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of Family Nursing

Colleen's Story: Reflections on the Concept of ''Patient and Family

Centered Care''
Colleen McGavin
Journal of Family Nursing 2013 19: 418 originally published online 12 July 2013
DOI: 10.1177/1074840713496114

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research-article2013
JFN19410.1177/1074840713496114Journal of Family NursingMcGavin

Article
Journal of Family Nursing
19(4) 418­–430
Colleen’s Story: © The Author(s) 2013
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DOI: 10.1177/1074840713496114
Concept of “Patient and jfn.sagepub.com

Family Centered Care”

Colleen McGavin

Abstract
As a patient who has also been a family caregiver, I would like to offer
my reflections on the concept of “patient and family centered care.” How
is it defined from a patient perspective? Why is it important? In what
circumstances is it evident? And where is it lacking? I would like to leave the
reader with a list of relatively small but, in my experience, powerful things
that health care workers can do today to improve the patient and family
experience.

Keywords
illness narrative, illness suffering, patient–health care professional relationship,
patient-centered care, family-centered care

Patient/Caregiver Background
I am what you might call a “frequent flyer” in the health care system. My
immersion into this world began almost 20 years ago when I got my first
cancer diagnosis. It was cervical and I was cured by undergoing a hysterec-
tomy. In those days, I was still young enough to imagine myself invincible
and far too busy to dwell on the situation. I dismissed the cancer, and my
worries, since I never actually had any physical symptoms. The worst part for

Corresponding Author:
Colleen McGavin, #26 - 881 Nicholson Street, Victoria, BC V8X 5C5, Canada.
Email: c_mcgavin@hotmail.com

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McGavin 419

both me and my young family was the postoperative recovery period.

Afterwards, there was no need for any kind of further treatment and, 8 weeks
later, I went on with my life: wife, mother of two tweenage daughters, and
instructor in the business school at our local community college.
But, in the years immediately following, I developed mysterious and
recurrent pelvic pain for which a diagnosis could not be found—until 10
years ago when I got my second cancer diagnosis. This time it was high-
grade carcinoma in situ of the bladder. One of its distinguishing features is
that bladder cancer has a propensity to recur frequently and this was true for
me. Over the ensuing 4 years, I underwent numerous chemo- and immuno-
therapy treatments plus minor surgeries to remove bladder tumors.
Unfortunately, all of the conventional therapies failed and so I consented to
participate in a clinical trial.
Throughout the period of treatment with the new drug and follow-up, I
continued to experience painful bladder symptoms, but I was repeatedly told
that my cancer was in remission. I received an alternative diagnosis of a con-
dition called Interstitial Cystitis (IC). IC is a painful but non-life-threatening
disease that mimics other bladder conditions like cancer. During this time, I
also experienced multiple urinary tract infections and ultimately developed
pyelonephritis from an antibiotic-resistant “superbug” called Extended
Spectrum Beta Lactamase Producing Bacteria (ESBL). Treatment required a
month of in-home intravenous antibiotic therapy through a PICC line.
Sadly, IC has few effective remedies so, in order to cope, I formed a sup-
port group and enrolled in a course on chronic pain self-management. On the
first day of the course, our instructors asked the question: what words come
to mind when you think about your pain? The first word that came to me was
grieving. I realized I was grieving the loss of so many aspects of my life,
which had significantly shrunk due to the limitations of chronic pain.
Gradually, I had given up competitive athletics, many social and volunteer
activities, and the dream of travel.
Within 2 years of receiving the IC diagnosis, worn down and with a gut
sense that something else was wrong, I decided to seek a second opinion. A
ureteroscopy showed an almost-completely blocked ureter, which explained
the chronic infections, and a biopsy showed that I did not have IC but that my
cancer had returned. As a result, roughly 18 months ago, I found I had no
option but to have a cystectomy.
The surgery to remove the bladder and build a continent urinary diversion,
also known as an Indiana pouch, out of approximately 2 feet (61 cm) of my
intestine, was long and complicated and so was my recovery. I spent a month
in hospital overcoming many obstacles including hemorrhages, infection,
and pneumonia. Going through this surgery was possibly the hardest thing I

