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Reflection On Jim Case Study On Patient-Centered Care


Task: Using the Gibbs Reflective Cycle as a framework, submit a reflective essay that describes and analyses Jim case study. This essay should demonstrate your developing understanding of patient-centered care.


The information provided in the Jim case study signifies that in patient-centered care, nurses tailor the services to meet the patient needs with the primary goal of having improved outcomes. The patient-centred approach also empowers the patient to have the necessary understanding of the need and the importance of the care a nurse offers. The nurses, apart from focusing the care on the patient, also have a role in providing essential education to the patient. This understanding of the critical role of nurses towards patient forms the basis of our discussion in this paper. Using Jim case study and Gibbs' Reflective Cycle, I will analyze the understanding of the impression patient-centred care puts on the patient's education needs. It is easier to think that nursing is all about managing the patient symptoms and offering the transient relief of symptoms. However, in this paper, I will try to argue that educating the patient on the socio-cultural and even the genetic factors have a great influence on how a patient tolerates the current practice of patient-centred care. I will present this argument as a reflection using Gibbs' Reflective Cycle and the readings of Jim case study.

Reflection Using Gibbs' Reflective Cycle
Graham Gibbs developed Gibbs' reflective cycle in 1988 to eliminate bias people may have towards healthcare and nursing, to create an environment of self-evaluation and improvement and also act as a link to theory and practice as well as exploring new ideas (Jayatilleke & Mackie, 2013). To work effectively, Gibbs divided the model into six stages which include description, feelings, evaluation, analysis, conclusion and action plan.

The case study that stood out for me was Jim case study. Jim has several socio-cultural factors that influence his health-seeking behaviour and acquisition of nursing care and reception of person-centred care. One of the principles of patient-centred care that also stood out during the study regarded the respect of the patient's values, expressed needs and preferences. The other outstanding principle was the information, communication and education. In my assumptions, a decent man of Jim's age would have a proper need and understanding of the need to seek medical care. As opposed to my presumptions, Jim only attended hospital when in severe conditions and would not see a physician quite often. Majority of Jim's decisions are subject to the socio-cultural influence and the environment he lives in. Well, that is what Jim believes, and you cannot force him to seek medical care when not willing. However, regardless of his beliefs outlined in the Jim case study, we know he has a bad background of health-seeking habits and practices running in the family, coupled with the inheritance of familial practice of smoking. The diet is also not well balanced, and this predisposes him to some risks. Jim also lives in a remote rural area which could also explain his poor health-seeking habits.

From the RLT model basis the Jim case study, Jim's situation is mainly socio-cultural because he also cares for the mother and takes care of his farm. Still, as a health practitioner, we know Jim is at risk of having compromised healthcare. To change his attitude, Jim needs education on good health practices and how he can balance his farm work and also adopt good health seeking habits. As a nurse, considering the scenario presented in the Jim case study I would do well to advise Jim on why he needs to stop smoking, and the health hazards associated with risky behaviors and also need to adopt good health seeking habits.

Before studying patient-centered care, I believed it mainly focused on patient targeted medication and nursing care. My thinking revolved around the physical care but after reviewing the RLT model, meeting the physical needs is just one aspect of patient-centred nursing care. I also discovered that patient-centred care has eight principles, one of which respected the patient's autonomy and the freedom of expressing their values and beliefs. As a nurse, it is easy to get in that position where you have full control over the patient. As long as the care is centred on the patient, they have the right to make personal decisions and the nurse is obliged to respect them.

For example in Jim case study, he does not believe in seeing a physician and changing his perceptions involves proper understanding of the reasons behind his belief then based on this understanding, the nurse can offer the necessary education. The broad understanding of this course enabled me to have a broader perspective on the socio-cultural factors surrounding the patient decision making, and I felt empowered having a better understanding on how I can improve Jim's health-seeking behaviour through education. While exploring Jim case study, my feelings shifted from the judgmental attitude to that sympathetic and an attitude of understanding, and it made me feel more empowered to educate patients with similar challenges (Kreindler, 2015).

