Patient participation in discharge planning decisions in the frame of Primary Nursing approach: A conversation analytic study

Primary Nursing (PN) is a model of care delivery which is described to favor patient participation, as a Primary Nurse is responsible for coordinating all aspects of care including discharge planning. The purpose of this paper is to explore patient-nurse interactions in a rehabilitation clinic in which PN is used. Twenty-five interactions of video-recorded data involving 12 patients with their primary nurse were included in this paper and analyzed using conversation analysis, an inductive data-driven approach. Our findings suggest that nurses use two different communicative styles – a “reciprocal” or a “individual” perspective – when discussing discharge decisions with patients. While the “reciprocal” style is a more collaborative approach, the “individual” communicative practice is more unilateral. Making those different approaches explicit might lead to refinement of Primary Nursing theories.