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420 Journal of Family Nursing 19(4)

have ever had to do and it is not an exaggeration to say that, coming on the
heels of years of chronic illness, it tested my very will to live.
Since the surgery, I have experienced chronic pyelonephritis and ulti-
mately I developed sepsis because of a blockage that again developed at the
base of the right ureter. This necessitated the implantation of a nephrostomy
tube using interventional radiology and recently a stent was added. Further
surgery will be needed to permanently correct the problem.
Overlapping all of this, for roughly 2 years, I became a caregiver for my
elderly parents. This meant I sat in at all of their many medical appointments
and tests and wrote email reports for my six siblings and our extended fami-
lies. I attended my parents at home and at the hospital as needed, taking up
residence with them in the days before my father passed away.
About 2 years ago, just after Christmas, my father passed away at home,
with my mother and me nearby. He joked that he always knew it would be us
three—the Three Musketeers—who would be the last ones present at his
passing. Only 9 months later, my mother died in hospice. This was another
very difficult time since many emotional issues arose around my relationship
with my parents, which had not always been happy.
While my father’s passing was expected, my mother’s was not. Dad had
been dealing with congestive heart failure for years and had latterly been
doing treatments for prostate cancer. Mom had always been hearty and strong.
She did have a seemingly benign form of lymphoma, but that had not given
her any real problems for years—until after Dad died. By the spring, Mom’s
lymphoma had become nasty and presented as a tumor behind her right eye.
Despite radiation and chemotherapy, the cancer became a raging beast and
we were stunned by how aggressively the tumors—clearly visible on her
face, scalp, and neck—grew. Ultimately, she refused further treatment and
died just 9 months after Dad.

A Definition of Patient and Family-Centered Care

As you can imagine, after so many interactions with the health care system,
the term “patient and family centered care” has become very meaningful for
me. My definition can be summed up as follows: decisions and actions that
have, at their heart, the welfare of patients and their families. To dissect this
definition, one should begin with the understanding that illness is a family
affair. When one family member gets sick, it affects everyone to some degree,
and when illness is serious or chronic, the effect is multiplied. I feel very
fortunate that my daughters were of an age that they were quite independent
and largely preoccupied by their own lives by the time I got really sick, but
my husband knows all too well how illness affects a family member. It is also

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McGavin 421

important to note that family are often an invaluable aid to healing through
the emotional and practical support they provide to the patient and it is impor-
tant to include them as highly regarded members of the care team.
With regard to “decisions and actions,” we need to recognize that health
care professionals make thousands of decisions, large and small, leading to
actions that affect outcomes. These can be as significant as the appropriate
treatment plan to something as seemingly small as the amount of care that is
taken when washing their hands or the tone that is used in addressing a
patient. Finally, the term “heart” suggests both centrality and compassion that
goes beyond the basic job description.

Family as Care Recipients

Over the years, I’ve come to believe two things: firstly, that family forms a
crucible that contains most of our hopes, dreams, ambitions, insecurities,
fears and so on; and, secondly, that physical pain can, and often does, touch
upon emotional pain—that is, it puts us in touch with long-buried psycho-
logical injuries, many of which happen within the context of family. As a
result, in addition to dealing with physical distress, the patient and family are
often struggling with these issues as well. We saw this phenomenon in action
in our family when my father became ill. My parents were married for 64
years. Such a long partnership that spanned a period in history where rela-
tionships between men and women were changing dramatically was bound to
be complicated. I know that my mother suffered with conflicting emotions;
for example, how was she to reconcile the excitement she felt about life as a
single person who suddenly had absolute control over her affairs, with her
feelings of grief and fear about losing her life’s mate, the man who had set the
direction for all of their married lives? No one in our family doubts that the
upsurge of her cancer and her sudden passing was due to the stress of dealing
with my father’s demise and the emotional issues it raised. While this may be
an extreme example, the lesson remains: one needs to consider how best to
support the whole family lest we end up with more than one patient.

Family as Caregivers
While family members are care recipients, they are also an important asset
insofar as they provide invaluable service through their loving care. After the
cystectomy surgery, my husband sat by my bedside for 30 consecutive days—
often from 7:00 a.m. to 10:00 p.m. He arrived early so he could help me to
wash up, brush my teeth, and comb my hair. Daily, he brought me a fresh
gown and changed my bed linens. He encouraged me to eat when I had no

