-centered care entails treating a patient as an individual and as an equal partner in the healing journey and should thus be individualized, coordinated, and enabling. Health providers seeking to provide person-centered care should seek to identify á patients’ abilities and potential to manage and better their health, rather than perceiving the patient as a victim of illness or passive treatment recipients (Santana et al., 2018). When planning for personalized care, health providers should develop a plan tailored to the individual patient’s needs. Therefore, the provider and the patient should have a conversation to set mutual goals and interventions for meeting the patient’s health needs.

Holistic nursing refers to an all-inclusive approach to patient care. In my future nurse practitioner (NP) role, I will apply the principle of holistic nursing by identifying each patient as an individual and recognizing the whole patient. Besides, I will evaluate patients holistically via open communication and seek to identify potential factors causing stress that may affect a patient’s health and wellbeing (Thornton, 2019). Cultural humility refers to a lifetime practice of self-reflection and self-critique through which a person examines their beliefs and cultural identities and learns about others’ culture (Greene-Moton & Minkler, 2020). I will apply cultural humility in NP practice by learning and understanding patients’ cultures, especially those from different races, ethnicities, socioeconomic statuses, religions, sexual orientations, and geographic locations. Besides, I will seek to understand and be sensitive to historical facts like the aftermaths of oppression and violence against particular groups of people. Lastly, I will apply self-reflection by evaluating my professional practice and clinical interventions and comparing them with the standard best-practice for NPs.

NR 500 Week 3: Person-Centered Care References

Greene-Moton, E., & Minkler, M. (2020). Cultural competence or cultural humility? Moving beyond the debate. Health promotion practice, 21(1), 142-145. https://doi.org/10.1177/1524839919884912

Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person-centred care: A conceptual framework. Health expectations : an international journal of public participation in health care and health policy, 21(2), 429–440. https://doi.org/10.1111/hex.12640

Thornton, L. (2019). A Brief History and Overview of Holistic Nursing. Integrative medicine (Encinitas, Calif.), 18(4), 32–33.

Patient-Centered Care

Person-centered care means treating a patient as a person and an equal partner in their healing journey and focusing care on their health needs. I believe person-centered care strategies should be individualized, harmonized, and enable patients to reach their full potential. Therefore, the nurse or healthcare professional providing person-centered care should consider the patient’s needs, values, and preferences when making clinical decisions, which fosters respectful care. Kwame & Petrucka (2021) assert that the healthcare provider must consider a patient’s previous healthcare experiences and knowledge and, thus, provide care that focuses on and respects their values, preferences, and needs by increasingly involving the patient in the care process.

A nurse practitioner should first evaluate the patient’s abilities to manage and improve their health and collaboratively identify strategies that will help the patient in these abilities (Kwame & Petrucka, 2021). I believe that a fundamental aspect of patient-centered care is delivering services that respect and meet patients’ needs. This fosters positive healthcare outcomes, improves patients’ perceptions of quality of care, and improves patient satisfaction with care.

Holistic nursing means a comprehensive approach to patient care. It entails treating the whole person by also considering their mental and social factors instead of just focusing on managing the symptoms of their diagnosis. I perceive holistic care as a nursing approach that addresses a patient’s physical, psychological, social, and spiritual needs. Thus, this type of care is comprehensive. Instead of treating the diagnosis, holistic nursing seeks to improve the individual patient’s overall well-being and quality of life (Papathanasiou et al., 2013). Furthermore, I believe holistic nursing is relationship-centered care that should be individualized, with the primary goal being optimal health. Therefore, the NP practicing holistic nursing should acknowledge the patient’s body, mind, and spirit by treating the entire individual instead of one symptom (Papathanasiou et al., 2013). Besides, the NP should acknowledge that various factors affect a person’s health, including dietary habits and environmental influences. Consequently, they should ask patients questions about their general lifestyle.

Cultural humility refers to being respectful and empathetic and applying critical self-reflection at

intrapersonal and interpersonal levels. Hughes et al. (2020) explain that the intrapersonal element of cultural humility entails being aware of one’s limited ability to appreciate the patient’s worldview and culture. On the other hand, the interpersonal component integrates an opinion toward a patient characterized by respect and openness to the patient’s point of view. It also focuses on learning from the patient by listening and building partnerships (Hughes et al., 2020). I believe that a nurse with cultural humility should have a mindset that enables them to be open to patients’ preferences by demonstrating respect and empathy. Furthermore, if nurses combine cultural humility with critical conversation skills, they can get an opportunity to discuss cultural misunderstandings, intercultural pain, and how to develop a cultural understanding.

