Part A: A personal reflective account of your learning arising from the meeting and the module

In this George a 79 years old man who had dementia suddenly fell down and broke his right arm. His neighbour discovered the situation and called the ambulance. He was extremely malnourished.

George was in the hospital for 4 weeks and was discharged after his surgery. His General practitioner suggested the involvement of an inter-professional team consisting of Social Worker, Domiciliary Care Manager, District Nurse, and Physiotherapist.

I was appointed for the role of the district nurse for this case. In this case the old injured man required a group of people to take care of him outside the hospital to make sure that he recovers properly in the safety of his home.

Some rationales that were followed during the inter-professional and associated justifications are:

• To make sure that George is physically handled with utmost care by all the involved members due to the severity of his health condition.
• All governmental guidelines concerned with healthcare that might be related to this scenario are followed strictly during the process to avoid any violation of rules.
• Making sure that he himself is made aware of his state and educated about what he needs to do in order to recover.
• Ensure that along with physical wellbeing his mental wellbeing is taken care of and he is never left to feel lonely and unwanted.
• The environment of the hospital is extremely depressing as well as sickening specially for a man of age but the absence of any medical care could prove to be life threatening to him and thus this process proved to be very helpful and beneficial.
• This case also educated people around about the presence of such practices and this enables them to get access of it if ever required in future.

Policies, organisational frameworks, approaches and professional codes are made and implemented by people associated with health care and these put an impact on inter-professional practice because it provides a detailed guideline to be followed while being a part of such a practice to make sure that the patient receives adequate and high quality treatment to ensure fast and efficient recovery and also make sure no law is being violated during the process. It also helps the associated people and educates them about things associated with the practice which they might not already be informed about. In my personal experience for this particular case these proved to be extremely helpful.

This case has provided me strength with respect to both knowledge and skill and made me feel grateful. The case has educated me to handle such kind of situations in my personal life and take care of people who are close to me in order to ensure their overall wellbeing. The case has made me more flexible and educate in my professional life as taking care of a person personally in a medical manner has sharpened my skills more as a nurse.

This report will provide a detailed analysis of the concept of inter professional practices along with the description of my role in it as a district nurse highlighting my experience and learning. The report will present a brief explanation of all the policies, legislations, frameworks and standards associated with this practice and will state how it impacts stakeholders, users, carers with respect to this context. All the advantages and disadvantages of inter-professional practices will be discussed in detail and in the end of this report a detailed statement will be given as to how this practice enhances personal and professional self awareness.

What is Inter-professional Practice (IPP)?

Inter-professional Practice (IPP) is a collective practice which takes place when healthcare providers work in association with people who are a part of their own profession, with people who are not directly associated with their profession, with patients involved and their families as well (Reeves et al., 2017).

When healthcare providers work together they try to achieve a common goal and are efficiently able to analyze and resolve any problems that might arise. When all these people work together they use of their skills and knowledge more effectively and provide care according to the requirements of the patient. This enables patients to obtain higher quality health care. This practice also provides increased job satisfaction for the healthcare providers associated (Weller, Barrow and Gasquoine, 2011).

Part B: A critical review of relevant theory, policy and ethical issues in relation to the given report title covering organisational frameworks and inter-professional practice

Inter-professional collaboration is one among the biggest trademarks of many highly successful health care organisations. Such kind of a collaboration associated with the provision of high quality and particular patient focussed health care enables the application of both individual as well collective skills and experience of all the team members to work together for enabling better outcomes.

A nurse personally knows everything related to a patient he/she is treating related to the patient’s medical history and present and also up to a certain personal extent. The nurse can because of which share these collective information with the others involved in the process as well which will enable them to function more efficiently focussing on the particular patient for whom the process is carried on. The nurse’s knowledge can be used to also to formulate a suitable plan for the treatment of the patient.

 The concept of inter-professional practice can be commoly defined with the help of five underlying concepts which are, sharing, interdependency, power, partnership and process.

