I'm really sorry for the lack of posts!
I've been juggling quite a few things at the minute (but, hey, my aim is to keep this particular blog 'professional' so...)
Today I'm gonna be talking about negotiated care, so here goes...
Negotiated Care
‘The power to heal lies within the patient and not the nurse'
Who are your caring for? What do we call those we care for?
•Service user
•Patient
•Client
•Individuals – nursing is about holistic care
•Customer
•Consumer
Terminology
•Patient – A person receiving or required to receive medical treatment - (concise oxford dictionary, 2010)
•Client – refers to all groups or individuals who have direct or indirect contact with nurses or midwives in professional capacity (used in mental health a lot) – (NMC, 2002)
•Customer – one that buys goods or services
•Consumer – recipient of health care such as a patient in a hospital
•Service user – a person who uses health services
Patient
•Have some form of treatment to improve their own health or wellbeing
•Are expected to co-operate and trust the nurse
•Patients can behave anxious, distress or nervous and tend to have ‘blind faith’ in doctors or nurses. They can become quite passive and may not ask questions as they do not want to make a fuss.
•Department of health, 1996 – patient or carer involvement is essential to help people make informed decisions about their own health care
•NHS plan, 2000 – patients must have more say in their own treatment and more influence over the way the NHS works.
•DH, 2008 – high quality care for all:
•“set new foundation for health services – giving patients more choice and thei healthcare is more personalised and fair”.
•Emphasis is on a partnership between healthcare professional and the patients. Focus is on meeting and exceeding the expectations of patients.
•NHS constitution, 2010: Includes rights to choose both treatment and providers and information on quality so that where relevant patients are able to make informed choices.
High quality care – what does it involve?
•Negotiation
•Patient choice
•Shared decision making
•Active participation in care
•What do we mean by negotiation?
•Working together
•Principles of decision making
For patients to make a decision they must be able to…
•Understand
•Know the risks
•Given enough information to enable them to make the right decision (DH, 2001)
A person is unable to make a decision if they…
•Are unconscious
•Are not active in the decision making process
•Cannot understand the information
•Cannot retain formation
•Cannot communicate the decision
Mental capacity act 2005
•Protect people who cannot make decisions for themselves
•Could have a brain injury, a stroke or a severe learning disability
•A person is presumed to make their own decisions
Children or young people
•16-17 year olds can legally consent to treatment
•Under 16 year olds can consent to treatment is deemed ‘gillick competent’
Children act 1989
•Those with parental responsibility can make decisions for a young person or child
•Children or young people have the right to be involved in decisions, be heard or have their views taken into account
What information do patients need?
•Who you are
•Information about the treatment including the pros and cons and side effects
•After care
•Up to date information
•Nurses to be honest to patients and use limited jargon
•What the treatment involves
•The role of the nurse is to inform and interpret for the patient
Benefits
•Can make quicker decisions
•Feel more in control of decision making
•Prevent further problems and issues in the future
•Confidence
•Helps them to plan their lives
•Makes people feel more respected and valued
Difficulties
•May think we do not have enough knowledge as a student nurse
•May take anger out on HCPs
•Can refuse treatment
•Can be difficult to communicate decisions
•Religious beliefs
Examples of when service users/carer might become active participants in care planning…
•Rehab
•Palliative care
•Support plans
•Medications
•Four levels of involving them in decision making…
•Give information about decision
•Consultation
•Joint decision making
•Giving responsibility for users to decide or act themselves
User involvement
+VE
•Can tell you things you don’t already know
•Aids recovery
•Builds rapor
•Greater sense of control
-VE
•Lack of co-operation
•May not understand or think they are not ill
Empowerment
•“Social process of recognising, promoting and enhancing people abilities to meet their own needs, solve their own problems and mobilise the necessary resources in order to feel in control of their lives.” – Gibson, 1991
•Nurses’ role is to empower and help patients to consider options and consequences in order to make informed decisions. Nurses must allow patients to participate in their own care.
Again, so sorry for the lack of updates. I know i did promise i'd update a lot. It's just a lot is going on for me now. Please bear with me! Keep checking for updates! I love my readers!
'Til next time.
Emily
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