Dimensions of Nursing Practice Essay

(Note: The citations below are provided for your research convenience. Students should always cross reference the current APA guide for correct styling of citations and references in their academic work.)Dimensions of Nursing Practice Essay

Read
Black, B. P. (2017). Chapter 6 and 7

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Online Materials & Resources

The Nurse Practice Act for the state where you are practicing. Go to your state’s board of nursing website to access the document.

Rogers, J. K. (2014). Reinventing shared leadership to support nursing’s evolving role in healthcare. Nurse Leader, 12(2), 29-34.
QUESTION

How has nursing evolved since you graduated from your original nursing program? Is nursing today what you expected when you enter nursing education?

Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources
All replies must be constructive and use literature where possible.Dimensions of Nursing Practice Essay

Your assignment will be graded according to the grading rubric.

This reflective Commentary will focus on a patient’s discharge planning liaison drawn from my experience in attending a Multidisciplinary team Meeting (MDT) held at my Elective Placement (Cardiology Ward) in the context of the dimensions of Interprofesssional Working (IPW) I will preliminary define in the introduction IP working; recognize policies; introduce patient scenario, identify the Reflection Model which I will use to evaluate and analyse the Dimensions of IPW.

IPW refers to professionals with different training backgrounds (medical, surgical, counselling, psychotherapy, Occupational Therapist, physiotherapist) sharing common goals an objectives but who make a difference but complimentary contribution to the given client group in order to provide holistic care (Leathard, 2003).Dimensions of Nursing Practice Essay

IPW has been highlighted by the United Kingdom (UK) government in a series of policies which shaped and continue to shape the way services and professionals work interprofesssionally. In 1998 The Department of Health (DoH) (1998) encouraged joint working through integrated provision. In 1999 papers such as DoH (1999) re-enforced that the effective care is the product of interagency working, promoting NHS to move towards interagency collaborative working or IPW in a shift from institutional to community-based care. The DoH (2000) a ten year programme of redevelopment practice to design and promotes a patient centered service and promote IP and Holistic care. One of the areas the DOH (2000) considered needed improving was the older generation patient discharge. To combat this, standard two of The Single Assessment Process (SAP) and Intermediate care services (ICS) was introduced by the National Service Framework for Older People by DoH (2001a) and this required services and professionals to work together in a co-ordinated assessment of needs for patients. From this, House of Commons Health Committee (2002) called for a number of key changes, one of them being a named Care Manager to coordinate all stages of the patient journey through hospital, up to and beyond discharge. And this coordination liaison could take the form of an MDT discharge planning meeting (DP).Dimensions of Nursing Practice Essay

New ways of working have to be found that cross professional boundaries, in order to allow a more flexible approach to care delivery (DoH, 2002). To achieve this, the Government introduced Interprofesssional Education (IPE) in pre-registered student’s modules and their aim was to integrate IPE into their curriculum, enabling students to develop transferable skills that will facilitate communication and collaboration in the future (Barr, et al., 2005). Rattay and Mehanna (2008) suggest that as students should make an effort to attend MDT meetings to develop IP.

I have used pseudonyms throughout my reflective commentary, to protect confidentiality in accordance with the Data Protection Act (1998) and the Nursing and Midwifery Council (NMC) (2009). I will refer to the patient as Sam.

Sam is a 74 year old lady who lives alone in a ground floor flat. Sam has no family living locally however her neighbour visits regularly. Sam suffers from Chronic Heart Failure (CHF). Prior to admission Sam was fully independent at house cooping with her Activities of Daily living (ADLs) with slight difficulty due to breathing and poor balance (which Sam reported to suffering from for years). Sam was originally brought into hospital via accident and emergency by her neighbour as her breathing became progressively worse.Dimensions of Nursing Practice Essay

There are many potential models of reflection. I will use Gibbs (1988) Model of Reflection (Appendix 1) as I find it more straightforward due to being depicted as a cycle, encouraging critical evaluation and analysis of the incident. Cyclical models are suggested by Ghaye (1998) to deepen awareness and increase knowledge and skilfulness from repeated movements around them.

Reflection will able me to learn from the experience and identify my learning needs in areas which solicit improvements (Allen, et al., 2008). As suggested by Price (2006) Reflection makes a connection between theory, policies and practice required to develop evidence-based practice, professional and academic growth throughout my career; important in the development of lifelong learning (NMC (2009).Dimensions of Nursing Practice Essay

Description

The MDT meeting was held at the sister’s office. The MDT consisted of a Ward Nurse (who was there intermittently due to staff levels), a Heart Failure Nurse Specialist (HFNS). Care Manager (Social Worker), Physiotherapist, Occupational Therapist, Doctor (Cardiologist Register) and myself. The meeting was led by the Doctor who gave an introductory overview of the Sam’s social situation and medical condition. The Doctor recommended that Sam was medically fit for discharge with a referral for HFNS community visits, as further health education was necessary. The physiotherapist suggested Sam was regaining confidence in her mobility but recommended further input to improve Sam’s balance and posture. The ward Nurse suggested Sam’s Nursing needs were stable and no input was required on discharged, upon this, I respectively argued that Sam discussed with myself earlier in the shift that she felt she was not coping at home and would feel more confident if she had minimal assistance with her ADL’s at home. The Doctor re-directed the question to the HFNS, who re-directed the question to the Ward Nurse, both dismissing my input. At this point I respectfully assured the MDT that what I was advocating, it was also documented in Sam care plan. Subsequently, The HFNS requested Sam’s discharge planning to be discussed in a second meeting.. Following to this, The Occupational Therapist recommended she would liaise with Sam regarding any house equipment that would facilitate Sam’s ADLs. The social worker (Care manager) who would be coordinating all stages of Sam’s journey through hospital, up to and beyond discharge, organise possible (i) care (ii) meals on wheels. The Doctor summarised the MDT plan and rescheduled the meeting for 2 days to allow professionals to liaise with Sam in order to evaluate the discharge planning in partnership with Sam. Doctor was reluctant to reschedule and to change Sam’s expected day of discharge (EDD), it seemed. In the follow up MDT meeting, Sam was medically fit for discharge, her it seemed, had improved, as had her slightly her confidence but she could still benefit from further rehabilitation; therefore, Sam was referred to Intermediate Care Services (ICS) (Appendix 2) for further rehabilitation in the community, with out-patient medical follow up and HFNS home visits.Dimensions of Nursing Practice Essay