NR 500 NP Week 3 Reflection the Importance of Person-Centered Care in Healthcare

Student Name

Chamberlain University

NR-500: Foundational Concepts & Applications

Prof. Name:

Date

Person-Centered Care in Healthcare: ICU and ED Perspectives

Introduction

Person-centered care is a fundamental principle in healthcare that influences every aspect of patient interaction. Throughout my nursing education, from my Associate Degree in Nursing (ADN) to my Bachelor of Science in Nursing (BSN), as well as during my professional experience in hospitals, the emphasis on person-centered care has been a recurring theme. However, I have observed that the ability to deliver this type of care varies depending on the healthcare setting. This variation is particularly evident when comparing the experiences of healthcare providers in the Intensive Care Unit (ICU) and the Emergency Department (ED).

In the ICU, nurse-to-patient ratios are generally lower, often one-to-one or two-to-one, occasionally reaching three-to-one depending on patient acuity. High-acuity patients require a lower ratio to ensure that nurses can assess and address their needs effectively. When patients begin to transition out of high acuity, they may be moved to intermediate care, where nurses manage a slightly higher patient load. However, even with an increase in patient numbers, the ratios remain within a manageable range, allowing for a more individualized approach to care. This setting enables ICU nurses to dedicate more time to each patient and their families, ensuring a higher degree of person-centered care.

Conversely, in the ED, the provider-to-patient ratio is typically four-to-one, though it can sometimes drop to three-to-one. Despite this ratio rarely exceeding four-to-one, emergency nurses often find themselves caring for multiple critically ill patients at once. This environment prioritizes immediate assessment, stabilization, and transfer, leaving limited time for in-depth, person-centered interactions. While I find the high-intensity nature of emergency care stimulating, I recognize that increasing demands on ED providers have made it more difficult to maintain a person-centered approach.

Comparison of Person-Centered Care in ICU and ED

Category	Intensive Care Unit (ICU)	Emergency Department (ED)
Nurse-to-Patient Ratios	Typically one-to-one or two-to-one, occasionally three-to-one, depending on acuity	Typically four-to-one, sometimes three-to-one, with limited time for each patient
Focus and Approach	Personalized, patient- and family-centered care with dedicated time for each patient	Prioritizes stabilization and rapid transfer, limiting opportunities for personalized care
Challenges	Manageable patient load supports individualized care	High patient volume and acuity levels reduce focus on person-centered care

Reflection and Future Advocacy

Reflecting on my early experiences in the ED, I recall that cases often included lower-acuity conditions, such as sexually transmitted infections or common colds, alongside critical emergencies. These cases have become increasingly prevalent, at times overshadowing urgent cases and creating additional challenges for ED providers. The need to balance both lower- and higher-acuity cases further limits the capacity to deliver person-centered care. Unlike the ICU, where long-term personalized care is more feasible, the ED’s primary focus on acute stabilization means that individualized care is often deprioritized. Nevertheless, as I advance toward becoming a Family Nurse Practitioner (FNP), I remain committed to integrating person-centered care into my practice. Despite the challenges posed by the ED environment, I believe that prioritizing patient-centered care can enhance both patient outcomes and satisfaction.

Hospitals have increasingly implemented post-discharge satisfaction surveys to evaluate patient experiences. Across multiple hospitals where I have worked, ED satisfaction scores have consistently been among the lowest. Common patient complaints include long wait times and insufficient interaction with healthcare providers. Although I have brought these concerns to management, the responses have been consistent—budget constraints prevent hiring additional nurses, and adjusting ratios based on acuity would require further staffing. As I transition into my role as an FNP, I hope to advocate for staffing improvements and acuity-based provider ratios to enhance the delivery of person-centered care.

Conclusion

Person-centered care is an essential aspect of quality healthcare, though its implementation varies significantly across different healthcare settings. In the ICU, lower nurse-to-patient ratios allow for more personalized care, while in the ED, the fast-paced nature of the environment often limits the extent to which individualized care can be provided. Addressing the challenges unique to emergency care, particularly in managing high patient volumes and acuity levels, is crucial to improving both patient satisfaction and overall healthcare outcomes. As I progress in my career, I aim to advocate for improvements in staffing and care models to ensure that person-centered care becomes a consistent standard across all departments.

References

McCormack, B., & McCance, T. (2017). Person-centred practice in nursing and healthcare: Theory and practice (2nd ed.). Wiley Blackwell.

Pelzang, R. (2010). Time to learn: Understanding patient-centered care. British Journal of Nursing, 19(14), 912-917. https://doi.org/10.12968/bjon.2010.19.14.49050