THE CONCEPT OF HEALTH AND HEALTHCARE DELIVERY SYSTEM

Introduction
Health is a concept that is central to the nursing profession and nursing practice. It remains a
dynamic concept, however, that has evolved over time and can be examined from contrasting
perspectives. Everybody utmost desire is to be healthy which explains the popular saying that
“Health is wealth”. Healthcare system therefore exists to help people maintain this optimal state
of health. WHO 1948 define Health as a “state of complete physical, mental and social wellbeing
and not merely an absence of disease or infirmity and the ability to lead a socially and
economically productive life”. WHO 1986 further made clarifications that health is “a resource
for everyday life, not the objective of living”. Health is a positive concept emphasizing social
and personal resources, as well as physical capacities.” This means that health is a resource to
support an individual’s function in wider society, rather than an end in itself. A healthful
lifestyle provides the means to lead a full life with meaning and purpose.
Operationally, health is a condition or quality of the human organism expressing the adequate
functioning of the organism in given conditions, genetic or environmental. In 2009, researchers
publishing in “The Lancet” defined health as the ability of a body to adapt to new threats
and infirmities. They base this definition on the idea that the past few decades have seen
modern science take significant strides in the awareness of diseases by understanding how they
work, discovering new ways to slow or stop them, and acknowledging that an absence of
pathology may not be possible.
Changing Concept of Health
Biomedical Concept: Health has been viewed as an “absence of disease”, and if one was free
from disease the person was considered healthy.
Ecological Concept: Health implies the relative absence of pain and discomfort and a
continuous adaptation and adjustment to the environment to ensure optimal function.
Psychosocial Concept: Health is both a biological and social phenomenon.
Holistic Concept: A sound mind in a sound body, in a sound family, in a sound environment;
All sectors of society like agriculture, animal husbandry, food, industry, education, housing,
public works, communication & other sectors have an effect on health.
Dimensions of Health
1. Physical Health: A person who has good physical health is likely to have bodily
functions and processes working at their peak. This is not only due to an absence of
disease. Regular exercise, balanced nutrition, and adequate rest all contribute to good
health. People receive medical treatment to maintain the balance, when necessary.
2. Mental Health: Mental Health has been defined as “a state of balance between the
individual and the surrounding world, a state of harmony between oneself and others, a

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 coexistence between the realities of the self and that of other people and that of the
environment”. Apart from mental disorders, psychological factors can also induce
Essential Hypertension; Peptic Ulcer and Bronchial Asthma
3. Social Health: Social wellbeing implies “Quality and quantity of an individual’s
interpersonal ties and the extent of involvement with the community”. Social health takes
into account that every individual is a part of a family and the wider community. It
focuses on social and economic conditions and well-being of the “Whole Person” in the
context of his social network.
4. Spiritual Health: Spiritual health in this context, refers to that part of the individual
which reaches out and strives for meaning and purpose in life. This dimension seems to
defy concrete definition. It includes; integrity, principles of ethics, purpose in life,
commitment to some higher being, belief in concepts that are not subject to “state of the
art” explanation.
5. Emotional Health: Initially mental and emotional dimensions were seen as being same
but as more research becomes available a definite difference is emerging. Mental health
can be seen as “Knowing” or “Cognition”, while emotional health refers to “Feelings”
Philosophy of Health

 Health is a fundamental Human Right

 Health is the essence of productive life
 Health is inter sectorial
 Health is an integral part of development
 Health is central to the concept of quality of life
 Health involves individuals, state and international responsibility
 Health and its maintenance is a major social investment
 Health is a worldwide social goal

The Healthcare delivery system

The health care delivery system is an organization of people, institutions, and resources to
deliver health care services to meet the health needs of a target population, whether a single-
provider practice or a large health care system. The health system may also be viewed as “a
system which consists of all organizations, people, and actions whose primary intent is to
promote, restore, or maintain health. This includes efforts to influence determinants of health as
well as more direct health-improving activities. It is the network of health facilities and personnel
which carries out the task of rendering health care to the people.

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Levels/Tiers of health care delivery system in Nigeria

The national health system is in principle decentralized into a three-tier structure with
responsibilities at the Federal, State and Local government levels. The three main levels of
Health care include:

1. Primary Healthcare system: Primary Health Care (PHC) is a grass-root management

approach to providing health care services to communities. This is the first level of care or the
entry point to the Nigerian healthcare system. It is the first contact of individuals, families and
communities with the national health system. It is offered in the Primary Healthcare facilities and
the services include health education, preventive, prenatal, emergency and basic health care
services for remote rural areas. Basically, Primary healthcare is the responsibility of the Local
Government with support from their respective State ministries of health as well as private
medical practitioners. The healthcare facilities under the Primary Healthcare system include;
Health post, Health clinic, Primary Healthcare Center and Comprehensive Healthcare Center.

