Nurse-patient encounters in the hospital ward, from the perspectives of older persons: an analysis using the Authentic Consciousness Framework.

ABSTRACT

BACKGROUND: Despite a growing theoretical base to support the development of person-centred practice, the evidence would suggest that this way of working is somewhat elusive in the care of older people. AIMS: The study aims to explore nurse-older person encounters and relationships within the context of person-centredness. DESIGN AND METHODS: This study involved secondary analysis of interview data originally collected from a commissioned study investigating whole-systems approaches in services for older people. The process of analysis used the Authentic Consciousness Framework. RESULTS: Nurses are often invisible to the patient, unless they are providing care to address a physical need. A sense of rolelessness pervaded the data, when patients were deprived from actively participating in important decisions about their future care. CONCLUSIONS: Patients would like nurses to work with them in more transparent ways. Patients are very conscious that nurses are busy and attempt to share the coping with the busy workload by limiting their expectations of the nurse. RELEVANCE TO CLINICAL PRACTICE Person-centred strategies must enhance the capacity of not only older patients and their ability to assert self, but also the capacity of their nurses. Nurses must work to actively recruit the patient in all decision making.