• Psychology– For ensuring that the patient is not victimised by any mental deformity or stress as a result of the physical pain and illness he/she has been going through. If also such situation is seen the involvement of a Psychologist will enable the fast treatment of the patient on time to prevent any severe mental illness (CARKHUFF, 2017).
• District Nurse– For taking medical care of the patient by forming a personal bond with him/her. Responsibilities include ensuring medication intake of correct dosage and on correct time, be present at all times in order to able to inform the doctor in case of any emergency, provide assistance in performing basic survival activities such as using the washroom and eating etc. (Arnold and Boggs, 2015)
• Social worker– For ensuring that the patient is being taken care of in accordance to all of his/her moral and civil rights and is treated with love, care and respect. The social worker also educates others people of what to do and expect when they face any problem like this in the future. The worker educates the patient as well as people around.
• Care Manager– The care manager ensures that the patient is being taken care of efficiently and all the rules and regulations according to law and morality are obligated. The care manager also supervises the work of other members and insures they are performing efficiently and correctly.
• Physiotherapist– The physiotherapist helps the patient to perform light physical exercises to recover any body part that has been damaged due to the patient’s illness.

Policy and legislation

• Care Act (2014)

The Care Act emphasises care and support legislation. This Act changes the method of work of care providers, councils and user organisations. It also changes peoples’ roles in the delivery of care (Government of UK, 2018a).

• Equality Act 2010

The Equality Act 2010 protects people from discrimination that takes place in the workplace and society. It provides different policies to state and object that it is unlawful to treat someone unequally (Government of UK, 2018b).

• Mental Capacity Act (2005)

The primary goal of the MCA is promotion and protection of decision-making within a legal framework. This is done by encouraging and empowering people to make their own decisions and by allowing them to pre plan about decisions for times they think that they might lack the capability to do so (Government of UK, 2018g).

• NHS (2015)

 It consists of a set of guiding principles of the NHS and rights of a patient associated with it (Government of UK, 2018d).

• Public Services Social Value Act (2012)

This Act requires people who are associated with public services to think about ways to secure more economic, social and environmental advantages (Government of UK, 2018c).

• Sustainability and Transformation Plans (STPs)

 These are five year plans for the future of health care services in local areas. NHS organisations, local authorities and other partners together have developed the plans in 44 areas of the country.

• Accessible Information Standard (NHS England)

This aims to ensure that people with any sort of disability are provided access to information that they are easily able to read and understand (NHS England, 2018a).

• Care Navigation

This describes the central competencies for people who provide care navigation (NHS England, 2018b).

• Care Quality Commission

Enlists the CQC fundamental standards that are the standards under which care must not fall (Care Quality Commission, 2018).

• Community Development National Occupational Standards

This provides standards for the definition of knowledge, skills and understanding required for undertaking and functioning of community development practitioner (Government of UK, 2018f).

• GMC generic professional capabilities

It comprises of skills like communication and team work a doctor must have (General Medical Council, 2018).

• Health Coaching

This aims for the development of conversational skills in order to support person-centred care for patients.

• Health & Care Professions Council (HCPC) standards

These are the standards for all professionals who are a part of the HCPC Register (HCPC, 2018).

• NHS England and Local Government Association, Personalised Health and Care Framework

The central concepts of inter-professional practice

 This provides suggestion and realistic guides for organisations to support growth with Integrated Personal Commissioning and personal health budgets.

• NHS Leadership Academy: Health Care Leadership Model

The model consists of nine leadership dimensions.

• NHS Improvement (2016), Developing People – Improving Care

This aims for improvement of skill-building, talent management and leadership.

• NMC standards

These provide the nurses and midwives professional standards that they must follow must in order to be registered to be able to practise in the United Kingdom (NMC, 2018).

• Skills for Health: Core Skills Education and Training Frameworks (CSTF)

This provides guidance and standards for delivering education as well as training in health care (Super User, 2018).

Impacts on stakeholders

• Provides them guidelines to function efficiently even outside of their organisational premises.
• Helps in ensuring that all participating members function ethically which provides them security against risks they might encounter due to their workers unethical behaviour.
• Makes their performance easy and smooth.

Impacts on users

• Educates them about their rights as a consumer of health care.
• Enables them to take the most out of the services for extra benefit.
• Enables them to raise voice against any person or event involved in the care process in case of any unethical or even threatening activity.
• Helps them to establish a better bond with health care providers for fast, efficient and happy recovery.

Impacts on carers

• Provides them a set of rules to work under making their work process easier and more efficient.
• Provides them certain rights to exercise in order to have flexibility in required situations.
• Helps formulation of bond with patients to make and makes their overall work easier.