2. Secondary Healthcare system: The secondary health care system is managed by the ministry
of health at the State level. Patients at this level are often referred from the primary health care.
This is the first level of specialty services and is available at different divisions of the State. It
serves as referral centers for cases requiring more advanced care.

3. Tertiary Healthcare system: The tertiary primary health care is provided by teaching
hospitals and specialist hospitals. At this level, the federal government also works with voluntary
and nongovernmental organizations, as well as private practitioners. More complex cases are
referred for specialized care.

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 DIAGRAMATIC REPRESENTATION OF THE HEALTHCARE SYSTEM

The role of the nurse in the health care delivery system

A professional nurse is someone who has been educated for a specified number of years, passed
the qualifying nursing examination and is fully registered and licensed by the board e. g Nursing
and Midwifery Council of Nigeria (NMCN) to practice Nursing in such a country. Focus of
training is on meeting deficiencies in health demands of clients and their families either within or
outside organized health settings.
Nursing is rightly a profession with its own unique roles that can only be offered by
professionals who have graduated from a certified institution for the training of nurses. Despite
the confusion in some developing countries where some people are trained to offer assisting
roles, wear white dresses and even answer the name nurses, there are still huge differences
between an untrained nurse (quack nurse) and a professional nurse. Professional nurses offer care
that are scientifically explained and evidenced-based while untrained nurses offer care that is not
evidenced-based and do not have the technical know-how to take critical decisions as regards
patient care. There is usually a stir and confusion when non-professionals attempt to define what
nursing roles are even though their roles are clearly delineated and visualized. Moreso, when
nurses themselves are called upon to clarify our roles, we have problems in clearly articulating
the unique work of a nurse. That is our core nursing roles outside the daily task of administering
medications and other treatments, documenting care and communicating with team members.
However, nurses roles go far beyond the eyes of the non-professionals and the daily basic role
mentioned above.

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Nursing encompasses autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well and in all settings. Nurses form the backbone of any health
care system and determine the success and failure of healthcare systems and programmes
globally. Not only because of their unique roles but more so that they are the single largest
healthcare professionals in the healthcare system. Again, they are the only single health
profession that stay by the bedside of clients 24 hours as they pass through the various stages of
illness and disease.
Most people do not know or appreciate nurses’ responsibilities as they are commonly labelled
“doctor assistants”. It is important therefore to clarify such misconceptions by discussing the
unique roles and responsibilities of the nurse in healthcare system. Distinct from the stereotypes
portrayed in the media and television, the actual roles nurses play are uniquely multifaceted.
Some definitions of nursing that highlight the roles of a nurse
Florence Nightingale, described nursing as “the act of utilizing the environment of the patient to
assist him in his recovery”
Virginia Henderson contends that “the unique function of the nurse is to assist the individual,
sick or well, in the performance of those activities contributing to health or its recovery, or to a
peaceful death, that he would perform unaided if he had the necessary strength, will or
knowledge, and to do this in such a way as to help them gain full or partial independence as
rapidly as possible (Henderson, 1977, p.4; Henderson, 1966)
International Council of Nursing (ICN) view nursing as “encompassing autonomous and
collaborative care of individuals of all ages, families, groups and communities, sick or well and
in all settings; including the promotion of health, prevention of illness, and care of the ill,
disabled and dying people”. Nurses roles also include advocacy, promotion of a safe
environment, research, participation in shaping health policy, Patient and health systems
management and education are also key nursing roles. (ICN, 2002)
American Nurses Association (ANA) argue that nursing, “as an integral part of the health care
system, encompasses the promotion of health, prevention of illness, and care of the physically ill,
mentally ill and disabled people of all ages, in all health care and other community settings.
Within this broad spectrum of health care, the phenomena of particular concern to nurses are
individual, family, and group "responses to actual or potential health problems" (ANA, 1980).
These human responses range broadly from health restoring reactions to an individual episode of
illness to the development of policy in promoting the long-term health of a population.
ANA also defined nursing as “the protection, promotion and optimization of health and abilities,
prevention of illness and injury, alleviation of suffering through diagnosis and treatment of
human response, and advocacy in the care of individuals, families, communities, and
populations”.

