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Thoughtful practice and
the process of care
THE PERSON
Each person is unique and has his or her own set of beliefs, values, memories, hopes and history. People
are holistic beings with emotional, physical, social and spiritual dimensions and needs that all meld
together to create the whole individual person. The fact that a person has a disease is only one aspect
of the whole in the same way as having red hair is only one aspect of the whole person. Therefore each
person’s health journey and personal care is individual. Clinical care is an interaction between the carer
and the person cared for. Each of the individuals within this relationship is unique and so the respect and
valuing of the individual applies to both. Relationships based on this principle can become therapeutic.
REFLECTIVE PRACTICE LEADING TO PERSONAL LEARNING
Reflective practice occurs when the carer has a profound awareness of self, of his or her own biases,
prejudgements, prejudices and assumptions, and understands how these may affect the therapeutic
relationship. This awareness is developed through the processes of reflection, thinking back on what has
occurred for the purpose of learning in order to improve. Chapter 13 outlines each of the components of
reflective practice, its professional context, strategies for developing the skill, and models for reflection
used in clinical practice.
CLINICAL REASONING, JUDGEMENT AND DECISION MAKING
Clinical reasoning is the process of analysing a situation, making a judgement, deciding on possible
alternative reasons and choosing an action to be taken. It is built on a foundation of knowledge,
experience and the personal attributes of the person doing the reasoning. Thinking is fundamental in the
process of clinical reasoning, and Chapter 14 describes the role of the many types of thinking such as
critical, creative and intuitive thinking. Clinical reasoning is an essential skill for all thoughtful clinicians
because, without the power to reason, care can be ritualistic and depersonalised.
CLINICIAN’S ACTION IN RESPONSE TO INDIVIDUAL CLINICAL NEED
The action that occurs in response to individual need completes the cycle of thoughtful practice when it
is considered, personalised, appropriate, valued and effective. Thoughtful practice requires that all the
components work in synchronicity for the benefit of the individuals within the therapeutic relationship.
PERSON-CENTRED PROCESS OF CARE
The process of care is the term used to describe the way in which care is organised through a series of
actions undertaken in response to the individual needs of the person. The components of the processes
of care are described in Chapters 15 to 19. These components are assessing, identifying health problems,
planning care, implementing care and evaluating care.
U N I T
I I I