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422 Journal of Family Nursing 19(4)

appetite. He disentangled the various IVs and drainage tubes coming from
my body, knelt to put on my slippers, and offered his arm so that I could
shuffle around the ward. He learned to irrigate my pouch and to give me
injections so that I wouldn’t develop a blood clot. He also helped me to be
positive, and operated as a second set of eyes, ears, and even a second brain
when I was simply overwhelmed by everything that was happening.
My husband significantly reduced the workload of the ward nurses while
I was in hospital; yet, neither of us can recall that any of the staff explicitly
acknowledged his contribution or thanked him. How powerful might it have
been had they done so?
The concepts of family as care recipients and as invaluable members of
the care team are relatively well-understood in some areas of medicine:
namely, child health and maternity. I believe that we have a natural protec-
tiveness about babies and children that is rooted in our understanding of their
helplessness. We understand how dependent they are on family and how sup-
porting the family is the right thing to do. These instincts have allowed us to
see the necessity for change in the areas of child health and maternity, and I
have witnessed how a tremendous amount of work has been done in these
areas over the past three or four decades.
As a candy striper when I was a teenager, it pained me to see the little ones
cry when parents had to leave after visiting hours. Fast forward 30 years to a
time when I was privileged to have a tour of the provincial children’s hospi-
tal. I couldn’t help but be impressed by the efforts that were made to include
families and to make the environment as upbeat, comfortable, and inviting as
possible. Everything—from walls painted with colorful cartoon characters, to
play areas for kids, to lounge chairs and sleeping areas for parents—spoke to
this understanding. A friend of mine whose son was treated for leukemia at
that hospital spoke often of the caring attitude of all of the medical staff and
about how inclusive they were when it came to him, his wife, and their
younger son.
It’s also apparent when one considers the changes that have occurred in
the area of maternity care. When my first daughter was born in 1982, I labored
in a sparse hospital room on a bed adorned with clinical sheets and blankets.
There was only one ordinary chair beside my bed signaling how my hus-
band’s presence was tolerated but certainly not welcomed. My husband sat
uncomfortably for the better part of 16 hours before I was whisked into a
sterile operating room for the final push. Those who attended on me were
masked, gloved, and gowned and, other than my family doctor who caught
the baby, I have no recollection of any human interaction with the others.
Immediately after delivery, my daughter was Apgared, cleaned, wrapped in
swaddling and removed to a nursery. I was left alone—baby and husband

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McGavin 423

headed down the hall—while a nurse, who performed her duties with great
efficiency, cleaned my body. I remember feeling very cold and alone and
desperately wanting to hold my baby girl. Thereafter, for 5 days, I had to beg
to have her brought to me so I could nurse her more often than every 4 hours.
While I still cringe remembering this experience, I know that it was much
more patient and family centered than the previous generation’s where moth-
ers were anaesthetized, fathers paced for hours in waiting rooms, and almost
no-one breastfed. Still, what a different world my daughter now faces as she
anticipates the birth of her first child! We expect that not only will her hus-
band be present, but so may we. They plan to have their baby at home, or at
a birthing house, ministered to by a midwife. Her daughter will be laid on her
chest, umbilical cord still attached, and the father will cut it. My daughter will
be encouraged to put the baby to her breast immediately so that naturally
occurring hormones, rather than an injection of oxytocin, can help her to
expel the placenta and the family will be left together so they can bond.
While babies and children naturally inspire compassion and caring in peo-
ple, unfortunately, it has been my experience that, all too often, adults do not.
This is unfortunate because, no matter what our age, we all have an inner
child who is frightened and worried when illness strikes.

Patient and Family-Centered Care—Hit and Miss

Patient and family-centered care is not always easy to accomplish. For one
thing, there are inevitably competing needs amongst the players in a system
as complex as health care. It is all well and good to say that patients and their
families must be at the heart of all decisions and actions; however, the reality
is that everyone—including nurses, doctors, administrators, and so on—has
needs and there are always practical constraints. For example, a pregnant
woman might be very concerned with the overall birth experience while a
general practitioner might be more concerned with liability issues and thus
focus solely on the physical aspects of healthy mom and healthy babe, pos-
sibly dismissing dad altogether.
Another case in point is my experience with the scheduling of home care
visits. While the story may seem trivial on the surface, it is typical of the sort
of interactions patients often have with the health care system that can greatly
add to a patient’s distress. After I had the nephrostomy tube inserted, hospital
personnel made arrangements with home care for dressing changes once a
week. I was told that a home care nurse would call me on the appointed day
between 8:30 and 9:00 a.m. to schedule a time during her work schedule when
she could visit me at my home. The only thing that I found slightly not “patient
centered” about this arrangement was the fact that I couldn’t make any other

