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Introduction
The Person-Centered Nursing (PCN) Framework was developed by McCance and McCormack (2017b). Currently, it is one of the theories that can be used in nursing practice. This paper will offer an overview of PCN and its approach to the nursing metaparadigm, justify PCN as a nursing theoretical framework, and apply it to a particular nursing role. Based on this information, the paper will argue that PCN is a strong nursing framework that is capable of guiding advanced nursing practice (ANP).
Model Overview. The Nursing Metaparadigms
PCN was first introduced by McCance and McCormack (2017b) in 2006, but since then, it was expanded. McCance and McCormack (2017a) proceed to update and enhance PCN: a recent development involved adding particular macro-context elements to it. Therefore, the framework is still developing and improving to suit the needs of the nursing practice, and the present paper will offer the most recent version of the framework.
PCN includes several key systems which constitute person-centered care. First, it describes prerequisites, which involve professional and interpersonal skills, beliefs, a good understanding of oneself, and commitment to the job that a nurse can show. Then, the model acknowledges the significance of the context of care (care environment), which includes multiple factors from staff relationships to decision-making and organizational systems, as well as the potential for innovation and physical environment. Then, PCN describes care processes, which incorporate holistic care, as well as “sympathetic presence,” work with the patient’s “beliefs and values,” and “shared decision-making” (McCance & McCormack, 2017b, p. 38-39).
The final element consists of outcomes, which must be patient-centered for PCN. Such outcomes include a personal assessment of well-being, patient satisfaction, and the development of a “therapeutic” or “healthful” culture in which the circumstances for care are optimal (McCance & McCormack, 2017b, p. 38-39). Thus, the model covers a number of important elements that can be of interest to APN.
The way PCN incorporates the nursing metaparadigm can help to understand how the model would guide practice. The metaparadigm “consist of four concepts: person, health, environment, and nursing practice” (Reed, 2017, p. 13). The person is central in PCN; the patient is viewed as a subject that is capable of making choices and should be involved in care. Health is shown to be a complex phenomenon that is not limited to physical well-being. PCN favors holistic care, and another important role of patients in PCN consists of determining the outcomes of care, which are linked to the definition of health.
In connection to that, nursing practice is also characterized by the patient; all the care processes and outcomes are centered on the patient and aimed at inviting him or her to participate in care. PCN highlights the importance of a nurse’s qualities and skills for care processes. Finally, the environment’s impact is acknowledged in PCN, and it singles out several important environmental factors to consider when providing care. To summarize, PCN’s focus on the patient determines how it incorporates the metaparadigm.
PCN as a Theoretical Framework in Nursing
McCance and McCormack (2017b) point out that their PCN can be defined as a middle-range nursing theory. Here, PCN is characterized as relatively specific (as compared to conceptual models) and rather narrow (as compared to grand theories) since it focuses on patient-centered care. PCN also introduces specific concepts while explaining the relationships between them, and, according to McCance and McCormack (2017b), it was derived from broader conceptual frameworks (particularly that by McCormack). This understanding of middle-range nursing theories is in line with modern ideas about nursing knowledge and its hierarchies (Reed, 2017).
Furthermore, McCance and McCormack (2017b) note that PCN was acknowledged as a nursing model and is of interest to interdisciplinary teams. The authors suggest that its primary use consists of explaining the concept of person-centered nursing along with the related constructs within the context of modern nursing practices. In summary, PCN qualifies as a useful theoretical framework for nurses in theory and practice.
Applying the Theory
APN roles are numerous, but the present paper will focus on family nurse practitioners. There is not much research on the topic, but it is still apparent that person-centered care is applicable to APN practice (Enzman-Hines & Gaughan, 2017). PCN can provide working definitions for the metaparadigm concepts, which makes it a useful tool that should help to determine personal or environmental factors which affect care, the content of care, and the means of its assessment.
However, family nurses are especially likely to apply PCN effectively. They are typically involved in caring for particular individuals throughout their life span (Enzman-Hines & Gaughan, 2017). Consequently, they should be able to form meaningful connections with patients, which would facilitate the nursing care processes described by PCN, including holistic care, improvement of patients’ beliefs, and their effective engagement in care and decision-making.
Furthermore, the focus on patient-centered outcomes can be beneficial for nurses, quality of care, and patients, especially when patient satisfaction is concerned. Thus, PCN is applicable to family nurse practitioners’ practice because it can provide structure for care while having potential benefits for both patients and nurses.
Conclusion
In summary, PCN is a valid nursing theoretical framework that can be of use in guiding and informing nursing practice, especially that of a family nurse practitioner. PCN’s primary feature is its focus on the patient, which determined the way it incorporates all the elements of the nursing paradigm. This focus makes PCN particularly useful for nurses who treat patients for prolonged periods of time, and because of its attention to patient-centered outcomes, PCN may be especially beneficial for patients and helpful for nurses.
References
Enzman-Hines, M., & Gaughan, J. (2017). Advanced holistic nursing practice narratives: A view of caring praxis. Journal of Holistic Nursing, 35(4), 328-341. Web.
McCance, T., & McCormack, B. (2017a). A considered reflection and re-presenting the Person-Centred Practice Framework. In B. McCormack & T. McCance (Eds.), Person-centred practice in nursing and health care (pp. 259-264). Oxford, UK: John Wiley & Sons.
McCance, T., & McCormack, B. (2017b). The Person-Centred Practice Framework. In B. McCormack & T. McCance (Eds.), Person-centred practice in nursing and health care (pp. 36-66). Oxford, UK: John Wiley & Sons.
Reed, P. (2017). The spiral path of nursing knowledge. In P. Reed & N. Shearer (Eds.), Nursing knowledge and theory innovation (pp. 1-20). New York, NY: Springer.
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