NR 500 Week 3: Person-Centred Care References

Hughes, V., Delva, S., Nkimbeng, M., Spaulding, E., Turkson-Ocran, R. A., Cudjoe, J., … & Han, H. R. (2020). Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. Journal of Professional Nursing, 36(1), 28-33. https://doi.org/10.1016/j.profnurs.2019.06.005

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1-10. https://doi.org/10.1186/s12912-021-00684-2

Papathanasiou, I., Sklavou, M., &Kourkouta, L. (2013). Holistic nursing care: Theories and perspectives. American Journal of Nursing Science, 2(1), 1-5. https://doi.org/10.11648/j.ajns.20130201.11

Immersive Reader

NR 500 Week 3: Person-Centred Care SAMPLE 2

Introduction

Caring has been a central concept to nursing since the inception of the profession. While, healthcare delivery and settings have changed as a result of a variety of social and technological factors, nurses must be mindful not to lose sight of caring as the core of nursing practice. Caring frameworks that include holistic and person-centred care can be used to guide the practice of master’s- prepared nurses in advanced practice roles as leaders of nursing care in a variety of healthcare settings.

Caring as a Nursing Concept

The American Nurses Association (2016) defines nursing as:

…the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.

Why is caring a central focus of nursing? Nursing theorist Jean Watson (1990) contended that caring is the moral ideal and essence of nursing. Caring can be conceptualized as a noun, a verb, or an adjective (Adams, 2016). As a noun, care is an act. As a verb, it is an action carried out in relation to another. As an adjective, caring describes the quality of an act. Nursing has a scientific knowledge that supports caring practices, ethics, attitudes and behaviors. Drahošová and Jarošová (2016) described several aspects of caring, including an individualized, empathetic approach; attentiveness; and sensitivity. A caring relationship can help support patient dignity and autonomy and reduce anxiety. Caring is influenced by the nurse’s knowledge, skills, and attitudes formed through lifelong learning and experiences. Caring is manifested in relationships. As a master’s- prepared advanced practice nurse you will have daily opportunities to demonstrate caring behaviors that establish relationships and promote positive outcomes in a variety of professional practice settings.

Caring in Complex Systems

Over time, healthcare systems have increased in complexity, in part due to advances in knowledge, skills, and technology, which has led to a reshaping of the role of the master’s prepared advanced practice nurse. Focus on safe, quality, and cost- effective care is paramount in the 21st-century healthcare delivery system. As the role of the professional nurse has expanded to include organizational and professional regulation, compliance, and technology -driven tasks, focus has shifted away from the patient care experience, challenging the fundamental nursing principle of caring.

Reflection

Take a moment to reflect on how you demonstrate caring in your current professional practice. What are barriers to practicing care? How can you enhance caring behaviors?

Person-Centred Care Nursing Framework

Caring is a central concept in nursing; however, the context for caring is changing. Healthcare is undergoing a transition from provider-driven care to person-centred care. Patients are increasingly involved in making decisions regarding their health and health practices. McCormack and McCance developed a Person-Centred Nursing (PCN) Framework, which can be applied to practice in complex healthcare systems (McCormack & McCance, 2017). The PCN Framework provides a standard of care for practice and is a multidimensional process emphasizes the person as the center of care delivery. The PCN Framework involves fostering therapeutic relationships that respect individuals as persons and partners in care. Care is relationship-focused, collaborative, and holistic.

The Person-Centred Care Nursing Framework consists of five constructs: prerequisites, the care environment, person-centred processes, and outcomes (McCormack & McCance, 2017). To deliver effective care, one must work from the outer circle towards the core.

The macro-context addresses the larger setting within which person-centred care takes place. The macro-context includes health and social care policy, strategic frameworks, workforce development, and strategic leadership. Prerequisites focus on the attributes of the nurses and include being professionally competent, having developed interpersonal skills, being committed to the job, being able to demonstrate clarity of beliefs and values, and knowing self. The care environment focuses on the context in which care is delivered and includes appropriate skill mix, systems that facilitate shared decision making, effective staff relationships, organizational systems that are supportive, the sharing of power, the potential for innovation and risk taking, and the physical environment. Person-centred processes focus on delivering care through a range of activities and include working with a patient’s beliefs and values, engagement, having a sympathetic presence, sharing decision making, and providing holistic care. Outcomes, the central component of the Framework, are the results of effective PCN and include: satisfaction with care, involvement in care, and a feeling of well-being.