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These and other definitions portray just a tip of an iceberg what nurses do in and outside a formal
healthcare setting.
SPECIFIC ROLES OF THE NURSE
Patient care
A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat
health conditions. To do this, they need to observe and monitor the patient, recording any
relevant information to aid in treatment decision-making. Throughout the treatment process, the
nurse follows the progress of the patient and acts accordingly with the patient’s best interests in
mind. The care provided by a nurse extends beyond the administration of medications and other
therapies. They are responsible for the holistic care of patients, which encompasses the
psychosocial, developmental, cultural, and spiritual needs of the individual.
Nurses take care of their patients in hospitals like a mother takes care of their children. Jean
Watson’s theory of caring describes the scientific basis of nursing as extending beyond human
interaction, to a moral concern for preserving human dignity and respect for the wholeness of the
care recipient
Patient safety
Nurses play a vital role in patient safety. After the doctor’s visit or diagnoses, it’s the nurse’s
duty to prevent medication errors and ensure patients receive the correct treatment. In the case of
fall or skin breakdowns, her responsibility is to provide proper safeguards as well as document
the incident (Ohaeri, 2019)

Patient Advocacy
The patient is the first priority of the nurse. The role of the nurse is to advocate for the best
interests of the patient and to maintain the patient’s dignity throughout treatment and care. Often
nurses might have to step in and advise the doctor to take a different approach due to the unique
circumstances of their patient. This may include making suggestions in the treatment plan of
patients, in collaboration with other health professionals. This is particularly important because
patients who are unwell are often unable to comprehend medical situations and act as they
usually would. It is the role of the nurse to support the patient and represent the patient's best
interests at all times, especially when treatment decisions are being made.
Every patient or client has the right to receive just, equal, and humane treatment. Current health
care system offers de-personalized and fragmented services. Many clients who are poor and
disadvantaged are frustrated and the nurse becomes an advocate for clients pleading their cause
and acting on their behalf (Ohaeri, 2019).
Planning of care
A nurse is directly involved in the decision-making process for the treatment of patients. It is
important that they are able to think critically when assessing patient signs and identifying
potential problems so that they can make the appropriate recommendations and actions. As
patient treatment decisions are being made, nurses should be able to communicate information
regarding patient health effectively. This is because nurses are the single healthcare team

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members that are closer and stay longer with the patient and so they are the most familiar with
the individual patient situation as they monitor their signs and symptoms on an ongoing basis.
They should therefore, collaborate with other members of the medical team to promote the best
patient health outcomes.
Communication
Effective communication in the healthcare system is necessary as it can improve outcomes in the
healthcare environment. The nurse has the responsibility of communicating with the patient,
patient family and other healthcare team members. To the patient and family, the nurse
communicates treatment decisions, treatment plans, reassures and clears their doubt because if
communication is not effective, the healing process will be inhibited.

Patient Education and Support

Nurses are also responsible for ensuring that patients are able to understand their health,
illnesses, medications, and treatments to the best of their ability. This is of the essence when
patients are discharged from hospital and need to take control of their own treatments. A nurse
should take the time to explain to the patient and their family or caregiver what to do and what to
expect when they leave the hospital or medical clinic. They should also make sure that the
patient feels supported and knows where to seek additional information (Yolanda, 2021).
Patient Education and Support: Learning and Guiding
Providers are using new types of machines and applications every day. Medicine is becoming
personalized requiring nurses to instruct patients about medical apps that can enhance traditional
care. The nurse in this role can actively teach and guide patients, families, and communities
about health/wellness and illness- about living and dying.

Management/Leadership role
It has become apparent that nurses must understand the true value they provide and to make their
voices heard. Part of spreading their message more effectively is becoming a better leader. The
first step to becoming a better leader as a nurse is advancing your education and growing your
expertise. The more knowledge and skill you possess, the more you can contribute. Certifications
and other advanced learning courses are great options for registered nurses. The other crucial
step is getting more involved in leadership roles in hospitals and other medical organizations.
Nurses have an incredible point of view that other healthcare leaders need to hear and learn from.
To create change, nurses must be proactive and challenge the current standards.
Fundamental to nursing practice is the role of nurse leader as manager. It involves pulling
together people with the common goal of caregiving. It requires a systematic way of providing
care, a precise tending to details, and working from a comprehensive assessment and plan, as
well as engaging colleagues in compassionate, collaborative, interdisciplinary practice. Authentic
leadership, is like the “glue’ needed to hold together a healthy work environment (Ohaeri, 2019).
Mentor: Sharing and Role Modeling
Mentoring refers to a formal or informal process in which a mentor and a mentee establish a
relationship with the mutual goal of meeting the career goals of the mentee. It’s been

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documented that the initial 3 months of a newly graduated nurse’s transition is vital to long-term
success in the profession (Ohaeri, 2019). Therefore, mentoring another nurse is a professional
means of passing along knowledge, skills, behaviors and values to a less experienced individual.

