Translating person-centred care: a case study of preceptor nurses and their teaching practices in acute care areas

Abstract

Aims and objectives: The research aims to explore how preceptors interpret, operationalize, document and teach person-centred care as they guide students within an acute surgical environment.

Background: Person-centred care is a term that is widely used in the nursing literature; however, its interpretation in nursing practice remains virtually unexplored. This is of great significance to nurses in general but to Irish nurses in particular on whom this study is focused. As preceptor nurses have been identified as key people in the education of clinical students, it was considered important to explore how clinical preceptors promote person-centred care to current undergraduate nursing students.

Design and method: Using a case study design and a qualitative approach, six preceptors were chosen to participate in this study. Data were collected by means of participant observation, review of nursing care records and semi-structured interviews. Data were analysed in two stages. The first stage involved the identification of themes. In the second stage data were analysed using a number of propositions to examine and explain what was gleaned from the data in the context of what was originally identified in the literature.

Results: Findings highlighted that preceptors had a limited conception of person-centred care. Measures of care reflected the medical model of nursing. Beyond that, preceptors expressed care in terms of good manners or respectful etiquette. Preceptors also had limited appreciation of what learning entails and were sceptical about classroom theory other than what they considered essential for safe practice.

Conclusions: This study highlights that preceptors need both internal and external support to implement the changes advocated by the Commission in Nursing in 1998, the Nursing Education Forum in 2000, the Department of Health and Children in 2001 and An Bord Altranais in 2003.

Relevance to clinical practice: Person-centred care is a relatively new concept in nursing and recommended for practice. Preceptors need facilitation with its implementation. In an effort to promote changes in the delivery of health care, it is suggested that university-based lecturers empower students to practice evidence-based nursing as students and subsequently as qualified nurses.