Reflection

Consider how the PCN Framework can support quality and safety outcomes. Identify three ways in which you can use the PCN  Framework to improve outcomes in your future professional practice setting.

Holistic Nursing Practice

Nurses are tasked with providing care that attends to all aspects of the person, health, and environment. Although nurses must certainly be knowledgeable about how disease physiologically affects the patient; it is important to address the needs of the whole person, not just a diagnosis. Holism is a person-centred philosophy that ensures care for the whole patient. The concept of holistic care expands beyond physiological aspects of health (illness and/or disease) and incorporates psychological, sociological, developmental, spiritual, and cultural aspects. Holistic care also considers environmental and economic factors. A holistic approach to care is recommended for master’s- prepared nurses in advanced practice roles. Holistic nurses recognize and treat each individual as a unique human being interconnected with family and community (Papathanasiou et al., 2013). Holistic nursing moves the nurse from a linear, task-oriented mindset towards complex and multidimensional care. Holistic nursing encourages nurses to integrate self-care, personal responsibility, spirituality, and reflection in their own lives. Hence, holistic approaches to person-centred care lead to better patient outcomes and improved nurse satisfaction.

Reflection

Consider ways in which you incorporate holistic care principles in your professional practice.

Chamberlain College of Nursing Conceptual Framework of Nursing

Acknowledging the centrality of care to nursing practice, Chamberlain’s philosophy of education is grounded in the belief that taking extraordinary care of students ultimately translates to the extraordinary care of patients, families, and communities (Chamberlain University [CU], 2018). The masters of nursing education program at Chamberlain University is guided by a holistic health, person-centred, care-focused framework (CU, 2018). Take a moment to explore the Chamberlain University Conceptual Framework of Nursing. Consider how this will affect professional growth in your current nursing practice and future practice as a master’s prepared advanced practice nurse.

Conclusion

Nursing practice is both an art and a science with foundational knowledge, skills, and attitudes based in caring. Over time, health care settings have changed and continue to evolve. The complexity of the current practice environment has led to conceptual and theoretical advancements that support nursing practice. Caring remains a central concept to the profession and practice of nursing. The Person-Centred Nursing Framework, holistic model of care, and Chamberlain Care philosophy serve as a models to guide advanced practice nurses.

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NR500NP-60450

Week 3: Reflective Practice

Immersive Reader

Week 3: Reflective Practice

Table of Contents

Self-Knowledge

Increasing diversity, globalization, and expanding technologies have produced complex ethical pressures that influence nursing practice. Master’s-prepared nurses are challenged to take on leadership roles and effect positive change to promote health and health outcomes. To be effective in the advanced practice role, it is important to understand one’s own personal values, beliefs, strengths, and limitations.

Knowing Self

Important prerequisites of the nurse’s ability to deliver person-centred included self-knowledge and clarity of beliefs and values (McCormack & McCance, 2017). Self-awareness or self-knowledge is developed through reflection. Reflection allows for the examination of personal experiences, which helps clarify the values and beliefs that shape one’s perspectives and actions. According to McCormack and McCance (2017), through reflection, self-awareness, and engagement with others, an individual is able to understand oneself. Self-awareness aids the nurse in understanding how personal beliefs and attitudes may influence interactions with others (Rasheed, 2015). Self-awareness has other advantages. Rasheed (2015) noted that self-awareness promotes personal and professional growth. Similarly, Eng and Pai (2015) found that nurses who engaged in self-reflection had higher nursing competence.

Value and Belief Clarification

Self-reflection helps nurses clarify their personal beliefs and values. While these terms are sometimes used interchangeably, there is a difference. Beliefs are convictions or assumptions one holds to be true, sometimes without actual proof or evidence. Values relate to what one considers to be important in life. Values stem from beliefs, and may include principles or standards of conduct (DeNisco & Barker, 2015).

Values and beliefs influence one’s thoughts, decisions, and actions. Clarification of values and belief is an ongoing process shaped by education; experiences (social, political, personal and professional); environment; and economic factors. Values and beliefs change over time as one engages in personal and professional development. Nurses are held to a standard of providing safe, quality care to all individuals in need. Nurses’ personal values may or may not align with professional nursing values. Clarification of values and beliefs strengthens nurses’ ability to make ethical decisions and to promote ethical and moral actions. A master’s- prepared advanced practice nurse must understand the interrelationship of values and beliefs and the effect on professional practice.