Specialist Roles
By choosing the appropriate medical specialization, nurses can address complications related to
diabetes, obesity, heart problems, kidney disease and dementia
Research (Inquiring and Discovering)
The role of a researcher in the nursing profession is vital for generating new knowledge to
underpin nursing practice, clinical care, and public health. As both a caring art and scientific
enterprise, nursing has an obligation to provide care that is continually examined through
research. The nurse applies research at the bedside by providing interventions that are based on
current evidence. At an advanced level, the role of nurse as a researcher is fundamental to
improving patient care and public health by defining research questions and designing scientific
studies to answer them.
Expanded Role of Nurses
The subject of role expansion has been much debated, particularly in recent years as a result of
changing healthcare policies, growing demands by nurses and the public, and arguments about
the very nature of nursing itself. An expanded role of nursing is one in which a nurse assumes
expanded or increased responsibilities in a practice area and in most cases practice with greater
autonomy. It means engagement of nurses’ role within the boundaries of nursing. It is the
responsibility assumed by the nurse within field of practice of the nurse but with greater
autonomy to practice. Expanded roles include:

 Advanced Nurse Practitioner: A Nurse who has an advanced education and is a

graduate of a nurse practitioner program is employed in health care agencies or in the
community settings and deals chronic illness and provide primary ambulatory care
 Clinical Nurse Specialist: The clinical nurse specialist has a master’s degree in nursing
and expertise in a specialized area of practice. CNS may work in primary care, acute care,
rehabilitative care and community based settings.
 Nursing Administrator: Manage client care and the delivery of specific nursing services
within a health care agency.
 Nurse anesthetist: Provide care pre-operative, intra operative and post-operative period.
Assist to anesthetist during surgery.
 Advanced Nurse Educator: The nurse is more advanced and frequently an expert in a
particular area of practice.
 Nurse Researcher: Participate in scientific investigation. Complete the research process.
 Acute Care Nurse Practitioner: An acute care nurse practitioner functions in the
settings where critically ill patients reside, this type of nurses provide special expertise.

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  Nurse Entrepreneur: An entrepreneur is an individual who organize operates and
assumes the risk of independent nursing practices, consultant services etc., the nurse may
be involved in education consultation research etc.
  Operating Room Nurse: The nurse monitor the progress of patients before and after
surgery from the time of entry in the operating room until he/she is dismissed to the
attending staff nurse.
 Professional Nurse Care Manager: The nurse case manager assesses the patients and
develops care according to expected outcomes in terms of cost and quality.
 Nurse Analyst: The nurse analyst is involved in data analysis and interpretation with
regards to effectiveness and efficiency of data collection, entry and use within the various
areas of the hospital and health care facility.
 Nurse Oncologist: A specialized nurse who cares for cancer patients.
  Sports Nursing: Sports medicine is a sub-specialty of orthopedic medicine, largely
involving injuries or traumas suffered as a result of training or competing in an athletic
event.
 Nurse Authors: Nurse works in any area of writing, this written material may be used in
research education, training and marketing
 Space Nursing: Space nurses provides health services to astronauts.
 Nurse Liaison: The nurse Liaison’s role is multifaceted. They are the vital link between
the potential patient and the rehabilitation facility.
 Hospice Nurse: The focus of hospice care is a comprehensive physical, psychological,
emotional and spiritual care to terminal ill persons and their families. Hospice care
promotes quality of life.
 School Health Nurse: Nurse support the educational process by helping students keep
healthy and by teaching preventive practices for students and teachers
 Tele Nursing: Providing nursing services by the use of telecommunication and
information technology whenever a large physical distance between patient and nurse.
 Cruise Ship/ Resort Nurse: These nurse work on ship or resorts to provide emergency
and general care to passengers if required.
 Nurse Attorney: Nurse attorney engage in a range of legal activities by legal
consultation.
  Disaster/Bio Terrorism Nurse: These nurses works in disaster areas that are result of
bio terrorist attack or in situation caused by natural or man-made disaster.
  Epidemiology Nurse: The nurse epidemiologist investigates trends in disease
occurrence in particular area. They identify the population at risk monitor the progress of
disease, special areas of health care need, determine priorities Ethicist: The nurse who
knows about legal/ethical issues and provides services for patients and families is called
nurse ethicist.

