Beyond the Bedside: How Emergency Nurses in South Africa are Transforming Family-Centered Care
"Understanding the vital role of emergency nurses in supporting patients and their families during critical moments in KwaZulu-Natal."
In the high-stakes environment of an emergency room, where every second counts, the focus often tends to be on immediate medical needs. However, a crucial element of care, often overlooked, is the well-being of the patient's family. In Durban, South Africa, emergency nurses are at the forefront of a movement to change this, embracing patient- and family-centered care (PFCC) to provide holistic support during some of life's most challenging moments.
This article examines the practices of emergency nurses in the Durban area of KwaZulu-Natal (KZN), South Africa, as they navigate the complex landscape of emergency care. It highlights their commitment to PFCC, the challenges they face, and the positive impact this approach has on both patients and their families. This study underscores the nurses' critical role in not only providing medical treatment but also in fostering a supportive and empathetic environment for those in crisis.
The research, conducted among emergency nurses in the Durban area, offers insights into how these healthcare professionals are putting PFCC into practice. This approach recognizes the profound impact of an emergency on families, acknowledging that their involvement and support are essential to the patient's recovery and overall well-being. The findings are particularly relevant in the South African context, where unique challenges, such as high rates of trauma and infectious diseases, add layers of complexity to emergency care.
Emergency Care in Context
The CDC's National Hospital Care Survey collects information on patient care in inpatient, emergency, and outpatient hospital departments in the United States. Its National Hospital Ambulatory Medical Care Survey reported that data from a sample of 16,025 emergency department visits in 2022 represented about 155 million emergency department visits. Research on patient-centered care in emergency departments also identifies patient experience and the practices most important to patients as key areas of study.
The Conventional Model
Emergency care commonly relies on rapid assessment, prioritization, clinical decision-making, and coordination among healthcare professionals. A family-centered approach adds communication with relatives and recognition of their role in supporting the patient. However, the emergency setting can make these practices difficult to apply consistently because urgent clinical demands may compete with time for explanation, collaboration, and emotional support.
From Patient Care to Partnership
Family-centered care has developed from a predominantly clinician-directed model toward greater recognition of patients and families as partners in care. This evolution reflects increasing attention to communication, participation, individual preferences, and the expertise families bring to decision-making. In emergency nursing, the shift remains an ongoing process rather than a completed historical transition.
The Pillars of Patient- and Family-Centered Care: What It Means in Action
Patient- and family-centered care is more than just a buzzword; it's a philosophy that fundamentally shifts the focus of healthcare. It's about creating a partnership between healthcare providers, patients, and their families, where the needs, values, and cultural backgrounds of all parties are respected and considered. In the hectic environment of an emergency department, this approach requires nurses to be skilled communicators, compassionate listeners, and advocates for both the patient and the family.
- Providing clear and understandable information about the patient's condition and treatment options.
- Encouraging families to be present and involved in the patient's care whenever possible.
- Offering emotional support and a safe space for families to express their feelings.
- Respecting the family's cultural and personal values.
What Recent Reviews Show
A 2025 review used the PRISMA framework to examine patient- and family-centered care interventions for adults admitted to intensive care units. It considered outcomes including depression, anxiety, delirium, and length of hospital stay. Related literature describes patient- and family-centered care as organized around the needs, values, and preferences of patients and families, while a 2023 systematic review found only two articles focused on patient-centered care in emergency departments and three addressing communication as a patient-centered safety intervention.
Where Implementation Falls Short
Family-centered care is defined by partnership among healthcare providers, patients, and families in planning, delivering, and evaluating care. Yet research examining nurses' family-centered care practice indicates that applying this holistic model across pediatric settings presents practical challenges. Patient-centered communication can support active participation by patients and caregivers, but emergency-department research also notes that the concept lacks clarity and that evidence for specific practices remains limited.
A Shared-Care Framework
Patient- and family-centered care recognizes the family's role in providing medical care, encourages collaboration with professionals, and honors individual and family strengths, cultures, traditions, and expertise. For children, the concept has evolved from family-centered care into patient- and family-centered care, although its application in nursing practice remains challenging because of ambiguity. The emergency department offers several opportunities for this approach, but the framework requires adaptation to the patient's condition, family context, and fast-moving clinical environment.
The Future of Family-Centered Care in South African Emergency Departments
The dedication of emergency nurses in the Durban area to PFCC is commendable, and their efforts are making a difference in the lives of patients and their families. As healthcare systems evolve, the principles of PFCC will continue to be essential for providing compassionate and effective care. Further research and investment in training and support for emergency nurses can help to ensure that this vital approach continues to flourish, offering hope and healing during the most difficult of times, as well as recognizing the families' needs during that process.
The Emerging Nursing Role
Emergency nurses can help translate patient- and family-centered care from a broad principle into everyday communication and partnership. The approach is most credible when families are treated as participants whose preferences, knowledge, and concerns inform care rather than as visitors outside the clinical process. Its practical success will likely depend on balancing that partnership with the urgency and uncertainty of emergency care.
Building the Next Generation of Care
The Emergency Nurses Association's 2025–2030 strategic plan calls for advancing emergency nursing through innovative education, training, resources, standards of care, and leadership for the future. A 2024 nursing perspectives article identifies telehealth, remote monitoring, artificial intelligence, robotics, and a shift toward patient-centered and community-based care as key trends. Research on the evolution of patient- and family-centered care likewise emphasizes future recommendations alongside the milestones and drivers that have expanded the approach.
Care Beyond the Emergency Room
Family-centered emergency care is shaped by wider pressures, including staffing, time constraints, communication systems, and access to follow-up support. These conditions can affect whether collaboration with families is consistently possible. Strengthening the approach therefore requires attention not only to individual nursing practice but also to organizational policies, training, resources, and continuity across services.
Partnership in Practice
At its human core, family-centered care asks clinicians to recognize patients and relatives as people with values, knowledge, concerns, and relationships that matter to care. Clear communication can help patients and caregivers participate more actively in the care process. For emergency nurses, this makes family engagement both a clinical responsibility and a way to support dignity during moments of uncertainty.