Family Nursing Is More Than Family Centered Care

Abstract

In this editorial, I would like to offer some distinctions between family centered care and family nursing, and declare my belief that family nursing is more than family centered care. I met Colleen McGavin (2013) at a Pre-Forum Deep Dive Session (a.k.a. preconference) in Vancouver called "Patient and Family Centered Care: From Concept to Practice." I was invited to offer a keynote at the preconference sponsored by the British Columbia Quality and Safety Council. Colleen was a member of the panel who responded to my keynote. The audience was not my usual tribe of family nursing scholars and practitioners. Instead they were an interesting mix of front-line health care providers, legislators, administrators, and patient care advocates (like Colleen) who care about "quality" and "safety" and who have diverse ideas about what "patient and family centered care" is and how it could be done better. For more than half a century, a philosophy of care known as patient and family centered care (which had its origins in child health care) has advocated for a seismic shift in health care from patriarchy and paternalism to partnership, dignity and respect, information sharing, participation, and collaboration with patients and families (Johnson, 2000; Kuo et al., 2012; Wells, 2011). These values extend to viewing families as integral members of the health care team and conceptualizing the family as the unit of care (Shields, Pratt, & Hunter, 2006). Patient and family centered care has been endorsed at the highest policy levels in developed countries and privileged in mission statements of most health care systems which has prompted the creation of numerous institutes for patient and family centered care that provide resources and gather data about implementation (Abraham & Moretz, 2012a, 2012b). Yet, concern and some mystery remain about why patient and family centered care has not yet been successfully implemented and why it is still not uncommon to hear patients and families evaluate their relationships with health care providers as uncaring, difficult, and intimidating (Coyne,

Managing Visitors During the Hospital Stay: The Experience of Family Caregivers of Patients With Traumatic Brain Injury

“…These findings have implications for nurse-family collaboration to improve family nursing care, emphasizing the need for staff to have open communication with family caregivers about managing visitors (Bell, 2013; Frampton et al, 2017; Lor, Crooks, & Tluczek, 2016). First, although this sample only included family caregivers of patients with moderate-to-severe TBI, these findings have wide reaching implications for family caregivers of patients hospitalized for various health conditions.…”

Dyadic incongruence in chronic heart failure: Implications for patient and carer psychological health and self‐care

“…Improved understanding of dyadic incongruence has the potential to inform clinicians in developing nursing interventions that not only allow for individualised educational approaches to promote engagement in the recommended rigorous CHF self‐care strategies, but would also enable therapeutic conversations aimed at improving the psychosocial health for both members of the dyad (Bell, ). At present, there is little research investigating the effects of dyadic incongruence in CHF caring relationships.…”

Cuidados centrados na família: do discurso à prática

“…(1,2) In most developed countries, these values are part of the health policies and mission of health systems. However, we often see that the family-centered care is merely a discourse in which family health is only spoken about.…”

“…(1) In one of the first texts on family nursing (1997), Dorothy Whyte, a Scottish nurse and researcher, stated the following: "Nursing work with families is not confined to community care, or to more obvious areas of practice i.e. paediatric or psychiatry nursing.…”

“…(3) Almost two decades later, her words remain true and are a challenge for us to move from discourse to practice and make the family-centered care the usual care. (1) …”