Extended roles of the nurse 

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A popular definition of a nurse's extended role is a procedure that is not covered in basic training
and for which further training is needed. There are activities concerned with patients, either in
hospital or the community, that are appropriate for delegation by doctors to nurses. The concept
implies expansion of the role of nurses into work traditionally seen as the province of doctors
and can be detected in many areas of clinical practice

COLLABORATIVE ROLES OF THE NURSE

Nurses are the only clinical professionals who are specially trained to understand the roles of
other healthcare providers, this training provides a strong foundation for successful
collaboration. Collaborative practice is a foundation for quality care. In order to provide safe,
competent, and ethical client care, nurses must practice in an environment that fosters
collaboration between health professionals for the benefit of clients and the health-care system
Effective teamwork and professional partnerships create a supportive care environment where
team members are empowered to work together within their respective scopes of practice.
Effective collaboration encourages patients, families and healthcare providers to be active
participants in the treatment process which in turn promotes improved quality outcomes,
improvements in patient experience, patient safety, and effective use of resources.

Nurses plan and participate in interdisciplinary care conferences; assign, delegate, and supervise
nursing team members; educate clients and staff; act as client advocates; make client referrals;
ensure continuity of care; and contribute to the evaluation of patient outcomes. These
responsibilities of the nurse are further described here.

1. Planning and Participating in Interdisciplinary Care Conferences

The nurse identifies clients who would benefit from interdisciplinary care conferences.
Interdisciplinary care conferences are meetings where interprofessional team members
professionally collaborate, share their expertise, and plan collaborative interventions to meet
client needs. As the interprofessional team member likely to spend the most time at the client’s
bedside, nurses are key members for advocating for client needs during interdisciplinary care
conferences. The nurse utilizes effective communication techniques by expressing and
advocating for client needs, listening attentively to suggestions of other team members,
formulating a collaborative plan of care, and documenting it in the client’s nursing care plan.
2. Assigning, Delegating, and Supervising
Nurses assign, delegate, and supervise care of other members of the nursing team, such as
licensed other cadre of nurse assistnts/ assistive personnel (AP). Appropriately assigning and
delegating care with appropriate supervision are strategies that ensure quality client care is
completed efficiently.
3. Educating Clients and Staff
Nurses provide patient education, train staff, and serve as a staff resource. For example, an RN
serves as a resource to assistive personnel (AP) floating to their unit. The RN provides a general
orientation of the unit, explains the pertinent needs of the clients as they pertain to the AP’s
assigned tasks, and shares how the staff interact and communicate within the unit. The RN

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ensures the AP understands the orientation information, is competent in their assigned/delegated
tasks, and utilizes the RN as a resource throughout the shift.
4. Acting As a Client Advocate
Nurses advocate for client needs with family members, interprofessional team members, health
care administrators, and, in some cases, health insurance companies and policy makers. Nurses
protect and defend the rights and interests of their clients and ensure their safety, especially if the
client is unable to advocate for themselves. For example, clients who are unconscious,
developmentally disabled, illiterate, or experiencing confusion often require assertive advocacy
with the interprofessional team to effectively meet their needs and preferences

5. Making Client Referrals

Nurses assess clients, determine their needs, and make referrals based on potential or actual
problem(s). If the assessed needs of the client cannot be met by the collaborative nursing
interventions, the nurse seeks out other resources to fulfill the client’s needs. For example, nurses
often advocate for referrals to community resources such as home health care, support groups,
social services, respite care, emergency shelters, transportation, elder day care, and parenting
groups. After needed referrals are identified, the nurse obtains necessary provider orders and
completes applicable referral forms. This information is shared confidentially with the client and
the referral resource.
6. Ensuring Continuity of Care
Nurses serve a vital role for maintaining continuity of care and making any client transition of
care smooth and unfragmented. Continuity of care is defined as “the use of information on past
events and personal circumstances to make current care appropriate for each individual.”[4]
Transitions of care include admission to a facility, transfer from one unit to another within the
same facility, transfer from one facility to another, or discharge to their home or a long-term care
facility. For example, a transfer occurs when a client is moved from a medical unit bed to the
intensive care unit.

