Principle D

Principle D letterNurses and nursing staff provide and promote care that puts people at the centre, involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.


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Principle D encompasses themes of advocacy, empowerment, patient-centred care, and patient involvement in their care.

You may find the following commentary article about Principle D a useful starting point for exploring this Principle. It was published by the Nursing Standard as part of an introductory series on the Principles of Nursing Practice:
Manley K et al (2011) Person-centred care: Principle of Nursing Practice D. Nursing Standard 25(31) 6 April pp.35-37 (PDF 560KB) [see how to access PDF files].

Other useful resources are:

A selection of RCN resources which are particularly relevant to Principle D

The following resources and services produced by the RCN provide guidance and support to people wishing to use the Principles for quality improvement purposes or their own continuing professional development.

To access any Learning Zone content you will be asked to enter your RCN membership number. If you require assistance with entering the Learning Zone, or would like further information on becoming a member of the RCN please contact RCN Direct on 0345 772 6100.

Clinical governance: patient focus: one of the themes within the clinical governance online resource, this signposts key policies, agencies, guidance and tools which support public and patient involvement, patient choice and improvement of the patient experience.

Dignity: an online resource which promotes dignified care and provides a range of resources to put this into practice. These resources will help to support a patient-centred approach to care and to enable patients, their relatives and carers to feel in control and be able to make decisions for themselves. 

Dignity in health care: this learning resource will help you to strengthen your understanding and practice in promoting dignity for your patients or clients and your colleagues. It is relevant to all registered nurses, student nurses, health care assistants and assistant practitioners working in any health care setting or specialism.

Real choice in the health service. An RCN discussion document (PDF 167.3KB) (2005): this document was published when the patient choice agenda was newly introduced. It consists of four essays from the RCN Policy Unit and Professional Nursing Department examining some of the key issues for nurses and patients at the roll out of the Choice initiative.

Social inclusion: an online resource that focuses on the needs of specific groups of excluded people and hard-to-reach communities. The resource provides a set of principles for a socially inclusive approach to the delivery of nursing care. The sections on the different groups - asylum seekers and refugees, Gypsies and Travellers, homeless people, people with a learning disability, people with a mental health problem, people with an offending history, sex workers – help to highlight the issues faced by these individuals and communities and signpost resources that will support care appropriate to their needs.

Spirituality: “a person’s spirituality, whether religious or non-religious, provides belief structures and ways of coping through which people begin to rebuild and make sense of their lives in times of trauma and distress. It offers ways in which people can explain and cope with their illness experiences...". This resource has been created to enable nursing staff to develop their knowledge and understanding of spirituality and spiritual care. It was created in response to RCN membership who identified the need for the nursing family to be able to be proactive in delivering spiritual care, and it builds on the RCN spirituality pocket guide published in 2011. Links to relevant RCN publications are provided as well as links to other resources and publications on spiritual care.

For further RCN publications see Publications.

RCN library and heritage services e-library: provides a range of resources that RCN members can access for further information. These include full text journals, databases, e-books and Fast searches which are up-to-date searches on frequently asked selected topics.