Background Patients want to be viewed as an individual with dignity and respect. In the busy day-to-day of caring for people it was identified that staff were focusing on tasks of care rather than on what was meaningful for the people in their care.

The project began with a desire to involve patients in their care by identifying what is important to them. Utilising time in a different way to engage people in conversations giving them permission to tell us what is important to them; enabling the person to be truly involved in decisions about their care and informing their choices.

A team from the ward including a staff nurse as psychoanalyst, the practice development facilitator and Matron led the project. It became apparent that it was not going to be straightforward to integrate the project into everyday practice as it was identified that staff felt uncomfortable instigating conversations, referring to patients by room numbers or diagnosis. The culture on the ward had to be influenced and changed.

Aims To positively influence culture change on the ward. To focus the team’s attention on the individual and what is important to them. To role model and support how conversations can be facilitated.

Methods Introduction of a new role led by the nurse psychoanalyst, to support team facilitation of meaningful conversations with patients. White boards installed in rooms to enable patients’ families to write what is important to them. Handovers discuss patient communication and notations on the white boards to influence care.

Results The new nurse psychoanalyst role is positively impacting on the team practice. Improved documentation regarding patient family conversations demonstrates the culture of reticence to engage is changing. Patients’ families are actively engaging in writing what is important to them on the white boards influencing their care.