Caring Practices: Dignity, Comfort and Family Presence

Synergy Model Caring Practices, Patient Dignity, and Privacy Safeguards

Under the AACN Synergy Model, caring practices represent nursing activities that create a compassionate, supportive, and therapeutic environment for critically ill patients and their families. Preserving dignity begins with addressing adult patients by their preferred names and completely avoiding infantilizing or dehumanizing language. In critical care, many patients are comatose, sedated, or otherwise unresponsive. The critical care nurse must consistently speak respectfully to these individuals and explain every intervention before touching them, even when their ability to hear cannot be clinically determined.

The nurse demonstrates advocacy and moral agency by identifying and communicating the patient's documented wishes, assisting the interprofessional healthcare team and surrogate decision-maker in using those wishes to direct care. When unresolvable conflicts arise regarding goals of care, the nurse acts as a moral agent by initiating an ethics consultation. Additionally, response to diversity requires integrating the patient's and family's cultural and spiritual preferences, as well as preferred family decision-making roles, into daily care while upholding the patient's documented wishes and legal surrogate authority.

Confidentiality mandates safeguarding protected health information across all oral, electronic, and written communication in compliance with federal privacy regulations. Accessing a patient's electronic medical record without a legitimate work-related need or proper authorization violates privacy policy and may violate federal privacy law. During shift handoffs and interprofessional team discussions, nurses must apply reasonable safeguards to prevent overheard disclosures, such as moving conversations to private areas whenever feasible. When performing bedside procedures or physical assessments, the nurse protects physical privacy by closing doors, drawing privacy curtains, and draping the patient when clinically feasible. Prior to sharing clinical updates over the telephone, the nurse must verify the caller's identity and authorization using facility policy and documented patient preferences.