Understanding Person-Centred Care for Nursing Associates

Myles Harris

• Editorial: Learning Matters
• Año: 2021
• ISBN:
  9781529737141
• Edición: 1
• Categoría: Medicina
• Categoría: Infermieristica

Understanding how to deliver effective, person-centred care is vital for a future career as a Nursing Associate. In this book, trainee nursing associates are introduced to the principles of person-centred care, with case studies from a variety of healthcare settings and guidance on caring for different patient groups, from acute care to long-term and palliative care. This allows TNAs to see how the theory can be directly applied to their daily practice, regardless of where they work. The book also covers key issues in relation to providing care, such as inclusivity, ethics, legal issues, and health inequalities. Key features:

• Fully mapped to the new NMC standards of proficiency for nursing associates (2018)
• Case studies, activities and other learning features help TNAs understand the theory and apply it to practice
• Designed around a Nursing Associate course, this book demonstrates how person-centred care feeds into each core module.

ABOUT THE SERIES: The Understanding Nursing Associate Practice series (UNAP) is a new collection of books uniquely designed to support trainee Nursing Associates throughout their training and into a professional career.

Chapter 1 Providing person-centred care

NMC Standards of Proficiency for Nursing Associates

This chapter will address the following platforms and proficiencies:

Platform 1: Being an accountable professional

At the point of registration, the nursing associate will be able to:

• 1.1 understand and act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and Nursing Associates, and fulfil all registration requirements
• 1.8 understand and explain the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care
• 1.9 communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges
• 1.10 demonstrate the skills and abilities required to develop, manage and maintain appropriate relationships with people, their families, carers and colleagues
• 1.11 provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times. Reflect on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments

Chapter aims

After reading this chapter, you will be able to:

• identify the predominant milestones in the NHS’s history, as well as describing how they have shaped the modern NHS and the formation of the nursing associate profession;
• list the members of the multidisciplinary team (MDT) and explain the role of a nursing associate in relation to person-centred care and the wider MDT;
• define and understand the core principles of person-centred care in relation to your role as a nursing associate;
• use a variety of tools to have a sense of self-awareness, as well as the impact that your personal characteristics have on patient care.

Introduction

Nursing associates are the newest profession to join the Nursing and Midwifery Council (NMC) register. Many healthcare practitioners and members of the public may not yet have an in-depth understanding of what nursing associates are and what they can do. Imagine someone asks, ‘You’re a nursing associate? What’s that?’ This question could have a very simple answer; however, as you begin to explain that a nursing associate is someone who cares for patients, I am sure you will agree that there is more to your story.

In this chapter, we are going to discuss the heritage of the NHS and learn how this has led to the formation of the nursing associate profession. Having an awareness of your professional history will enable you to confidently discuss with colleagues, patients and the public what it means to be a nursing associate. Moreover, it will consolidate your understanding of your role in providing person-centred care.

Person-centred care is a broad subject, hence the diverse content of this book. A good starting point is to understand the core principles of person-centred care and how this improves the quality of care for patients. During this chapter, you will gain an insight into these principles and learn how to apply them in your practice. However, every practitioner is different. Diversity in the health and social care workforce is a representation of the patients we care for – no two people are the same. Your life experience and background make you a unique practitioner. Of course, we strive for standardised, high-quality person-centred care across the NHS; however, having a higher level of self-awareness will improve your understanding of how you, as an individual, have a positive impact on providing person-centred care. This is what you will uncover by the end of this chapter.

A brief history of the NHS

The NHS was originally established to provide healthcare that was free at the point of delivery (NHS, 2018a). The idea was that if people maintained good health, their reliance on acute services would be minimal. In other words, people would only need to use secondary healthcare services (such as hospitals) when they were severely unwell. The NHS was the first organisation in the world to provide such a service with zero cost at the point of delivery. Since its establishment on 5 July 1948, however, the NHS has undergone several changes and the patient population it serves is very different. Table 1.1 is a timeline of significant events that have happened in the history of the NHS.

Table 1.1

Source: BHF (2018)

Now that you have read about some significant events that have happened in the history of the NHS, complete Activity 1.1, which will help you to explain and understand how the history of the NHS has shaped the nursing associate profession in the present day.

Activity 1.1 Critical thinking

Think about how the significant events in each decade of the NHS timeline in Table 1.1 affected patient care. Make a list of each decade and identify the connections between events in each decade and the NMC Standards of Proficiency for Nursing Associates.

An outline answer is provided at the end of the chapter.

The modern NHS

In the present day, the NHS is one of the largest employers in the world, not to mention the largest and oldest healthcare service. The management system is complex, which reflects the scale of the NHS at large. Table 1.2 outlines different micro-organisations that contribute to maintaining the standards of the NHS, outlined in the NHS Constitution (NHS England, 2015b).

Table 1.2

Source: DHSC (2018)

As a nursing associate, it is important for you to have an understanding of the micro-organisations that manage the NHS because the decisions they make directly affect your clinical practice. Complete Activity 1.2 to consolidate your understanding.

Activity 1.2 Reflection

Rearrange the list in Table 1.2 into a thought cloud, starting with the NHS in the middle. Link all the different micro-organisations together to illustrate how the NHS management system is structured.

As this activity is based on your own reflection, there is no outline answer provided at the end of the chapter.