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424 Journal of Family Nursing 19(4)

plans for that day since I wouldn’t know until the morning when the nurse was
coming, but I accepted that because I imagined that there were many other
patients needing her on any given day and I assumed there were logistics to
consider. The first week, everything went smoothly. The nurse called at the
appointed time and scheduled her visit. I arranged my day accordingly.
The second week, things did not go as well. By this time, I was feeling
well again and anxious to get on with the activities of my life, many of which
involved going out, so the fact that I couldn’t schedule any other activities for
that day was a little more annoying. But, still, I accepted it. 9:00 a.m. rolled
around and there was no call. It reached 9:30 a.m. and there was still no call
so, feeling somewhat frustrated and let down, I phoned the home care number
and reached my district nurse. Trying to be diplomatic, I asked if I was mis-
taken about the process for scheduling a home care visit and explained my
expectations. The nurse, who sounded somewhat annoyed by my inquiry,
replied that actually, the phone call is a courtesy and that each nurse defines
their own process; therefore, there are inconsistencies. She declared that
home care is a service for homebound people (which was news to me) and
that I had a choice to make an appointment at the community care clinic
nearby. By her tone, I had the feeling that the latter option was offered almost
as a threat; however, I was happy to hear this as being able to make appoint-
ments would enable me to plan my days much more effectively.
Nevertheless, I was starting to feel defensive. I wished that the hospital
staff member who set up the arrangements originally had offered me these
alternatives and wanted to say that to make the assumption that a person who
has a nephrostomy is homebound is ludicrous! But I restrained myself. It
bears noting that, as a patient, you always worry that you are going to push
too hard and that there might be some consequences that will affect your care.
This feeling speaks to a harmful power imbalance that exists in the patient–
health care worker relationship.
Following the district nurse’s suggestion, I called the clinic nurse to sched-
ule my next dressing change. Again, I received a frosty response and was
told, No, we don’t work that way. You need to talk to the district nurse; the
district nurse and clinic nurse then work it out. She informed me that she was
sitting at her desk and could see where the available spots were, but they did
not work directly with patients to schedule appointments. Can you imagine
how frustrated this runaround made me? A few phone messages later, I had
my first appointment at the clinic.
I don’t know what the dynamics were that were playing out in the back-
ground. Perhaps it had something to do with the nurses’ workloads; never-
theless, it seems apparent to me that “inconsistencies” in policy and
procedure are not satisfactory for either the patient or the health care

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McGavin 425

workers. There is wasted time making and responding to phone calls. The
patient may feel, as I did, that their whole day is put on hold to accommodate
the nurse and that our time is less valuable, which places the nurse at the
heart of this interaction, not the patient. At the very least the system lacks
fairness when there is no option for negotiation about appointment times,
and so on. Confusion regarding process leads to miscommunication, misun-
derstanding, and possibly even resentment. This resentment only adds to
everyone’s stress levels. In this instance, the origin of the problem might be
traced to the person in the hospital who set up the home care visits.
Apparently, she made the assumption that I would be homebound, which
was not the case. Would it not have been better had she explained that there
were two options (did she even know there are two options?), and given me
a choice, thus making me more of a partner in my care rather than a passive
recipient of same?
Another constraint of our health care system is that most providers are
focused almost exclusively on the physical aspect of the patient’s problem
and do not ask about mood or whether the situation is difficult for the family.
On many levels, this is understandable since no one can be an expert in every-
thing and why open a can of worms if you’re not prepared to deal with it?
However, it is very powerful when one runs into someone who does acknowl-
edge these concerns. For example, one of my favorite urologists—someone I
saw on a regular basis—always began our conversations, as most doctors do,
by asking how I was. Most often, I managed a fairly enthusiastic fine; how-
ever, on one occasion the tone of my voice gave away a depressed mood. This
doctor was a very compassionate man and I know that he wanted to help me.
He said he suspected that I was depressed but admitted that his expertise was,
in his words, focused on the waist down. I appreciated the admission of his
limitations. His observation prompted me to acknowledge my own feelings
and to seek counseling.
By way of stark contrast, in so many medical settings where tension and
anxiety run high, the assembly line approach to patient care, with long unex-
plained periods of waiting between stations along the conveyor belt, and the
almost singular focus on empirical measurement of vital signs and test results,
often serve to compound and complicate whatever physical ailment the
patient may be suffering by increasing distress. It is almost more than the
person can bear at times, and thus the need for signs prominently displayed in
such areas that warn of the consequences of verbal abuse or other unaccept-
able behaviors. While these signs may be necessary, once again they clearly
reinforce the power imbalance between patients and health care workers and
they further deny the reality that illness causes psychological suffering as
well as physical. Instead of acknowledging the patient’s emotional response

