Background Delivery of safe, compassionate and dignified care is based on a mutual relationship between individuals, where openness, honesty, trust and respect are essential components (Reed, 2011); recent reports indicate, this isn’t always the reality for some patients and their families (Abraham, 2011). The NMC standards of proficiency for registered nurses state: the ability to communicate with sensitivity and compassion and to manage relationships, is central to person centred care and that communication and relationship competencies must be demonstrated in all practice settings and adapted to meet people’s needs.
Project description Our aim was to encourage student nurses to understand their role in caring for people with long term conditions and evaluate their role in promoting and facilitating self-care and empowerment. We aimed to immerse them in an authentic experience and evaluate their skills objectively within a protected environment.
A repeating rotation was created, incorporating the introduction, interaction and debrief. Scenarios were developed by simulation experts with input from patients and relatives. The scenarios reflected the NMC standards, the values of the NHS and the principles of person-centred care.
Simulated patients/relatives (SPs) were selected and trained for three roles. A person:
at home, non–compliant with diabetic self–care
recovering from a stroke with a frail partner
as a family–member of a parent with dementia.
Summary of results 110 second year undergraduate student nurses have completed the long term conditions simulation. During the facilitated debrief, the students focused on three aspects of the activity; what went well, what (if anything) they would change and the application of learning within their practice. SPs as the patient/relative advocate provided valuable feedback from the patient/relative perspective; we maximised this impact by fully involving the SP in the debrief.
Discussion Designing the rotations, for large numbers of students and writing realistic scenarios, has been challenging. We have ensured that the scenario reflects the patient/relative perspective, has met the needs of the students, the SP and the facilitator, is low risk, ethical and complies with ASPiH standards. The outcome has been a manageable rotation and a set of scenarios which have a replicable template. The students have requested increased exposure to this simulation modality.
Having developed a rotation and template that works for long term conditions, we will be expanding our engagement with SPs and involve them in other areas such as: safeguarding, discharge planning, adverse incidents, DNAR and care of the vulnerable person at home.
Reed A. Nursing in partnership with patients and carers. Transforming Nursing Practice 2011. SAGE.
Abraham A. Care and compassion: Report of the health service ombudsman on ten investigations into NHS care of older people, fourth report if the health service commissioner for England; session 2010–2011, HC 778 2011. London: The Stationary Office.
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