Ask the experts: person-centred care

Abstract

My work covers four domains: Expert clinical practice Working within a critical companionship model has enabled me to challenge practice at the bedside. Reflective sessions within stroke care areas allow me to hear about difficulties staff face and, in turn, for me to challenge practice. Professional leadership and consultancy As a member of the professional executive committee and board of my primary care trust I have an insight into policy development and decision making. This knowledge has enabled me to forge ahead with service developments. Education, training and development Following years of holding formal training and education sessions, I have adopted a practice-based learning approach to education. Ascertaining what clinicians know, what they believe they need to know, and demonstrating how best to build on clinical skills is a very effective method of learning. I am also able to access older people across a range of settings. Primary and secondary prevention of stroke in residential care is vital and I have undertaken work in partnership with both statutory and non-statutory providers. Practice and service development My duty is to be flexible and adaptable, facilitating innovation and service redesign from the patient’s perspective. I have developed a community stroke rehabilitation team based on a study that gathered the views of older stroke survivors and their carers. Listening to and being able to represent their needs provided the stimulus to modernise local services. Research I have undertaken has affected clinical care by ensuring that ethical, sensitive decision making regarding feeding after stroke is person and family-centred. The use of audit and evaluative data ensures that stroke care remains a high priority on each local organisation’s agenda. The role of consultant nurse in stroke care is dynamic and innovative. Eighty per cent of strokes occur in people over the age of 65 and keeping abreast of the needs of older individuals is crucial. It is imperative to be politically aware at local and national levels, and to have the courage to speak out and be innovative. Retaining clinical credibility and having sound leadership skills will ensure that other clinicians learn by example and aspire to consultant practitioner roles. Jane Williams