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Within Nursing in general and Mental Health Nursing specifically the phrase \u2018person centered nursing\u2019 is often used, the concept essentially involves collaboratively understanding and working with \u2018the whole person\u2019, putting the individual at the centre of their own assessment and treatment.\u00a0 Person centered care involves the treatment of the person as an individual rather than as a \u2018medical diagnosis\u2019 or \u2018procedure\u2019, and seeing the situation from their perspective regarding their interests, concerns and wishes (Chapman, 2017).\u00a0 Of course, the origins of this stem from Rogers (1951) and humanistic psychotherapy, this means for the nurse that they are not the \u2018giver\u2019 of care and the patient is not the \u2018passive receiver\u2019 of care, rather there is a partnership one built on collaborative empiricism.\u00a0 This approach is strengths based and promotes self-esteem and self-efficacy (Chapman, 2017).\u00a0<\/p>\n\n\n\n
Can we honestly say this approach is truly possible within modern nursing when we consider the use of the traditional medical diagnosis, does the \u2018person\u2019 become lost within this process and if so what then of person centeredness?\u00a0 If the nurse becomes too focused upon the diagnosis or the procedure they are in danger of losing the patient, losing sight of the patient\u2019s problems, their needs, their strengths, their goals, in other words the diagnosis or procedure becomes the centre of care not the patient.\u00a0 This if true denies the patient their sense of control and power and in turn damages their sense of agency, their self-worth and self-esteem.\u00a0 Of course this can become further complicated when we as the nurse bring our own unconscious bias into the relationship or are ignorant of issues such as race, culture, religion, gender identity or sexual identity.\u00a0 It is important that we continue to reflect on our own practice and ensure that we always put the person, the whole person, at the heart of care.\u00a0 Person centred care is then only truly possible if we move from a medical model approach to one which focuses on the relevant social, economic and cultural context for the patient (Johnston et al 2018).\u00a0 The overriding issues should be centered around the physical, spiritual, psychological, emotional and spiritual aspects of the patient to help create in collaboration with the patient a problem focused, shared understanding of their problem rather than on a specific diagnosis.\u00a0 This approach is based on the idea that the beliefs and the values of the patient and indeed different cultural groups need to be understood.\u00a0 This understanding will help the service and the nurse to arrive at an understanding, which reflects the distinct ways in which individuals and differing cultures understand their health problems.\u00a0 <\/p>\n\n\n\n
How can a nurse arrive at a position that allows cultural sensitivity and true person centered care? Firstly an acknowledgement that an unconscious bias exists and secondly the use of self-reflection and good regular personal and clinical supervision will help to identify and ameliorate any such difficulties.\u00a0 In addition, the nurse needs to decide whether or not to use a cultural adaptive model (CAM) or a culturally sensitive model (CSM) in all their interactions.\u00a0 The CAM approach incorporates into practice elements of a groups (or individuals) distinct culture, works to understand how their culture understands and expresses their mental health problems.\u00a0 A CSM approach takes the view that the evidence base for the interventions we use translates across all cultures and we need only make adaptions not wholesale but rather on a patient-by-patient bases.\u00a0 Regardless of the model we choose in order for them to be meaningful we need to have the insight to know when we are working in a non-inclusive way, we can see this via patient engagement and patient outcome but self-reflection and good clinical supervision are essential.\u00a0 If we are serious about person centeredness then we should acknowledge that we often allow bias to enter our decision making process as it is only through this vulnerability can we identify problems and take corrective action.<\/p>\n\n\n\n
Colin Hughes and Dr Barry Quinn.<\/p>\n","protected":false},"excerpt":{"rendered":"
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