Student nurse Elena Ivany believes patients should be allowed to participate in the clinical decision making process
So far I have spent most of my holiday reading up on patient participation. It seems that modern nursing policy and theory both welcome the idea that patients should be involved in their treatment. From my own experience as a patient, I realise that someone who wants to heal is more likely to take an active role in the healing process, and vice versa.
For inpatients, all levels of involvement are a valuable step towards positive recovery. This can range from individuals performing their own personal care to gathering information about medical conditions and procedures.
As a nurse, I can only welcome such active participation from my patients. If all goes well, seeing a client become independent is proof that they are well on the way to recovery or that they have successfully adjusted to living with their condition. On a ward, where time and man-power are scarce, independent patients are a godsend because they allow nurses and HCAs to concentrate on those individuals who require extensive support with personal needs. Equally, well-informed patients are less likely to be anxious and more likely to recover sucessfully from a variety of procedures.
All in all, patient participation in the process of care is the way to go.
Yet what of patient participation in the decision-making process? The general shift towards client-focused care encourages nurses to place patients’ needs at the centre of nursing care. The NMC code talks of ensuring a prompt response to calls for assistance, of upholding the values of dignity and privacy when it comes to personal care, of allowing clients the right to chose.
These are all vital patient rights and nursing obligations. But what of the patients’ right to be involved in the process of creating a care plan? When nurses talk of patient choice, do we mean that the patient should be able to exercise choice from the very moment that they enter into contact with the healthcare service?
If so, then nursing still has some way to go. The age old distinction between the knowing nurse and the passive patient may be disappearing but I still believe that not all patients are given the opportunity to truly voice their preferences when it comes to making clinical decisions.
Please do not think that I am advocating for a complete system overhaul, whereby patients would dictate their own care plans to passive nurses. What I am advocating, however, is a situation where nurses embrace the fact that patients wish to play an active role in making decisions. The notion of the expert patient is not a theory or an ideal, it is a reality that is all too often ignored despite the many benefits that it can bring to the nurse-patient relationship and to the process of nursing care. If nurses believe in patient choice, then patient involvement in the decision-making process should be a priority for all of us.
Elena Ivany is a mature student nurse at King’s College London.