Advantages of inter-professional practice

• Enables provision of Person centred care.
• Accumulation and association of the skills and knowledge of so many people enables faster and more efficient care process that will result in fast and efficient recovery of a patient(Huxham and Vangen, 2005).
• Allows patient to live independently. Provides faster and more efficient health recovery.
• Being in the hospital in a close association to its depressing environment witnessing sick and dying people is mostly mentally frustrating to any patient and thus such a practice is extremely beneficial as it allows a patient to recover effectively in the safe and happy place of his/her house away from the negativity of the hospital (Payne and May, 2009).
• Involvement of social workers and increased social interaction helps patient to feel more self confident and allows them to befriend their care provider.
• Continues care is provided and regular medical and medication reviews enable better and faster recovery (IPE, 2018).
• Provides a wider vision to the world of health care and opens new ways and paths for development of services and facilities.
• Removes cultural barriers due to involvement of diverse people, both carer and user in the process.
• Similar groups can be used to take care of patients with extremely similar medical issues.
• Risk is minimised due to constant supervision and care.
• Enhances job satisfaction for carers and allows more comfort in their job along with better pay and learning.

• Difficulty in communication may arise due to participation of people with diverse background and also diverse age group and economical background which may come across as a challenge.
• Direct supervision at all times must seem as a barrier to organise regular group meetings.
• Social care services funding that are provided by local authorities might get minimised or cut completely after knowing about the presence of such facility.
• Might initiate in the formation of distance between the user and his/ her family due to such close involvement and presence of service providers.
• Might lead to decrease in the Power of Anthony and advocate due to involvement of all the service providers.
• Involvement of such ethnically and economically diverse people might often lead to activities that promote the justification of acts of inequality and even ill behaviour at times.
• Flow of personal information is common when so many people are involved in a process that might lead to the violation of privacy of the user or might expose any highly secretive information that might be even dangerous if gone to the wrong person(Edwards, Lunt and Stamou, 2010).
• Involvement of so many unknown people and their right to visit a patient in their private space might sound risky. The ill behaviour or practice of a particular member might result in risk for the entire organisation they are a part of (Li, 2008).
• Inefficiency of one member might negatively influence the entire process and eventually affect the results.

Reflection on personal self-awareness

My personal self awareness has obviously increased by participating in this inter professional practice because of the establishment of personal connectivity with the patient involved as well as my work. When working in a hospital my responsibilities include the supervision of a huge number of patients but in this case my entire time and effort was entirely dedicated to one single patient. This experience enabled me to enhance my care taking skills as this required a lot more work than I usually did. Only due to homely comfort and personal association with the patient my work was eased up to a little extent. This experience has made me more aware of my capabilities as a human and as a care provider to a person and as this work is measured my personal caretaking capabilities were able to be judged in this case.

My professional duties and particular works were similar in this case up to a certain extent but this case demanded more association with the particular patient involved. This enabled me to possess skills more than just the medical aspect of nursing. This experience enhanced my knowledge, skill capability of providing medication, health care and also assistance provision abilities (Government of UK, 2018e). This particular experience has obviously made me more aware of my professional work and made me attain more and wider perfection in it. The involvement of the description of the fact that I was associated with such a group, in my resume will prove to be an advantage for me in my career as it will serve as a statement to the recruiter of my enhanced nursing and caretaking abilities. This experience also provided me with enhanced job satisfaction as it pleased me in both professional and personal level and provided me to work and learn more but more comfortably and in a friendly manner.

I was involved in this case as a district nurse and so I was one of the most active members of the group. I was responsible for the provision of direct health care of the patient and assist him to carry on his day to day activities. My responsibilities involved:

• Providing medication in the right dose, method and time to the patient.
• Assisting the patient to do basic activities such as using the washroom, eating and other basic activities.
• Being a friend and a caretaker to the patient all times of the day.
• Assisting the patient while visit with other members of the group who are providing him health care.

This experience has educated me about inter- professional practices and how it is carried on. This has helped me in my career as well as personally. This practice in my opinion is hugely beneficial for the patients who are critically ill and require constant care even outside the hospital. This is also beneficial for widening the work efficiency and spectrum of the health care organisation and carers like me.

Key partners and organisational relationship- Multidisciplinary teams (Community base)

Conclusion

Inter-professional practices in health care are the involvement of many people or the formation of association among the health care organisation for the treatment and care of a patient who is in critical state health wise. This helps in provision of health care outside hospital premises for more efficient and faster recovery of patient .A definite amount of policies, legislations, frameworks and standards have been laid to ensure its ethical and efficient functioning. Along with the huge number of benefits it comprises of it also have certain disadvantages. This experience allowed me to enhance my skills and abilities as a nurse.

References

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