Patient Centered Care Page 1

Patient Centered Care

Paramedic to RN Transition Course

Sharidan Mattson

Utah Tech University

Patient centered care is a multidimensional concept that involves each patient in the

decision making of their own care. There is no universally agreed upon definition of patient

centered care, however, it may be defined as “care that is respectful of and responsive to

individual patient preferences, needs, and values, and ensuring the patient values guide all

clinical decisions.” This concept has increased patient outcomes and satisfaction including

patient willingness to comply to the regimens involving their health care. There are eight

dimensions that patient centered care is based around. The dimensions include Respect for

values, preferences, and expressed needs, Coordination and integration of care, Information and

education, Physical comfort, Emotional support/alleviate fear and anxiety, Involvement of family

and friends, Continuity and transportation, and Access to care. Along with these dimensions,

there are other important factors to include in patient care involving empathy, communication,

cultural sensitivity, patience, and privacy.

Working along side the nurses at the St. George Regional Medical Center, I have been

able to witness and help integrate some of the listed eight dimensions of patient centered care to

several patients. Out of all the patient encounters I have had, there are a couple patients whose

care has stood out to me. One of the patients was a fifty-two-year-old male in the behavioral

medicine unit, and the other one was a seventy-four-year-old female in the west one med-surg

wing. The male patient was admitted for depression, opioid abuse, and suicidal ideation, whereas

the female patient was admitted for aspiration pneumonia along with other respiratory and aging

issues.

When I had my encounter with the male patient, he had already been admitted for three

days, and that day was the day he got to go home. By observation of this patient, he looked
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malnourished, he had difficulty walking and using his arms and legs due to chronic pain and

arthritis, he had an animated affect but seemed to be very sad, and he was very kind and had no

issues with talking and listening to the nurse and I. This patient could barely use his hands and he

had difficulty even getting dressed and shaving his face independently. The nurse I was being

precepted by had been this patient’s nurse several times prior to our shift, so they had a good

rapport. One of the big things that was integrated in his care was involving his family in it. The

patient relies a lot on his wife and his son to help him at home due to his mobility difficulties.

The nurse called the patients wife when we were getting ready to discharge him and let her listen

to all the instructions and things this patient should and can be doing to benefit their health and

wellbeing. Because this patient was prescribed opioids for his pain, and has history of opioid

abuse, the nurse educated this patient on the appropriate times to be using the medication, how to

use the prescribed naloxone if needed, and he taught the patient and his wife signs of an

overdose. The nurse included the suicidal hot line numbers and emphasized that there are people

and ways to help those who feel suicidal and how helpful it can be to just talk to someone. These

educational points that were included are very important for this patients situation. Before the

patient was about to leave, the nurse helped him button up his shirt, shave his face, and told him

that he is very cared for and that we all wish him well. In return the patient started to cry and

shook the nurses hand and thanked him for all his help. These points are great examples of

respect for expressed needs and emotional support. Along with those aspects of the eight

dimensions, the nurse included information and education, and family involvement.

The other patient whose care stood out to me was the seventy-four-year-old female. This

patient was admitted for aspirated pneumonia affecting both of her lungs. She had a gastrostomy

tube placed for all nutrient and oral medication administration, and several IV medications
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ordered. This patient also had some difficulty speaking due to a history of surgery on her vocal

cords. She could not tolerate the prescribed nutrients ordered, so the nurse had to slow down the

infusion rate to which it could be tolerated and give her antiemetic medications and an emesis

bag because she vomited several times throughout administration of medications through her

gastric tube. The nurse also have her the suction catheter to suction her mouth every time she

would cough up mucus, and we changed this patients bedding when she was taken to get imagine

done. All of these things are examples of providing physical comfort for this patient. The

dimension of Physical comfort can make a big difference for a patient because their health status

may be restricting them from being able to help themselves in this aspect. This patient had a

DNR/DNI. The nurse who handed this patient off to us emphasized that when giving report, and

this shows respect for patient preference. Another dimension that I observed being done was

alleviation of fear and anxiety. This patient had a very hard time breathing, especially when they

would start to cough up mucus, and at one point stated “don’t leave me alone for too long”. My

nurse made sure to tell the patient that she can press her a call light at any time for any reason

and told her that he would just be right outside if she needs anything. By doing this it helped the

patient feel a little more at ease knowing she could rely on us.

Reflecting back on the dimensions of patient centered care and observing them being

integrated in real time has taught me so much about what it actually means and how it actually

helps. I have realized a lot more from working in the hospital, that these patients are really

relying on you to make a difference. They do not want to be in the hospital, and they are tired of

being sick. When I am a nurse, I want to implement all eight dimensions of care for my patients

to not only benefit their health status, but to also let them be able to put trust into me with their

life. I think that making sure my patients know they can trust me can make things go smoothly
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and it can possibly make them feel better mentally and somewhat physically. I plan to

incorporate as many of the dimensions as possible for each patient that I have. For example, I

will always have respect for my patient wants and needs, because it is their life not mine. I will

always inform them about their status and what medications they need and how they work. I will

involve their family as long as they are okay with it. Most importantly, I will always give my

patients a choice, whether that be to take a medication or a choice in what interventions should

be done. Though nurses have more medical knowledge than most patients and know what may

help them, the decisions being made for their care should always be their choice.

In summary, the idea around Patient Centered Care is a very important aspect for each

health professional to integrate. Patient centered care is a model of care that respects the patient’s

values, needs, choices, and preferences in the planning process and implementation of his or her

care. It has been shown to improve patient outcomes and satisfaction, and I have personally seen

it do so with certain patient encounters I have experienced. I think this model is very important

and should be used more often in every hospital when it comes to patients having a voice in their

own care and benefiting their health status.

References

Araki, M. (n.d.). Patient Centered Care and Professional Nursing Practices. Journal of
Biomedical Research and Clinical Investigation. https://doi.org/10.31546/jbrci