Family Centered Care At The Hospital

From a pediatric perspective, the family is an integral part of the healthcare team. Parents are the primary ally and resource in providing individualized care for their child. Even in adult patients, who they are is impacted by the relationships that they have. Serious or chronic illnesses and injuries affect the entire family. The family, then, becomes the patient, particularly when it is necessary to make lifestyle changes.

Including the client as an expert member of the team creates an enhanced quality of care (Coad, Patel & Murray, 2014). In pediatrics, parents are often at the center of the child’s care. When asked to define what made the client care experience positive, parents stated that sensitivity, empathy and honesty were key factors (Coad, Patel & Murray, 2014). Working in healthcare, nurses can become desensitized to difficult experiences because they deal with them daily. Integrating the client and family as part of the healthcare team, allows the nurse to see the patient and family as a people first. By avoiding using illness as context, and instead using person as context, care will be more holistic (Coad, Patel & Murray, 2014). A family-focused approach helps to ensure that the whole family feels a part of the experience and is valued. In the case of bereavement, family centered care is particularly important. If the family is not included in the care from the start, it can provide barriers for grieving and impact how the family deals with loss (Jones, Contro & Koch, 2014). Nurses have an opportunity to help support the family through the grief process (Jones, Contro & Koch, 2014). Families have a significant impact on how the client heals, so by caring for the family’s needs, the nurse is indirectly caring for the patient. It is in the client’s best interest for the care to be holistic for the patient as well as the family (Jones, Contro & Koch, 2014). All

The article goes on to address the importance of specifically designing practices related to family centered care in the pediatric setting. Four recommendations are set forth in this guideline: family visitation, family centered rounds, family presence during CPR and invasive procedures, and family conferences. Recurrent themes in these areas are listening to and respect the family. communication of information and answering questions, education, and collaboration in developing treatment. While most of the information in this article is focused on the parents and ill child, many of the suggestions are applicable and adaptable to siblings (Meert, Clark, & Eggly, 2013).

Communication is key to effective healthcare practices. According to American Journal Of Critical Care (2014), Patient-centered care starts with “effective communication, being empathetic and available, avoiding personal prejudges, and listening therapeutically are integral parts of patient-centered care” (Riley, White, Graham, Alexandrov, 2014, p. 320). This will improve communication; promote patient involvement in care, which creates a positive relationship with the healthcare provider and medical team. This results in improved adherence to treatment plan. Clinical practice guidelines need to be implemented for the patient and family members to be able to be involved in informed decision-making regarding healthcare needs. The fundamental core of nursing is to have a partnership with the patient and their family regarding the patient’s outcome.

It can be very frustrating at times dealing with the family members of the older patient that I see in the emergency room. I have such limited time to take care of everyone’s needs before the next patient comes in by ambulance that I often forget how the family feels seeing their parent on an emergency room cart in pain and confused. My definition of the comfort I can provide in the emergency room are often very different from the family’s expectations. According to Gerontological Nursing (Tabloski, 2014), the attending nurse needs to understand the patient and family’s goals, wishes and values to attend to their

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

First of all, I recognized that I was dealing with humans, and not just dealing with a disease process and application of the nursing process in the aspect of restoring patient health. I was dealing with emotions, and families, and cultural beliefs that influenced individual’s aspects of care. I started to see that health did not just incorporate healing the disease, but also recognized the importance of making sure patient’s felt that their

1) I will observe how my preceptor and other nurses on the unit demonstrate patient and family centred care, and I will do a literature review on the importance of providing family centered care in nursing practice when working with paediatric patients (Harrison, 2010), (Kuo et al., 2011). (Roberts, Fenton & Barnard, 2015).

-A succinct philosophy of family nursing is seen in The Association for the Care of Children’s Health standards stating the expectation for healthcare providers to facilitate family/professional collaboration at all levels of care, and to recognizing family as the constant in the patient’s life whereas the healthcare providers will fluctuate (p.40, 2003).

