What are ‘Fundamentals of Care’?

Fundamental care is defined by the International Learning Collaborative (ILC) as: “actions on the part of the nurse that respect and focus on a person’s essential needs to ensure their physical and psychosocial wellbeing. These needs are met by developing a positive and trusting relationship with the person being cared for as well as their family/carers.” Read more on the ILC website

What are we talking about here?

Actually, we mean everyday activities most of use take for granted. Things like going to the toilet, washing, drinking, eating, and moving around. They include how we communicate to others, and the relationships we have with people around us.

The term ‘fundamental nursing care’ describes the actions we as nurses undertake to meet the physical and emotional needs of patients’ and their significant others. These needs are the things that people normally do for themselves if they have the ability to do so.

• These include actions to care for a patient’s physical needs such as hygiene, eating and drinking, rest and sleep, mobility, going to the toilet, comfort, safety and medication management.
• Fundamental nursing care also includes what we do to establish and maintain a caring relationship with patients and others through verbal and non-verbal communication. This includes talking and listening and coming to shared decisions with patients about their care.
• Thirdly, it concerns how we meet the cultural, spiritual, mental health, emotional wellbeing and dignity needs of people we care for and those that matter to them. We call these psychosocial or emotional needs.

From time to time we cannot do these things. Maybe we are physically or emotionally ill. Perhaps social and financial issues get in the way. At these times we turn to others for help.

Nurses support people when they cannot do these things alone. For people in hospital, for example, when everyone else has left the room, we remain in there for our patients.

Unfortunately, this ‘fundamental care’ has become devalued in favour of more technical aspects of nursing. And yet these are the actions that remain in people’s minds long after their needs have been met. We need to re-value fundamental care so it is regarded as at least as important as these more technical aspects of caring.

When the COVID-19 pandemic came along, nurses all over the world realised that they were not experienced in pandemic-specific care procedures. Things like infection prevention and control. Nurses had to give care in unfamiliar environments to critically unwell patients. We had to wear restrictive personal protective equipment that got in the way of communication. We had to arrange our working activities to cope with restrictions on moving in and out of patient care areas. Life turned upside down.

Our team developed the COVID-NURSE guideline you will see referred to in the course. We wanted to help nurses overcome these barriers to care. As you move through the course, you will find some aspects that are very specific to pandemic nursing.

However, at the end of testing the guideline in a clinical trial, nurses told us that many of the ideas in the guideline could be used in lots of different care situations. You do not need to be working in a pandemic situation to gain from this course.

We made this course and the guideline free for all nurses to use. We hope you can take some good ideas from it to help you in your practice, wherever that may be.