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在 COVID-19 大流行之前和期间提供以患者为中心的护理的论述:关怀成为附带损害。

The discourse of delivering person-centred nursing care before, and during, the COVID-19 pandemic: Care as collateral damage.

机构信息

School of Nursing Midwifery and Social Sciences, Central Queensland University, Townsville, Queensland, Australia.

School of Nursing, Massey University, Wellington, New Zealand.

出版信息

Nurs Inq. 2024 Apr;31(2):e12593. doi: 10.1111/nin.12593. Epub 2023 Aug 15.

DOI:10.1111/nin.12593
PMID:37583275
Abstract

The global COVID-19 pandemic challenged the world-how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person-centred care (PCC) is the philosophical premise upon which models of health care are developed and implemented. Given the strain that COVID-19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic.

摘要

全球 COVID-19 大流行挑战了世界的运行方式、人们在社交世界中的移动方式以及政府/政府服务和人们之间的互动方式。在新公共管理原则下运作的卫生服务已经对服务提供和护理模式进行了快速变革。显而易见的是,当代卫生服务运作的机制以及服务如何没有将护理中心的人置于优先地位。以患者为中心的护理(PCC)是医疗保健模式发展和实施的哲学前提。鉴于 COVID-19 对卫生服务和提供护理的人员造成的压力,探索这一领域存在的紧张关系至关重要。本文认为,在大流行之前,PCC 主要是一种言辞,在大流行期间变得不可见。本文通过福柯的视角,即治理和生命政治,对 PCC 在这些充满挑战的时代中的作用进行了调查,以审查政策、优先事项和实际影响,因为卫生服务已经转向并适应不断变化和紧急的需求。具体来说,本文借鉴了澳大利亚的经验,包括转移护理人员的工作重点以及由于封锁和限制等公共卫生指令而带来的额外挑战。这一探索的结果为围绕 PCC 的言辞、护士的地位以及大流行期间失去的内容展开讨论开辟了空间。

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