There is high risk for medical errors during transitions of care. Nurses help make transitions
seamless with good handoff reports and documentation while effectively collaborating with the
interprofessional team.
7. Safely Admitting and Discharging Clients
Admission refers to an initial visit or contact with a client. Discharge refers to the completion of
care and services in a health care facility and the client is sent home (or to another health care
facility).Admissions and discharges are more than just the physical movement of an individual.
They require a great deal of confidential information sharing to maintain continuity of care.
During an admission, nurses use the nursing process to thoroughly assess the client, diagnose
nursing problems, establish expected outcomes, and create a nursing care plan. Referrals for
other inpatient services, such as a dietician, wound care nurse, chaplain, social worker, or other
interprofessional team members, may be initiated.
8. Reporting New Information and Changing Conditions
The nurse is often responsible for reporting new information to the interprofessional team
regarding inpatients, such as newly reported laboratory or diagnostic results or changes in a
patient’s condition. Here are some examples of a nurse reporting and following up on issues:
9. Contributing to the Evaluation of Client Outcomes

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In today’s complex health care system, data regarding patient outcomes is constantly
documented and analyzed. This data drives management decisions and is also reported to
insurance companies as a component of “pay for performance” reimbursement processes. The
nurse is directly involved in this data by establishing expected outcomes customized to the client,
evaluating these outcomes, and documenting data supporting outcomes related to collaborative
nursing interventions.

ROLES OF THE NURSE PRACTITONER

Since the profession started in 1965, the nurse practitioner role has become increasingly
important to our healthcare system with each passing year. Broadly speaking, the nurse
practitioner of today is an advanced practice registered nurse (APRN) who provides acute and
primary care to people across the lifespan. Nurse practitioners work independently and in
collaboration with other healthcare professionals, in settings that include hospitals, private
practices, urgent care clinics and long-term care facilities. Keep in mind that the scope of
practice for a nurse practitioner varies from state to state, and sometimes even from setting to
setting. The roles include;

- Listening to patients, families and communities to understand their health needs and offer
emotional support.
- Diagnosing and treating health conditions.
- Creating patient care plans.
- Prescribing medications (level of authority varies).
- Educating individuals and families on disease prevention.
- Ordering, interpreting and discussing results of diagnostic tests with patients.

The patient as a member of the family

A family refer to a team of individuals that are connected with bonds of marriage, blood
and adoption, and interact between each other. A family may include a wider social team,
which is constituted from two or more individuals who live in the same space, have
common sentimental bonds, aims and objectives, and fulfill interdependent activities (Bellou &
Gerogianni, 2014). The family has a significant role in hospital treatment of patients, since
it can provide effective psychological and emotional support to patients undergoing
treatment to hospital (Bellou & Gerogianni, 2014). The presence of family constitutes an
important source of psychological stability for the patient, as well as a source of support for
better recovery. Moreover, the role of family, friends, and relatives is of vital importance for the
maintenance of quality of life in hospitalized patients with chronic problems. This is because
family members can satisfy basic needs of the patient in the hospital to a large extent and can
also help decrease client stress as well as encourage him to comply with recommended treatment

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regimen. The family support can also enhance client ability to effectively cope and face any
complications of his illness (Boyle, 2015).

When focusing on the goals for the patient's recovery, the healthcare team should make efforts to
include patient’s family in taking appropriate treatment care plan for the patient on both a short-
and long-term basis. It is vital that this multi-disciplinary approach occurs during the formation
of the care plan and should be frequently updated as time goes on. The loved ones of a patient
may not have a medical license or healthcare background, but their voice and presence matters in
the hospital room. The communication between the patient, family, and health care providers is
very important throughout the entire process (Boyle, 2015). Consequently, the medical and
nursing staff needs to maintain a continuous contact with parents and relatives of patients,
and provide them with the appropriate information concerning the condition of their patient
and the progress of the therapeutic programme. This can make them capable of providing
effective psychological support to their patient. When communicating with client family, it is
important the nurse should:

 The extent of information revealed to the client depending on her scope

 Establish a dependable point of contact in the family that can relay information to the rest
of the family and friends.
 Review information regarding the hospital procedures, visiting hours, important contacts
and their phone numbers.
 Be aware of what you are saying and how you are saying it.
 Speak in a gentle tone of voice, using their names and the name of the patient.
 Try to form a connection in order to build a sense of trust.
 Reflect on the type of family you are talking to.
 Provide realistic expectations.
 If you can’t answer their question, do not attempt to provide answers you cannot defend.
Refer the client family to the appropriate senior health team member. However, just
taking the time to listen helps a lot.
 Do not shout, ignore or avoid responding to client family agitation for information

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