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426 Journal of Family Nursing 19(4)

and finding constructive ways of handling it, these signs say: behave, or we
will exercise our power to deny you service—a very big threat, indeed!
While I understand that it is important to protect health care workers and I
accept that the signs are necessary, I also wonder: is there a better way of
dealing with things? Can we address that question by asking another: how do
patients get to the point where they “lose it” and how can we minimize the
chances they’ll get there in the first place?
Very recently, I had to be rushed back to the hospital because my nephros-
tomy tube had become dislodged. It needed to be reinserted and stabilized on
an emergency basis. I was very fortunate because I was able to get into the
angio room before the end of their work day and I was their last case. The radi-
ologist had completed his work and was gone. The nurse was finishing up with
my dressing when another nurse poked her head into the room. The second
nurse sighed heavily and a conversation started about how busy and stressful
her day had been. Apparently, the imaging department had been down one
technician which had caused a backlog. As a result, some patients had become
difficult. The nurse exclaimed: I just want to tell them, this is not a spa!
I had sympathy for the nurse, but I was struck by a few things: firstly, there
was a question in my mind about the appropriateness of her making such a
comment in my presence; that is, the appropriateness of complaining about
patients in front of a patient. It seemed indicative of something I have felt on
any number of other occasions: a blatant lack of awareness of the patient’s
presence. Another example was the indignity I felt some years previously
when, lying supine with legs in stirrups in an OR, cold and naked under a
flimsy hospital gown and covered only partially by a green cloth, I observed
the nurses, standing at the foot of the table, chatting in friendly terms to each
other while awaiting the arrival of the anesthetist and surgeon. In that moment,
I truly felt as though, for them, I didn’t exist as a sentient being.
My next thought involved a certain irony in what the frustrated nurse was
saying. As a patient who had visited the medical imaging department on several
previous occasions, I had experienced a very “spa-like” environment in a room
just down the hall in nuclear imaging: one of my tests involved a scan that took
a long time—upwards of 20 min, if memory serves. Someone—I presume it
was a group of nurses—had gone to great lengths to make patients comfortable
and relaxed: there were pillows for knees and neck and a warm blanket was
placed over me. The lighting was subdued, and someone had hung a mobile on
the ceiling from which dangled small sailboats that moved slowly about against
a background of sky blue walls. The atmosphere was made even more dream-
like by soothing music that was piped in. Very spa-like indeed, and much
appreciated! It made me feel as if someone understood that these procedures
are not routine for patients and are often fraught with anxiety.

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McGavin 427

Finally, I wondered if she or anyone else had bothered to talk to the

patients to tell them what was happening and to ask for their understanding.
I’ve been one of those patients who had to wait weeks for a test or procedure,
all the while wondering if it might be painful or uncomfortable and how
much my condition might have deteriorated in the meantime. By the time the
day of my test came around, I was very keyed up indeed. Sometimes, I was
fasting and suffering from a headache due to low blood sugar. I’ve been one
of those patients who had to sit in a waiting area well beyond the appointed
hour with no explanation and with no concern or sympathy shown. I’ve expe-
rienced anger and impotence when a long-awaited test was cancelled because
the necessary directions for how to prepare were not communicated. I know
the patient’s side of this story and I know that, for me, whatever negative
emotions I might have been feeling in that moment would have been diffused
considerably if only staff had kept me informed about what was going on,
expressed sympathy and understanding for my inconvenience, and apolo-
gized when appropriate. People are trained to do this in other service areas,
why not in health care?
Perhaps it is difficult to be patient and family centered in settings such as
a triage station, emergency department, imaging department, perioperative
area, OR, and the like where interactions are brief and there is little time to
develop any kind of relationship. On the other hand, in settings where the
patients, family members and health care providers work together on a more
ongoing basis, it seems to exist more naturally. One of my doctors demon-
strates it through the environment he and his staff have created in his clinical
practice. Picture this:

•• The waiting room is modern, clean, comfortable, and organized.

