Define and describe the key concepts of Care
This essay will introduce, define and describe the key concepts of care, and state how these concepts can be put into practice. The author will clarify why the Department of Health (DH) in England introduced the ‘6Cs’ as values for practice within the new nursing strategy (Cummings and Bennet, 2012) and emphasize its importance in development. This will also include how care has been viewed historically in the health care sector and how care has changed to date. Fundamental standards will be identified and explained why they are now enforced by law and how it improves the National Health Service (NHS) as a whole. Following this, this will conclude by justifying the importance of the topic area in regard to putting theory into practice.
Sir Robert Francis, has been a barrister since 1973, specialising in medical law. Sir Francis chaired the independent inquiry into the care provided by the Mid Staffordshire National Health Service (NHS) Trust. His finding was, vast unnecessary suffering, ignored poor care and increased mortality rate between 2005-2009. The final report was published in 2013, where there were lots of complaints, 250 witnesses interviewed and one million pages of evidence. The Hospital put corporate self interest above care of patients. The Francis inquiry report highlighted the lack of compassion in health care. Fundamental standards are now enforced by law, the ‘6Cs’ are 6 concepts of care that every medical professional must abide by. The ‘6Cs’ have proven to achieve excellent health and wellbeing outcomes due to the Government, the National Health Service, Commissioning Board, the Nursing & Midwifery Council, the Care Quality Commission, the Trades Unions, and all the other services in the system to support staff and their professional instincts for compassion (Department of Health). This is called intergraded care. Integrated care is also known as coordinated care, organisations and care professionals combine different care elements that a patient needs to do what is best for the patients’ best interests. The main principles of person centred care are to treat people with respect and dignity by supporting the patients’ preferences, beliefs and values. There was inadequate coordination in a well-known case called Winterbourne view in 2011. Winterbourne View were exposed, to have mistreated patients, physical and psychological abuse was suffered by people with learning disabilities and challenging behaviour at the public funded hospital in Hambrook, South Gloucestershire. Complaints from the senior nurse was ignored by management and Care Quality Commission. As a result, the mistreatment continued. 11 staff members were found guilty and 6 were jailed because of the abuse. Winterbourne view is now closed. All the above comes down to Health Care being fragmented before the ‘6Cs’ were put in place.
Population Health means different things to different people but can be broadly defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group” (Kindig and Stoddart, 2013).
Public Health is about helping people maintain their health, promote healthy life choices and prevent diseases by offering vaccines and doing additional research on medication. Back in the 1900’s when we didn’t have Public Health, the most common cause of deaths was infectious diseases at 25%, then 14% died of circularly diseases and 5% died with cancer. Whereas in the 2000’s infectious diseases lowered to 1% of all deaths, 25% died with cancer and 38% died with circulatory diseases, due to increased use of radiation and an increase of poor life choices e.g. eating fatty foods (choosing health, 2004). Public Health is defined as “the art and science of preventing disease, prolonging life and promoting health through the organised efforts of society” (Acheson, 1988; WHO).
The ‘6cs’ are as follows; Care is the health, welfare, maintenance and protection of someone or something (Oxford English Dictionary). Caring is considered as an important behaviour and a key aspect in promoting patient’s health and the accelerating the healing process. Care can be felt, taught and practiced, if the person has intention to perceive it. According to Watson’s theory the goal of nursing is helping a patient to achieve harmony within the mind, body, and soul. (Watson, 2008). We have a variety of different theories of caring, Leininger (1991) who considered caring is a worldwide phenomenon originates from the cultures and affects the individual response. Based on the needs of an individual, she also stated “care as the essence of nursing and the central, dominant, and unifying focus of nursing”. Commitment to patients and families, defined by beliefs and morals. Regardless of illnesses or diseases patients are having, they should be seen as a whole, and complete transpersonal Caring allows unity of life and connect to move caring from one individual to another” (Watson, 2003). Make a vision and strategy a reality for all and meet the health care and support the challenges ahead (Baillie, 2017).
Conceivably, effective care cannot be provided without the other 5Cs, compassion, competence, communication, courage and commitment (British Journal of Nursing, 2017). Compassion is how care is given through relationship based on empathy, respect and dignity. Bearing in mind the Nursing theories integrates the caring concept in nursing practice and considered the nurse as the main key point in the whole process. Therefore the “Nursing has distinctive views of persons and strong commitments to compassionate and knowledgeable care of persons through nursing” (Parker, 2001).
Competence is having the ability to put theory into practice. Deliver effective care and treatment based on research and evidence. Courage enables health professionals to do the right thing for the people they care for and to speak up when they have a vision to embrace new ways of working. Communication is the foundation of good health care. In health care and nursing practice it is essential that there is effective communication. The benefits of successful communication include, vital caring relationships and effective team work (Cummings and Bennett, 2012).
The care should grant the use of the nursing process (to assess, plan, implement and evaluate patient care), clinical, ethical and practical experience followed by evidence-based practice to maximize patient’s outcome.
“The theory practice gap occurs between the knowledge and practical application that can affect professional competence and contribute to difficulties in progressing from student to a novice professional” (Michau et al, 2009).
Florence Nightingale International Foundation visualize the importance of the care behaviour by designing a nice Caring Symbol which illustrated four elements together such as a flame, hand, heart and globe. The flame represents the light of nursing knowledge and caring. It also reflects back to the lamp Florence Nightingale carried while caring for the wounded during the Crimean War. The hand illustrates nurses reaching out to help and comfort others. The white heart characterizes the knowledge and humanity that infuse the work and spirit of nursing, and finally the globe shape illustrates the universality of the Foundation and the world in which each nurse provides care.
Nevertheless, the Florence Nightingale International Foundation awarded scholarships and fellowships to allow nurses to take on projects in several areas including advocacy, leadership, new models of patient care and new roles for nurses. On the other hand, merging nursing theories with practice will always be on the top of our list as the Institute of medicine (2009) believe that the community will need a fundamental, sweeping redesign of the whole health system to suit the steps needed. Pryjmachunk (1996) and Fealy (1997) and cited in Cronin (2004) agreed that theories, research and practice were interdependent. Providing the best quality of care and developing nursing practice, nurses should apply the nursing process in such a way that a nurse can use her discretion in dealing with a patient’s situation instead of applying the nursing theory as it is.