Person centred care – what not to do

Having worked as an occupational therapist now for over two decades, there are a couple of experiences I recall as a student OT, that have really stuck with me.  One of my student placements involved working in a hospital setting.  Cognitive screening, particularly of older people using the MMSE was fairly routine.  Hospitals are not generally known for being particularly person-centred, particularly 20 years ago.  People were often spoken about by bed number, rather than by their name and cognitive screening of anybody of 65 was encouraged, regardless of whether there was any clinical indication.  For example, someone may have come in for a knee replacement who is over 65 and we would complete an MMSE.  Most of the time people were agreeable to completing the assessment, but I do recall one lady who was very offended that I was even questioning her cognition and refused to complete the assessment.  As a student, I initially put this down to her possibly just being unhappy with me, but the older I get, the more I understand why she was quite affronted. 

As an OT in training, it was very easy to follow the example set by others.  I recall being asked to complete an MMSE on a person.  Using the patient bed list printed off that morning, I went to that particular bed number and began to try and undertake the assessment.  Very quickly, it became clear that my attempts were not working at all.  Not only did the person not appear to speak English, but they were also very confused.  After several minutes, I finally worked out the issue.  The person I was meant to see had moved to another room and now had a different bed number.  It was an important lesson for me to always remember that people are not a bed number!  Each person is an individual, and needs to be known and cared for as a person not a bed number. 

Both practices were not person centred. These two scenarios are certainly not my proudest moments, but they were excellent learning opportunities that have stayed with me.  Since that time, I always make it a point to never refer to a person by their bed number, only by their name even when others around me continue to do so.  This can be challenging as it often goes against the norm during ward / case conferences and meetings.  Not only is the practice not person centred for the individual being cared for but is also open to resulting in mistakes being made.