Chapter 1: The context of nursing
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Source: Adapted from NHS England ([21]) with permission of the NHS.
Finally
This book is intended as a reference and a resource, not as a replacement for practice‐based education. None of the procedures in this book should be undertaken without prior instruction and subsequent supervision from an appropriately qualified and experienced professional. We hope that The Royal Marsden Manual of Clinical Nursing Procedures will continue to be a resource to help nurses deliver high‐quality care that maximizes the wellbeing and improves the health outcomes of patients in acute hospital settings.
To paraphrase the quote from Leading Change, Adding Value (NHS England [21], p.5) near the beginning of this chapter, compassionate care delivered with courage, commitment and skill is our highest priority as nurses. This is made more explicit in Commitment 4 of Leading Change, Adding Value (NHS England [21], p.21), which highlights the importance of putting the person at the centre of care (Box 1.9).
Box 1.9
Commitment 4: We will focus on individuals experiencing high value care
We will ensure that individuals are always supported to influence and direct their own healthcare decisions, so that they are confident that ‘no decision is taken about me without me’.
Care planning should involve the development of a personalized plan for each individual who is entering, leaving or transitioning care environments whether within a hospital, in their own home, care home or rehabilitation unit.
We need to encourage people to take more responsibility for their health by focusing on personalized care planning, self‐management and behaviour change.
It is important to remember that even if a procedure is very familiar to us and we are very confident in carrying it out, it may be new to the patient, so time must be taken to explain it and gain consent, even if this is only verbal consent: ‘the views of the person [receiving the treatment] should also be taken into account when choosing which treatment is most likely to be successful for an individual’ (NMC [27], p.38). The diverse range of technical procedures to which patients may be subjected should act as a reminder not to lose sight of the unique person undergoing such procedures and the importance of individualized patient assessment in achieving this.
(Anon. in Dossey et al. [7])
When a nurse |
Encounters another |
What occurs is never a neutral event |
A pulse taken |
Words exchanged |
A touch |
A healing moment |
Two persons |
Are never the same |
Nurses have a central role to play in helping patients to manage the demands of the procedures described in this manual. It must not be forgotten that for the patient, the clinical procedure is part of a larger picture, which encompasses an appreciation of their unique experience of the reason they have needed nursing care in the first place.