After completing Activity 1.2, you will have a clearer picture of how the NHS is managed. Your thought cloud may look complex, but this is a true representation of the systems in place that ensure the NHS meets the standards described in the NHS Constitution (DHSC, 2015). At this point, you have learned about the NHS’s past and present, but what about the future?

What is next?

Across England, there are trials of new systems of health and social care services, called vanguard sites. Vanguard sites aim to encourage organisations to work more closely together, including the collaboration of physical and mental healthcare needs, in sustainability and transformation partnerships (STPs). STPs are groups of organisations that work together to achieve the objective of vanguard sites; there are 44 in England. STPs aim to transition into integrated care systems (ICSs). ICSs work together with a joined budget to coordinate care and improve services for people who live in a particular community. In short, ICSs aim to manage the limited resources of the NHS more efficiently and provide continuity of care across their organisations’ services. This involves working with other bodies, such as local authorities, social care services and public health organisations, in order to drive up standards of service.

What does all of this change mean for patients? Some services in the NHS are moving closer to patients to provide the care they need where most people would choose to be – at home. There is a substantial increase in support to improve and maintain good health, thus reducing the intense pressure on hospital services (King’s Fund, 2017). There are, however, some points for consideration. Regional health specialist services will become more common, which means that patients may need to travel further for specialised care. Moreover, the NHS will need to continue to change over the next few decades. Although more change may seem arduous, change is very much needed in the NHS because our patients continue to change. As a nation, we are living longer, with more complex care needs, so NHS services need to be able to meet new patient needs. Make sure you keep up to date with how the NHS is managed and the services that it provides throughout your career, as this will have an impact on your future as a nursing associate. See Chapter 8 for advice on how to keep your practice up to date and current.

The multidisciplinary team

The NHS is clearly complex, but where do nursing associates fit in this system? A multidisciplinary team (MDT) is a group of health and social care professionals who work together to provide care for patients. You are part of this team and have a unique, important role. Before going into which professionals make up an MDT, we need to discuss what a professional is.

Being a professional is more than doing a good job. As a nursing associate, you are a health and social care professional, but what does this actually mean? There are many attributes of a health and social care professional that are important for you to understand. Professionals’ behaviour is of a consistently high standard, even when not at work. Being a professional is also about being in a professional community: we have common values and morals, we always strive to do our very best in everything we do, and we always continue to learn and adapt our practice. All of this is done in the best interests of the patients we care for. Table 1.3 lists important key documents that guide you in being a professional, with a short explanation of how they do this.

Table 1.3

It can sometimes be hard to understand how overarching policy documents such as these relate directly to your practice as a nursing associate. To help you understand this, read through the following box, which breaks down each document and explains how it is relevant to your daily practice.

Understanding the theory: key documents

The Code (NMC, 2018b)

This document is fundamental to your practice, and you are encouraged to know it in depth. There are four sections that guide your clinical practice: ‘Prioritise people’, ‘Practise effectively’, ‘Preserve safety’, and ‘Promote professionalism and trust’. Another important document closely linked to The Code is the Standards of Proficiency for Nursing Associates (NMC, 2018a). Take the time to read this too because it outlines your scope of practice.

Leading Change, Adding Value (NHS England, 2016)

The ‘Leading change’ section is grouped into three topics: ‘Health and wellbeing’, ‘Care and quality’, and ‘Funding and efficiency’. As a nursing associate, you can positively contribute to all of these. First, it is part of your scope of practice to promote health and wellbeing for patients in your care. Second, you use evidence-based practice to provide person-centred care (see later in this chapter). Lastly, by using resources effectively and efficiently, you will reduce the expenditure of the area you work in, and by extension the NHS. By doing these three things, you will reduce unwarranted variation, which minimises the things we do not want to happen (people becoming more ill and then receiving poor standards of care, which costs a lot of money). The ‘Adding value’ section explains how you can achieve better outcomes, better experiences and a better use of resources for patients by consistently demonstrating the 6Cs: care, compassion, competence, communication, courage and commitment.

The NHS Constitution (DHSC, 2015)

The foremost message is that the NHS belongs to the British public. Both patients and practitioners have a vested interest, and this document explains this. The guiding principles of the NHS are outlined, as well as the NHS’s values. The rights of patients and the pledges the NHS has made are also defined in the NHS Constitution. Without NHS staff, there would be no service, so staff rights and responsibilities are also included.

A good way to assess your own practice and check that you are maintaining the standards of the health and social care profession is to ask yourself throughout your day, ‘If this was being filmed, would I edit the film before showing it to my manager?’ If your answer is ‘no’, you can be confident that you are acting with professional integrity.

Now that you have an understanding of what it means to be a professional, let us look at an MDT in more detail. Any MDT will meet to plan the necessary care for a patient they are all caring for. If possible, it is recommended that the patient attends this meeting too because, after all, they are why the MDT is meeting. Table 1.4 lists the professionals who may be involved in an MDT. This will depend on ...

Índice

• Cover
• Half Title
• Publisher Note
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• About the Author
• Acknowledgements
• Introduction
• Chapter 1 Providing person-centred care
• Chapter 2 Acute and long-term care
• Chapter 3 Healthcare ethics and law
• Chapter 4 Palliative and end of life care
• Chapter 5 Inclusivity in person-centred care
• Chapter 6 Public health
• Chapter 7 Health promotion and practice education
• Chapter 8 Your future in person-centred care
• Glossary
• References
• Index