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Do No Harm

5/4/2018 1:20:29 PM

I recently read an article that rephrased “Person Centered Care” as “Relationship Centered Care”, and it stopped me in my tracks. [1] The goal in PCC is to focus on the uniqueness of the individual for whom you are caring.  However, the umbrella of continuity of care and trust that we call Person Centered Care morphs into “wear as many hats as possible” out of the sheer necessity of caring for so many people with intensive needs. 

 

Well-intentioned caregivers frequently do not have the time or energy to really know the people they are providing care for. They are too busy running from room to room, serving lunches, changing clothes, bathing people, and helping people use the restroom to really focus on what makes Mr. Smith tick and what really ticks him off.  When you have 15 people to change and shower, you simply care more about getting Mrs. Jones’ call light than knowing Mrs. Davis used to be a deaconess.  It isn’t that you don’t care, or don’t want to take the time to get to know them.  It’s about priorities.

 

The notion of changing terms for the care that we provide won’t solve our problems in the healthcare world.  Simply switching from verbalizing “Nursing Home” to “Long Term Care” to “Person Centered Care” didn’t make the significant changes in the quality of care that individuals received.  We all know that deep change stems from focused funding. When you have ample human and financial resources, you are better able to serve others.  Yet to receive funding, it has to be proven without a doubt that aspects of our current system are fundamentally broken.  So we turn again to words, because they are POWERFUL. Words can make us focus, and that focus is what brings the change.

 

If we started calling Person Centered Care “Relationship Centered Care”, it will not change the way that we fund healthcare. It will not instantly create fair pay for the amount of hard labor done. It will not magically change the frustrating, unfair way that the government, insurance companies, or corporations operate—at least not initially. But sharpening our focus could catalyze an important change in healthcare; a target that we have been aiming for, but missing. Real care is not just “given”.  For real care to occur it must be a complex interplay between a team and an individual; a give and take that requires work, reflection, and input from both parties.  When the patient becomes an active member of their own care team, human dignity becomes an integral component of their treatment.  Otherwise, dignity boils down to the bare minimum—the byproducts of any given treatment, or even worse, simply pulling a curtain, or covering someone’s naughty bits with a sheet. Here’s some news folks—that isn’t dignity. That’s a smidgen of privacy.   Are we following the Hippocratic Oath? To do No Harm, we have to focus on relationships. 

 

Words matter. Kindness matters. And above all else—Do No Harm. 

 

Amber Dennis is a staff writer and personal biographer for LifeBio, where she helps record personal histories.  Before working for LifeBio, Amber worked for a number of years in customer service, and also worked in nursing homes and home care as an STNA.  She holds a BA in History from Otterbein University.

 

[1]  Mahler B. Care of the Older Person: A Model to Develop Compassionate Relationship-Centred Care Between Older People, Relatives and Staff Identifies Seven Factors Necessary to Promote Appreciative Caring Conversations. Evidence Based Nursing. http://ebn.bmj.com/content/17/4/123 . Accessed April 25, 2018. 

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