‘But What if Margaret Says No?’: Teaching Person‐Centred Fundamental Care in an Era of Advanced Life‐Sustaining Technology

AIM: To propose an educational framework and simulation design for teaching advanced practice nursing students to distinguish technological feasibility, clinical proportionality and person-centred appropriateness as advanced life-sustaining therapies and artificial intelligence (AI)-supported decision-making expand what clinicians can offer. DESIGN: Discursive paper. METHODS: This paper synthesizes literature on person-centred fundamental care and the fundamentals of care (FoC) Practice Process, clinical judgement and simulation pedagogy, clinical ethics and shared decision-making and AI in clinical decision-support. RESULTS: A three-question framework developed by the author (Can we? Should we? Does the person want us to?) and a group-based prediction simulation are proposed. The questions are taught sequentially but operate iteratively: clinicians contribute expertise about what an intervention can reasonably achieve, while the person determines which outcomes are worth achieving. The FoC Framework positions the nurse-patient relationship as the mechanism through which technological reasoning becomes person-centred care: it generates trust, reveals what matters to the person and enables the nurse to carry that understanding into decisions with the interprofessional team and the person's care network. Learning objectives, reflective prompts and adaptations for divergent learner conclusions are included. CONCLUSION: As life-sustaining technologies and AI-supported decision tools expand what clinicians can offer, nursing education must prepare learners to distinguish technical eligibility from person-centred appropriateness. The three-question framework offers a portable structure for doing so. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The framework and simulation design give nurse educators a transferable approach to teaching and assessing clinical reasoning about advanced technologies while keeping patients' goals, values and preferences central to care. IMPACT: Advanced practice curricula and simulation-based education can use this framework to integrate technological expertise with person-centred fundamental care. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement. 'Margaret' is a composite educational exemplar and is not based on a real patient.