The major stressors of hospitalized children include fear of the unknown and unfamiliar people. Lying to children about upsetting realities, such as their diagnosis or a procedure that is occurring, is ineffective and does not help children deal with stress. Educating children on their treatment better prepares them for stressful situations while hospitalized. While nurses identify crying as a sign of stress, child life specialist recognize crying as an effective coping mechanism for stress (Kaddoura). While both nurses and child life specialists are helpful to treating a child, child life specialists focus on children’s emotions while nurses focus on medical care. The issue here is that not all hospitals have child life specialists, so the emotions of children are disregarded. Although medical care is obviously a priority while a child is hospitalized, a child’s emotion and stress are very important to their recovery and health. Research shows that focusing on children’s emotions with the use of child life specialists makes a difference for children and families. Child life programs have been shown to reduce children’s pain, decrease the emotional distress children feel while in the hospital, and lower parents’ anxiety about their children’s hospital stays

When creating care plans for children it is so important to include the child’s family in their care as it will benefit in this case both James and his family in helping to meet his milestonesIt is especially important when creating care plans for children to include where possible the philosophy of children’s and young person’s nursing which is family centred care. (Glasper and McEwing, 2010). Family centred care does not mean that parents have to remain with their child at all-times in hospital.it Care planning is all about prioritising what is best for the patient and putting the patient first (in this scenario James) but also incorporating family centred care in the patients plan. As discussed in care plan 3, we saw how James experienced anxiety as a result of hospitalisation for the first time and how his mother also suffered from anxiety as a result of not being able to stay with James all the time. In spite of this, James’ individualised care plan alleviated this problem by assigning him a nurse that he built a trusting relationship with and by creating a home environment for him by bringing in some family photos and comforts like his blanket and favourite toys.

When a family member is interfering with a crisis the nurse can ask them politely to leave and try not to escalate the situation. If the family member does not listen then security will have to be called and the family member will have to be removed.

“Family-centered care” is a term heard often in healthcare settings and in nursing practice. Family-centered care has been recognized as being an integral part to patient health, satisfaction and health care quality (Kuo, et al, 2012). Family-centered care is implemented with the goal to increase partnerships between, families, patients and providers; and has been prioritized as a core-concept of quality healthcare (Gallo, Hill, Hoagwood & Olin, 2016) Many professionals, however, would be hard-pressed to state what the term “family-centered care” actually means and how it applies to nursing practice. They would be at a loss for how to implement family-centered care and what is absolutely necessary to have in order for family-centered care to be successful. Advanced practice nurses are faced with the challenge of adhering to family-centered care in their practice. Illness, both chronic and acute, and health does not just affect the patient involved in care. Illness and health affect the patient, their children, their spouses, their parents, their brothers, their sisters, their grandparents and anyone else involved in their life. Research by Davidson (2009) supports the idea that the perceived effectiveness of communication between healthcare providers and the patient’s family is related to the overall satisfaction of care. Advance

Several of the roles which I observed this morning were expected: the nurses took vitals for incoming patients, performed focused assessments, and were the main communicators between family, the patient, and the physician. I realized when the first patient came in around 10:00 am, the RN’s role in assessments, gathering blood work, and carrying out all the necessary steps to situate and stabilize the patient as soon as possible. It was incredible seeing the nurses work together, in sync, in those first moments when the patient was brought in. And though expected, I appreciated seeing just how much communication was held and information was gathered from the patient or family members by the nurse. Jessica asked the right questions from both parties, while still showing incredible empathy and not making the whole situation seem rushed and flustering. I understood this as another essential role of the nurse in the ED; he or she must maintain even in such a fast-paced environment empathy and focus in each interaction.

During a patient stay in the hospital the most important care given is to encourage family centered care. Last year, my younger sister had reoccurring strep throat. Which lead to her decision to get her tonsils removed. My sister is terrified of needles and the idea of a hospital makes her jump out of her skin; she can be a horrible patient. While being admitted the nurse was very kind and patient. Her nurse needed to get an IV into her arm; while doing this the nurse explained everything that she needed to do and even distracted my sister by creating conversation with her. The nurse also noticed how nervous she was and gave her a lilac smelling stick. At the time the hospital was conducting an experiment to see if the stick decreased nerves before an operation. While we waited we tried keeping her mind off the operation to help her nerves stay low. After a little while, we were moved into the operating rooms waiting room. In the waiting room we meet the operating room nurse, the anesthesiologist and the doctor. They came out to talk to us before the surgery. They explained what was going to happen and this relieved some of the anxiety my sister was feeling as well as my Mom and I. Since my sister was on the older side of getting her tonsils out, the operating room nurse; who also had her tonsils removed at an older age, shared her experience and told my sister it was the best thing she has ever done. When she said this, my sister was automatically less nervous and