We live in the greatest age of scientific discovery and medical breakthroughs. Advances in the innovation and understanding of diseases are providing more insight into how we treat, and often cure, people with life-threatening illnesses. What was once deemed a death sentence diagnosis is now described as a chronic disorder, that can be handled with the help of the patient and a team of healthcare providers.
The Era of Patient-Centered Care
Similarly, with medicinal cannabis, assisted suicide, and palliative, hospice, and end-of-life care laws designed to put patients first, we are entering a new era of patient-centered care. The National Academy of Medicine (NAM) identifies patient-centered care as a core component of quality health care, defined as “health care that establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care.”
On its face, this seems an obvious and natural design for the implementation of health care. However, only recently have providers taken into account what the patient seeks to achieve from a treatment plan. It is a remarkable time to be alive!
So, it is interesting that a Pew Charitable Trusts report brought to light some contradictory results. Although Americans want to die at home, most do not. Although we want to be pain-free, the process is all too often the opposite. And although people are eager to not be a burden on their loved ones, sadly, most of the time they have little control over the experience. Some key suggestions to correct this include:
- Establish Medicare reimbursement for advance care planning.
- Implement quality metrics for palliative and end-of-life care.
- Encourage states to improve Physician Orders for Life Sustaining Treatment programs.
- Ensure advance directive accessibility across healthcare settings.
- Support evaluation and dissemination of promising end-of-life care delivery models.
Broad and cross-cutting, such recommendations are meant to change the way Americans think and act about health care. These policy points belie a change in the philosophy of patients, but more than that, in the many and varied healthcare providers, of which an integral one is the nurse. This paradigm shift is recent and although positive, isn’t always implemented as desired.
The Nurse’s Role in Care Coordination
As nurses are, for the 17th year in a row, the most trusted healthcare providers, it is often up to them to relay the patient’s wishes to the rest of the caregiving team. Through direct interaction with patients, nurses collect, interpret, and distribute information to relevant providers. This coordinated-care model is a change, and it comes from the healthcare industry’s understanding that putting patients first is a quality measure.
In 2010, NAM released a report outlining the future of nursing. The document provided four main goals, but the essential outstanding one was that “nurses should be full partners, with physicians and other healthcare professionals, in redesigning health care in the United States.” This represented a new approach to the delivery of health care and one which the nursing community wholeheartedly promoted in the best interest of quality care.
For years, ONS has been a leader in patient-centered care. Core health policy principles demand “the essential role of oncology nurses on the interprofessional team in the planning and implementation of cancer care and prevention services and as leaders in quality improvement.” It is this kind of glass-ceiling breaking leadership that defines nurses to patients, and their provider peers. Patient-centered, symptom management education, and coordinated care. These are hallmarks of the field, and why it takes a special person to be called a nurse.