Put patients and caregivers, not HMOs, at center of health policy

Nurses are the Philippines’ largest health care professionals whose practice can severely impact care outcomes (both positive and negative). They spend much time with patients and their caregivers.

As a result, positive nurse-patient (and caregiver relationships) are therapeutic and constitute a core component of care.

In many instances, nurses serve as translators or patients’ advocates, in addition to performing their primary care duties. Nevertheless, there are institutional and health care system-related barriers that limit nurses’ efforts to provide health care that meets patients’ and caregivers’ needs. Common issues in our country’s nursing sector include shortage of nursing staff, high workload, burnout, and limited time. All of them constitute one complex institutional and health care system-level barrier to effective care delivery.

Despite the gargantuan barriers, there is still a silver lining. Patient-centered care can be facilitated in many ways, including building solid nurse-patient relationships.

First, an important facilitator of patient-centered care is overcoming practical communication barriers in the nurse-patient dyad. Active listening among care providers is essential to addressing many barriers to patient-centered care and communication. By listening to patients’ concerns, nurses can identify patients’ care needs and preferences and address their fears and frustrations.

Another facilitator of patient-centered care is by understanding patients and their unique needs, showing empathy and attending attitudes, expressing warmth and respect, and treating patients and caregivers with dignity and compassion as humans. Showing empathy, active listening, respect, and treating patients with dignity are core to nursing and care, and are recognized in the Code of Ethics for Nurses. Nurses explain information about patient care and condition, including treatment options, prognosis, potential side effects, and costs. Thus, helping patients make informed decisions about their care.

Besides, engaging patients and caregivers in the care process through sharing information, inviting their opinion, and collaborating with them constitutes another facilitator of patient-centered care and communication. When patients and caregivers are engaged in the care process, misunderstandings and misconceptions are minimized, and there is an environment where patients and caregivers feel safe. This includes, for example, providing care and treatment that includes personal privacy, such as separate treatment rooms, screens, or curtains.

Finally, health policy must be oriented toward health care practices and management to facilitate patient-centered care and communication. Nonetheless, if patients are placed at the center of care and treated with dignity and respect, most of the challenges and barriers of patient-centered care will gradually diminish. Empowering nurses, equipping them with interpersonal communication skills through regular continuing professional development activities, supporting them to overcome their emotional challenges, and setting boundaries during nurse-patient interactions will enhance patient-centered care practices.

Patient-centered care is about how health care services and governments create and support policies to put patients and caregivers, not health care organizations, at the center of care.

Jerome Babete, Beta Nu Delta Nursing Society


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