Diminished role autonomy and ambivalence: key factors in the demise of person-centred care

Background: The nursing workforce has been under prolonged strain, beginning with the pandemic and continuing into a post-pandemic inflationary economic crisis. Research published in 2017 in Australia identified registered nurse practice to be person-centred. This practice is embedded as a foundational concept in the Australian Registered Nurse standards for practice, and it was determined to represent actual, rather than aspirational practice at the time of the underpinning research. Critique: This critical assessment paper considers the question as to whether the axis has shifted to a bio-medical, or system centred, model of nursing care in response to the sustained stress. Conclusion: It is concluded that axis appears to have shifted to a bio-medical or system centred model of nursing care. This shift has not been a consciously decided upon course of action, but rather a regression to an older vision of nursing. The re invigoration of bureaucratic hierarchical models of care impinging role autonomy, are conceived as the mechanism of the shift, arising through ambivalence.