The part of the learning experience that worked for me concerns the two principles of patient-centred care which include informing, communication and educating the patient. The other part consists of the aspect of the autonomy of the patient, where I need to respect the patient's values and expressions (Sedig, 2016). I also found the RLT model useful because it helps look at the patient from all aspects of life. The Jim case study involving Jim had issues regarding the social life, and the cultural influence and this aspect of the module were beneficial. Patient-centred care requires cultural integration of the patient socio-cultural experience in healthcare and the holistic view of the patient as a complete social human being. This consideration means that the patient has emotional and other non-physical needs (Delaney, 2018).

My challenge during the course was majorly in care integration and patient autonomy because patient education is not the ultimate solution. Therefore, there is a need for a multidisciplinary approach. As an individual, the interdisciplinary approach can be expensive and hard to achieve, making care integration a nightmare. As a nurse, there is a temptation to be in full control of the patient's affair, finding the balance was a bit hard to understand but with much practice, it is possible because most ethical issues emanate from this aspect (Dellenborg, Wikström & Erichsen, 2019).

Concerning my topic, it is clear that not so much effort is put in enforcing the role of nurses in patient education. Implementing it in the cases study was, however, easy based on the in-depth understanding of the circumstances surrounding the patient's decision making. The materials and models used in the learning were illustrative and were therefore easy to recall, for example, the RLT model of care which looked at the surrounding of the patient (Williams, 2017). Compared to the previous learning experience, this was an eye-opener with the literature putting more details on focusing on the patient as opposed to the nurse and the caregiver. The literature also emphasizes the consideration of the patient holistically. The belief that patient-based care is only on temporal issues is wrong, and from my understanding, it is more than we can imagine. From my analysis on Jim case study, it is clear that the education of the patient and the society by the nurse is one way of implementing patient-centred care and also changing the attitude towards patient-centred care (Flagg, 2015). I believe education is the fastest way to make patients and society to appreciate new care techniques. Many people make poor choices of health because they lack knowledge of the right decisions, and nurses have this information. If they imparted this knowledge to the patients, the implementation of patient-based care would be so useful (Kalra, Magon & Malik, 2012).

From my learning experience, I have learnt how several factors surround patient decision making. I also saw the need for patient education in the implementation of patient-centred care. Patients are not fully aware of their roles, and it is the work of the nurses to educate the patients on their roles. The experience from Jim case study has opened my eye to how we can link education and fill that gap needed in integrating education and patient-centred care. From this learning experience, I'm more interested in providing patient education. I have a challenge in implementing care at the bedside, and this makes me want to work on educational policies to the patients and the caregivers. Through the experience, I have discovered that I can be a good nurse educator, and I would recommend social nursing education as an appropriate way of promoting patient-based care.

Action Plan
By considering the overall Jim case study analysis, I can say that in order to implement patient-centred care, I need good leadership, staff engagement, patient and family engagement, innovations, aligning the priorities and roles of the staff, care environment and organizational structures and processes. I would also make the learning more frequent and updated, for example, every four months to ensure the staff stays up to date. My priorities of knowledge will be first on patient and society education then implantation in the care facility. To realize this plan, I will mobilize the hospital staff and offer seminars. I will also use community education centered on passing my policies to the public. This goal means I will require rooms and human resource to help teach all these principles to the patients and the surrounding community. I will also use print materials and electronic materials to help reach out to a large group of people.

Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia. Collegian, Jim case study 25(1), 119-123.

Dellenborg, L., Wikström, E., & Erichsen, A. A. (2019). Factors that may promote the learning of person-centred care: an ethnographic study of an implementation programme for healthcare professionals in a medical emergency ward in Sweden. Advances in Health Sciences Education, 24(2), 353-381.

Flagg, A. J. (2015). The role of patient-centered care in nursing. Nursing Clinics, 50(1), 75-86.

Jayatilleke, N., & Mackie, A. (2013). Reflection as part of continuous professional development for public health professionals: a literature review. Journal of public health, 35(2), 308-312.

Kalra, S., Magon, N., & Malik, S. (2012). Patient-centered care and therapeutic patient education: Vedic inspiration. Journal of mid-life health, 3(2), 59.

Kreindler, S. A. (2015). The politics of patient?centred care. Health Expectations, 18(5), 1139-1150.

Sedig, L. (2016). What's the role of autonomy in patient-and family-centered care when patients and family members Don't agree?. AMA journal of ethics, 18(1), 12-17.

Williams, B. C. (2017). The Roper-Logan-Tierney model of nursing. Jim case study Nursing2019 Critical Care, 12(1), 17-20.


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