Fundamentals of Nursing and Midwifery 2e

Unit III Thoughtful practice and the process of care

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this phase of the process, you will continue to collect data and to modify the plan of care as needed (Figure 18-1). All activities are documented in the format used by the healthcare facility. IMPLEMENTING PERSON-CENTRED CARE When applying a person-centred approach to implementing planned healthcare you must include the person and family

in all aspects of the process. Feedback from the person is essential to ensure that the identified health problems are being addressed through the delivery of the planned care. The person should be encouraged to be part of the decision- making process relating to their care. You cannot reliably identify a person’s health problems and plan and implement care without their input. In all interactions with the person, the nurse or midwife is concerned with the person’s response to health and illness and their ability to meet basic human needs. Whereas other health- care professionals focus on selected aspects of the person’s

TABLE 18-1 Relationships, role responsibilities and related competencies

Relationship

Role responsibilities

Related competencies

Repertoire of therapeutic interpersonal behaviours— attending, listening, interview- ing, non-verbal communication, touching, facilitating, coaching Ability to establish trusting relationships Demonstrated competence in the roles of carer, teacher, counsellor, advocate

Nurse/midwife– person

Communicate your concern for the person (as well as the disease) and your interest in how this change in health state will affect the person’s overall well-being. Create an environment in which the person can commit their energies to health promotion or restoration or peaceful dying, confident that basic human needs are being addressed. Encourage the person to develop self-care abilities that promote holistic health. Develop in the person and family, the knowledge, attitude and skills that will enable them to respond to the self-care challenge of the health or illness state. Intervene as appropriate to promote healthy functioning. Educate the family or others to be wise and assertive healthcare consumers. Support one another’s efforts to deliver quality care; work collaboratively with administration to improve quality care. Provide creative leadership—formally or informally—to make the unit a satisfying and challenging place to work. Supervise the care given by other personnel; affirm the strengths of others, and constructively address the deficiencies encountered. Enhance the professional development of self and others through active participation in professional organisations.

Nurse/midwife– person–family or significant others

Communication Teaching/counselling/advocacy

Nurse/midwife– nurse/midwife

Assertiveness Collaboration Coordination Group process Organisation

Leadership Delegation Change strategies Problem solving Decision making Conflict resolution

Nurse/midwife– healthcare team

Communicate clearly nursing/midwifery’s perspective regarding the person and family with the healthcare team. Coordinate the inputs of the interdisciplinary team into a comprehensive plan of care. Serve as a liaison between the person and family and the healthcare team, as necessary.

Nurse/midwife– community agencies

Communicate with community agencies as required.