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#NurChat - Promoting choice

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Did you miss the latest #NurChat discussing empowering patients through the promotion of choice? Let us sum it up for you…

Patient care and promoting choice have been hot topics recently, highlighted in particular by Nursing Times’ two part series on ‘Humanising nursing care’, but its underlying principles have been the aim of many healthcare professionals for some time now. This NurChat discussion began by looking at whether we as nurses inadvertently assume choice when delivering care.

@Ramck001 “I think whether we do or not, it is imperative to remind patients that their care is all about them and have them make choices. #NurChat”

@sroo91 “#NurChat we should never assume choice! And whatever choices a patient makes we should always respect them.”

A choice is nothing if it’s not respected and adhered to, and person-centred care should always be the healthcare professionals’ primary approach. Some discussed the patient taking ownership of their care and how that proactive involvement often leads to a more positive outcome than had they not been involved. However, some patients can be of the opinion that the actions and suggestions of their healthcare professionals are always correct, or they may simply be conditioned not to make any fuss when it comes to receiving care:

@Ramck001 “I think it’s also part of a larger problem. In a lot of people it’s practically ingrained that AHP’s are always right. #NurChat”

@hello_harris “Have this particularly with older and long stay patients who seem to have just given up “you know best” “you do whatever” #Nurchat”

It was also highlighted that a patient’s choice doesn’t necessarily have to relate to a choice about a care plan - it can simply be a choice about what to wear or what to eat. Respecting these types of choices is just as important as it can influence a patient’s wellbeing and their trust in the healthcare team.

@Susie8lue “#NurChat just today I saw someone mix together a purée meal, not allowing the patient any option but to eat every type of food”

@TildaMc “Day to day in my work it is little choices like which blouse ect .Remind staff importance of little things. #NurChat”

But what if the opportunity of choice is not sufficiently presented? It may be the case that person-centred care has been overlooked to some degree, and the patient feels they haven’t been offered any choice at all. This can often be inadvertent, but nonetheless makes the patient feel that they have little control over their care. This can also happen when healthcare professionals don’t communicate effectively with their patients, both when listening, hearing and delivery information.

@davidcragg “Ive never been given choice, I have always had to challenge to get options or suggest options myself”

@type1teenager “big difference in my attitude and compliance to doctors who involve me #nurchat”

@paintoolkit2 “I recently had to make a choice in changing a consultant because old one was a poor communicator. Today I have a choice #nurchat”

As with many of the issues we’ve discussed on NurChat, the underlying factors come down to education and communication. Empowering patients to take control of their own care is only achievable by ensuring they have the information they need in a way they can understand, and ensuring their decision is implemented.

  • Join us again on 23 Oct 2012 for the next #NurChat discussion.

Donna Mullikin is R/N Clinical Assessor for Newcross Healthcare Solutions and facilitator of #NurChat. You can read the full transcript at

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