The concept of person-centered care is crucial in healthcare, extending beyond nursing. Throughout my ADN and BSN programs, as well as my experience in various hospitals, the significance of person-centered care has been emphasized. However, I have realized that the ability to provide this level of care varies depending on the healthcare setting. To illustrate this point, I will compare the experiences of ICU and emergency room providers.
In the ICU, the nurse-to-patient ratios are typically one-to-one or two-to-one, occasionally extending to three-to-one, based on my experience. These ratios vary depending on the acuity level of patients. A lower nurse-to-patient ratio is necessary for highly acute patients to ensure adequate assessment and care. On the other hand, as patients in the ICU transition to intermediate care, nurses may be assigned an additional patient or even two. Despite the increase in patient load, the ratio remains manageable, allowing for person-centered care. Providers in the ICU have the opportunity to spend more time with each patient and their families, fostering a more personalized approach.
In contrast, the emergency department operates with a higher provider-to-patient ratio, typically four-to-one, based on my experience. Although the percentage has never exceeded four-to-one in the hospitals I have worked in, there have been instances of three-to-one ratios. In the emergency department, providers often face the challenge of attending to four critically ill patients simultaneously, resulting in limited time spent with each individual. Their primary focus is completing physicians’ orders, continuously assessing and stabilizing patients, and facilitating their transfer to the appropriate unit. Despite the demanding nature of emergency care, I find it exhilarating. However, I must acknowledge that the workload for providers in the emergency room has significantly increased over the years.
NR 500 NP Week 3 Reflection on the Importance of Person-Centered Care in Healthcare
When I initially started working in the emergency department, we occasionally encountered patients with less acute conditions, such as sexually transmitted infections or common colds. However, these cases have become more prevalent, gradually overshadowing the critical issues. Consequently, some providers care for three to four patients with lower acuity levels, while others may have a mix of higher and lower acuity patients. This imbalance leaves the second provider stretched thin and less able to prioritize person-centered care. While this situation is unfair to all patients, the emergency department often receives less focus on person-centered care since it is not intended for long-term stays like other hospital units. As I transition to becoming an FNP, I am determined to prioritize person-centered care for all my patients. Although it may pose challenges, especially since I plan to continue working in the emergency department, I believe this aspect needs greater attention in our department.
In recent years, patients have been given satisfaction surveys after their discharge, and consistently, the emergency department receives the lowest scores in the hospitals I have worked in. The return of these surveys often reflects long wait times or inadequate time spent with the provider. I have addressed this concern with management multiple times. Still, the response remains consistent: adding nurses to reduce ratios is not within the budget, and adjusting ratios based on acuity would require additional nursing staff for higher acuity patients. As an FNP in the emergency department, I hope to have a stronger voice as an advocate for my patients and coworkers. I aim to push for alignment between acuity levels and ratios to ensure every patient receives person-centered care.
In conclusion, person-centered care is an essential aspect of healthcare delivery. While its significance is widely recognized, its implementation varies across healthcare settings. It is crucial to address the challenges faced in the emergency department, where patient loads and acuity levels pose obstacles to providing.