The person-centered nursing framework can be described as a model whose main objective is to focus on the individual needs within the healthcare environment. According to McCance, McCormack, & Dewing (2011), the model was derived from previous empirical research that focused on person-centered practice with older people, as well as the experience of caring in nursing practice. The framework comprises of four main aspects, which include; prerequisites (attributes of the nurses), the care environment, person-centered processes, and outcomes. The objective of this working paper is to illuminate on how the model addresses the four concepts within the nursing meta-paradigm, how it qualifies as a theoretical framework within the nursing profession and how a family nurse practitioner can apply it.
Firstly, the model places the person at the center of the healthcare system. The ‘person’ refers to both the healthcare provider and the patient. Most prominently, the model was inspired by humanistic psychology, which emphasizes on the individualized qualities of optimal wellbeing (Bland, & DeRobertis, 2017). Starting with the nurse, knowing oneself is a very important aspect of the model. That implies recognizing one’s strengths and weaknesses and trying to strike a balance to foster quality healthcare. Secondly, the nurse must be competent; he or she needs to have the requisite knowledge and skills to perform their duties. Besides, the nurses need to demonstrate commitment to their jobs. Therefore, the personal attributes of the nurse are very important qualities in the healthcare process.
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Secondly, the framework perceives health or the wellbeing of individuals to be a combination of various factors. The nurses’ empathy and demonstration of care towards patients are very crucial towards the attainment of positive health outcomes. Chochinov (2014), in his article titled “Health care, health caring, and the culture of medicine” states that “Health caring insists that attending to the needs of the patient goes hand-in-hand with sensitivity to the feelings of the person”. Chochinov provides an example of a scenario where an oncologist used a felt pen to mark the treatment fields of a breast cancer patient. The oncologist did not bother to explain to the patient why he was using a felt pen or how the whole process would be. Consequently, the patient felt like ‘a slab of meat’ and later considered withdrawing from the treatment altogether. Chochinov posits that healthcare providers, especially nurses, need to be aware of the feelings of their patients. Patients need to be involved in the treatment process. Seemingly benign actions such as nodding while a patient talks or smiling could go a long way into enhancing their wellbeing.
The model recognizes nursing as an important field in the healthcare sector. To a large extent, the framework focuses on nurses. The most prominent reason is that nurses spend considerable amounts of time with patients compared to other professionals within the healthcare environment (Frisch, 2001). Secondly, the framework portrays nursing as a field, which relies on empirical research and evidence-based practice. Therefore, nursing is accurately depicted as a field that is central in the administration of quality healthcare. For instance, the ‘outcomes’ construct of the model focuses on the patients’ satisfaction with care and the nurses mostly play a major role in recording the feedback from the patients. Therefore, nurses are not only involved in providing care but they also keep records and collect feedback, which can be used to improve care of patients.
The environment also forms a vital component in healthcare according to the PCN framework. The environment comprises of supportive organizational systems, effective staff relationships, potential for innovation and risk, the physical environment, shared decision making systems and appropriate skill mix (McCance, McCormack, & Dewing, 2011). Evidently, the framework suggests that quality healthcare is intricately linked to the positive physical and work environment. That also implies that leadership within healthcare can determine the healthcare outcomes. Good leadership promotes quality healthcare and vice versa. The physical environment needs to promote the safety and health of healthcare workers. Secondly, the leaders need to be approachable and not too authoritative or demanding as such qualities could have devastating effects on the mental and psychological wellbeing of the healthcare professionals. The most desirable leadership style that would support the model is democratic or motivational type. The healthcare professionals ought to be given freedom and a chance to be creative, risk and advance. Secondly, the model emphasizes on the need for positive relationships among the various professionals within the healthcare sector. Such interaction is desirable for support. It fosters knowledge sharing, which is very crucial within the healthcare environment. For instance, junior employees are always relatively inexperienced and they could face different challenges while working. Nevertheless, with supportive colleagues who are also approachable, they can find solutions to their challenges quickly and adapt to their work environment with ease.
Regarding the qualification of the framework within the profession of nursing, the framework has gone through a dynamic process. Bousso, Poles, & Cruz (2014) states that, “the theory framework of nursing science is built in a dynamic process that arises from practice and is reproduced through research, mainly by analysis and development of concepts and theories”. This statement is consistent with scientific knowledge which arises from common sense to critical evaluation and analysis. The PCN arose from a concept, which was observed in various healthcare practices, and is still being tested. For instance, McCormack (2003) proposed the framework after observing care of older people. Therefore, the framework was created after an idea or concept was supported by evidence from observation of care of patients, especially by nurses. The framework has gained a lot of prominence within the practice of nursing. In the past, most nurses only focused on performing routine procedures such, dressing patient’s wounds, or making sure the patients to which they were assigned adhered to the correct dosage. On the contrary, most nurses currently demonstrate empathy towards patients, talk to them and ask them about their experiences and feelings. While interacting with the patients, they collect feedback, which is shared with their colleagues and senior staff members. Secondly, leaders within the healthcare sector are using the framework to foster positive work environment as well as to make nurses aware of patient’s needs in an attempt to improve healthcare delivery.
In conclusion, the PCN can provide positive results when used by family nurse practitioners. Firstly, it is important to evaluate individuals’ strengths and weaknesses and devise strategies to address the weaknesses. That also means evaluating personal beliefs to identify any bias and try to adjust the biases. A family nurse will mostly work with families to address their health needs, which may be physical or emotional. In that light, a family nurse practitioner is likely to encounter families of various racial, ethnic and cultural backgrounds. Therefore, apart from having the requisite knowledge and skills, a family nurse practitioner needs to acquire dynamic skills to work with diverse groups of people. Besides, different families have different needs; one intervention strategy may not apply to all families. That means a family nurse practitioner has to be creative and at times risk to offer the best care to patients. Therefore, dealing with families will almost certainly be an emotional affair and most of the clients or patients may have different cultural backgrounds, a situation that makes the PCN model very crucial in the practice.
References
Bland, A. M., & DeRobertis, E. M. (2017). Maslow’s unacknowledged contributions to developmental psychology. Journal of Humanistic Psychology , 0022167817739732.
Bousso, R. S., Poles, K., & Cruz, D. D. A. L. M. (2014). Nursing concepts and theories. Revista da Escola de Enfermagem da USP , 48 (1), 141-145.
Chochinov, H. M. (2014). Health care, health caring, and the culture of medicine. Current Oncology , 21 (5), e668.
Frisch, N. (2001). Standards for holistic nursing practice: A way to think about our care that includes complementary and alternative modalities. Online Journal of Issues in Nursing , 6 (2), 4.
McCance, T., McCormack, B., & Dewing, J. (2011). An exploration of person-centredness in practice. http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No2-May-2011/Person-Centredness-in-Practice.aspx
McCormack, B. (2003). A conceptual framework for person-centred practice with older people. International Journal of Nursing Practice, 9 (3), 202-209.
