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 aPrimary Nurse is responsible for coordinating all aspects of care including discharge planning. The purposeof 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 includedin this paper and analyzed using conversation analysis, an inductive data-driven approach. Our findingssuggest 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 collaborativeapproach, the “individual” communicative practice is more unilateral. Making those different approachesexplicit might lead to refinement of Primary Nursing theories.