Imagine one of your family members is admitted to the hospital. You’d want to be there to “help” and to let the staff know you’re a nurse. Also, this would serve as a unique opportunity for you to help craft the role of family member as care partner.
One of the Joint Commission’s 2007 patient safety goals emphasizes active involvement of the patient and family in the patient’s care. Most nurses embrace family members as important to the patient’s care and healing. Family members are familiar with the patient and can lend valuable advice and help—if we listen to and engage them.
At its foundation, patient- and family-centered care promotes mutual respect for partnerships among healthcare providers, patients, and their families. It’s widely recognized as a way to achieve better outcomes and improve patient and family satisfaction. We must all embrace the core concepts of family-centered care, as described by the Institute for Family-Centered Care—dignity and respect, information sharing, participation, and collaboration.
Several years ago, I accompanied an elderly relative to the hospital for elective surgery. When visiting him postoperatively, I found him disoriented to place and time but able to recognize me. His patient-controlled analgesia pump had been turned off, but it would take time for his sensorium to clear. When he was discharged, still confused, to a rehab facility several days later, I was appalled to read the nurse’s discharge note indicating he suffered from dementia. Preoperatively, his cognition had been completely normal. But apparently, no one had evaluated his normal baseline or understood that he remained confused after general anesthesia. Fortunately, his nurse at the rehab facility asked all the right questions and took careful notes to formulate her assessment and plan of care.
Especially for the elderly and our other vulnerable patients, we need to respect family members as a valuable part of the care team. As nurses, we would expect and demand that level of respect. In turn, we should take every opportunity to help colleagues recognize the positive effects of family involvement. Incorporating personalized care respects the patient as an individual and gives the family confidence in your care and caring. It says you listened to the patient and family and valued the information they shared.
Can we accomplish this in today’s hectic healthcare environment? We can’t afford not to. Too often, patient complaints stem from poor communication and unmet expectations.
A few years ago, I responded to a call to speak with a husband who thought his wife wasn’t getting appropriate care. She had a large open abdominal wound held together with retention sutures. He explained he’d been caring for her at home, along with a home care nurse, for more than a month. He’d diligently cleaned and redressed the wound daily, being careful to use products that protected her fragile skin. But in the hospital, for several days in a row he found the wound covered with a leaky dressing that in no way resembled the meticulous care he’d provided at home. Fortunately, the nurse that evening listened to him. She recorded the products and supplies he used at home, drew a picture of the wound and dressing, and obtained the orders needed to replicate his care techniques.
Why hadn’t the other nurses who’d cared for his wife put this same type of plan in motion? Why did several days elapse during which they failed to question the husband and listen to him to ensure he was included in the care of this complex patient?
Family-centered care needs to be part of our culture. Nurses can set the example by reaching out to families and showing respect for them as care partners. Stop to consider how important they are. Look at patients and family members and observe their roles and relationships. Above all, listen to them and ask questions to learn all you can about your patients.
Reexamine the value and philosophy of care at the healthcare organization where you work or seek care. Help colleagues excel in welcoming families as part of the care team. As a caregiver, you have a responsibility to do this—and also a vested interest: When you yourself, or a family member, becomes a patient, you’ll want to receive the same respect.
Pamela F. Cipriano, PhD, RN, FAAN