•• There is a very apparent emphasis on privacy. Files are neatly stored in
closed cabinets, and not left out on counter tops where anyone can see
them. Music drowns out personal conversations.
•• There is a water cooler inviting patients to refresh themselves.
•• There is a sign, prominently displayed, that encourages patients to
bring family or other caregivers to all appointments.
•• One wall is covered with a neat, well-organized display containing the
latest information pamphlets about the various conditions this physi-
cian treats.
•• The patient is provided with a leaflet explaining the doctor’s practice
and how it works so the patient is properly informed from the start about
the policies and procedures that will guide their working relationship.
•• The patient is encouraged to call whenever there is a question. Staff
members, who have obviously been trained in good “customer”

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428 Journal of Family Nursing 19(4)

relations, rarely appear too harried to answer questions. Absent is the

“gatekeeper” mentality that is prevalent in so many other offices I’ve
called.
•• Even the magazines are current and include things other than dog-
eared copies of Golf Digest!

Ways to Make it Better

In my experience, our health care system gets top marks for its handling of
medical matters. In fact, it’s amazing to me when I think of what has been
accomplished in the areas of cancer research and interventional radiology, as
examples. And I must acknowledge that I have been cared for by some out-
standing and compassionate professionals. But it has also been my experience
that care is not always very patient and family centered. For one thing, most
professionals who work in health care appear to be poorly trained on how to
act or what to recommend when it comes to the psychological needs that arise
for the patient and their family members. Basically, patients and their family
members are left to their own devices to cope as best they can. As well, the
competing needs of others in the system—be they doctors, nurses, technicians,
or administrators, and so on—often override the needs of patients and their
families. Factors such as workload, bureaucracy, information systems that
don’t mesh, lack of cohesion and consistency between work units, poor com-
munication, lack of feedback, and desensitization of health care workers seem
to compete with the ability to provide patient and family-centered care.
The good news is that while some changes—for example, those that
require funding or policy changes—may take years to implement, many
involve relatively simple changes in culture that are driven largely by shifts
in attitude. Here are some things that can be done today:

•• Welcome family and explicitly acknowledge their roles as both care

recipient and caregiver. This might entail something as simple as post-
ing a sign or as novel as offering a handshake and a thank-you for all
that the family member has done.
•• Educate yourself about resources that exist to support patients’ and
families’ emotional, psychological, and spiritual needs and refer to
these areas whenever possible. These might include support groups,
reputable Internet sites, or counseling centers.
•• Recognize the inherent power imbalance that exists in health care and
consciously work to overcome it by treating patients as partners.
•• Adopt a service attitude: offer explanations, understanding, and apolo-
gies as appropriate.

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McGavin 429

•• See patients as individuals. Do this by remaining attentive to their

presence and their needs, even after your need to dot the i’s and cross
the t’s has been met. Make eye contact and use active listening skills.
•• Understand that ill health takes away one’s sense of being in control
and makes one feel very vulnerable so help patients to cope by keeping
them informed, providing them with information, and empowering
them to make choices.
•• Confirm and follow through on agreements so patients know they
haven’t fallen between the cracks.
•• Protect patients’ dignity and privacy.
•• If nothing else, provide simple comforts: a glass of water, a warm
blanket, a smile.

To sum it up, remember that your interaction with the patient and their
family members is likely only one stop along a path that may be long, circu-
itous, disjointed, and full of emotional ups and down. The decisions you
make on how to act have a profound effect on that journey. Recognize the
interconnectivity of the patient and their family and work with them as part-
ners in care. By doing these things, hopefully, patients and families will
remain at the heart of health care.

Editor’s Note
After hearing Colleen eloquently describe her illness narrative and offer her recom-
mendations to improve patient and family-centered care at Quality Forum 2013 spon-
sored by the BC Patient Safety and Quality Council in Vancouver, I invited Colleen
to publish her ideas in the Journal of Family Nursing. I am inspired by her passion to
use her illness experience to call for change in the patient/family–health care profes-
sional relationship.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding
The author received no financial support for the research, authorship, and/or publica-
tion of this article.

Author Biography
Colleen McGavin is a retired business educator having taught for almost 25 years at
Camosun College in Victoria, British Columbia, Canada. Areas of specialty included
information technology and business communication. Her experiences as a patient

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430 Journal of Family Nursing 19(4)

and family caregiver prompted her to become an activated member of the Patient
Voices Network, a program administered by Impact BC under the banner of the
“Patients as Partners” initiative of the BC Government’s Ministry of Health. She is
passionate about using her experience to help bring about positive change in the
health care system. In the role of patient voice, she regularly participates on focus
groups, panel discussions, and speaking engagements with organizations such as the
BC Medical Association and the BC Patient Safety and Quality Council. She cur-
rently serves as a member of the Strategic Advisory Coalition for the Vancouver
Island Health Authority. This is her first publication.

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