Shahriari et al., (2013) described 10 common professional nursing values: human dignity, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency. Similarly, Kaya et al., (2017) found human dignity, altruism, aesthetic, equality, freedom, accuracy, and justice as core professional nursing values.

Biases and Stereotypes

Whether we realize it or not, we all have stereotypes and biases about a variety of things. Stereotypes and biases often develop out of the brain’s natural need to filter stimuli. The brain receives a constant barrage of thoughts and sensations. The brain would quickly be overwhelmed if it had to provide an equal level of attention to every stimulus (Meyers & Twenge, 2016 ). To efficiently discriminate between the most pressing matters and matters that may be handled automatically, the brain develops shortcuts, which are then selectively reinforced by our experiences. Examples of shortcuts include stereotypes, heuristics, and biases. People frequently rely on these shortcuts in decision-making without realizing they are doing so. Self-reflection can help us identify the stereotypes and biases we hold so that we can engage in authentic, person-centred care.

While some stereotypes may be neutral (Ex. Nurses wear white), others are harmful. Bias is a sensitive topic to address; however, it must not be ignored as bias may lead to intentional (explicit) or unintentional (implicit) disparities in care and subsequent health and healthcare outcomes (DeNisco & Barker, 2015). Biases in the areas of gender, race, sexual orientation, religion, and obesity are most relevant among health care providers (Dunagan et al., 2016). Ageism is also a concern in nursing and sustained through social stereotypes, lack of knowledge, and practice policies (Kagan & Melendez-Torres, 2015). Regardless of the type of bias, all have the potential to negatively impact health and healthcare outcomes. Attitudes of prejudice interfere with one’s ability to practice cultural humility and to make nonbiased ethical decisions.

It is important to acknowledge personal biases, as these affect beliefs, behaviors, actions, and interactions with others. With this awareness, you can begin addressing your biases. Personal and professional growth are aspects of professional identity and are influential in the demonstration of leadership and the promotion of positive change in people, systems, and the profession of nursing (National League for Nursing, 2012). Identifying, understanding, and being mindful of stereotypes and prejudice help to reduce bias. Working toward controlling and resolving biases through the development of attitudes and skills that promote human dignity, respect, and value diversity and cultural humility is critical to effective nursing practice in varied settings.

Reflection

Students reflect on known biases. What are my biases and attitudes toward people with various cultural, gender, sexual orientation, age, weight, and religion that are different than my own? Identify new biases or confirm current biases. Develop a plan to reduce bias.

Complete selected surveys at Project Implicit, Harvard University https://implicit.harvard.edu/implicit/takeatest.htmlLinks to an external site.

Cultural Humility

Cultural humility is another important aspect of person-centered care as well as a key concept of the Chamberlain Conceptual Framework of Nursing (Chamberlain University, 2018). Cultural humility begins with self-reflection. It involves the acknowledgment that one’s own perspective is limited and may contribute to barriers in providing care (DeNisco & Barker, 2015). Cultural humility involves awareness of cultural differences. The concept of cultural humility is a fluid and active process that allows for growth and knowledge development related to other cultures. One approaches cultural differences with respect, openness, flexibility, and humility. As a practice of cultural humility, it is useful for the nurse to think about cultural phenomena, to understand variations related to different cultures, and to perform careful individual assessments to include personal preferences as there are intracultural as well as intercultural variations (Engebreston, 2016). Practicing cultural humility places the person at the center of care and helps to develop mutually respectful and beneficial partnerships.

Engebreston (2016) described six phenomena found in all cultural groups: communication, personal space, time, social organization, environmental control, and biological variations as the. Communication includes the expression of feelings, body contact, and humor; personal space incorporates comfort levels related to the area surrounding a person’s body; and time includes both social time—the arrangement of social activities— and time that represents past, present, and future with an emphasis on one being more dominant. Social organization includes family structure, one’s relationship in the world, and environmental control centers on different perceptions on the ability to control. Locus of control can help provide insight on how one views the environment and whether he or she can influence events and outcomes based on personal decisions and actions. Lastly, the culture phenomenon of biological variations includes characteristics such as body size, hair texture, and variations in facial features and skin color. Cultural humility acknowledges and seeks to understand differences.

Reflection

Think about the culture