Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Core Process of Client Centered Care - Caring and Service

a) Involve clients throughout the caring and service process.

b) Acknowledge the client’s expertise and encourage clients/communities to share their knowledge and skills. Follow the client’s lead in using language that is appropriate to the client (including the use or non-use of technical jargon).

c) Respect and honour client choices and decisions though they may not be related to the illness/disease process or health services and regardless of the nurse’s own values. The responsibility of the nurse is to not abandon clients in times of their need/conflict, but to explore situations of ethical conflict by listening, understanding, and responding; to be aware of relevant legislation; and seek additional information and resources before next steps are taken.

d) Use trust-building strategies to develop the nurse-client relationship.

  • Introduce yourself and call clients by preferred name.
  • Give clients written and/or visual information identifying members of the team; explain the role of each and identify the primary contact.

e) Demonstrate respect and value for clients by listening with openness.

  • Listen to accept – validate what is being said.
  • Ask clients regularly about their experiences with the care and service that they are receiving.

f ) Use positive language to discuss clients.

  • Use the client’s own words to describe situations (i.e., “Mr. Smith says he doesn’t want to take his pills because …” Or, “Mrs. Jones says she doesn’t want to get out of bed because …”)
  • Use strength-based language (i.e., instead of “demanding,” or “controlling,” use “good advocate,” or “knows needs well”).
  • Do not describe clients as compliant or non-compliant.
  • Do not refer to clients as diagnoses, problems, labels.

g) Involve family/significant others as per client wishes.

h) Ensure that the client’s goals are central to the coordination, continuity, and consistency of care:

  • Develop customized action plans with clients that reflect activities or actions aimed at achieving the clients’ identified goals.
  • Solicit the client’s perceptions about the coordination of care or services and make this information available to the clinician in charge or discharge planners (i.e. Does the clients understand the roles of service providers? Is the information provided consistent?).
  • Make discharge a critical opportunity to promote independence and sustainability by identifying sources of on-going support (i.e. health care professionals, support groups, etc.).
  • Act as a resource (i.e. how to reach health care professionals after discharge for consultation, who to ask to get help).