Inter-Professional Working and Practice - Essay Example

A Transition from Nursing Student to a Professional Nurse: An Inter-Professional Working This essay describes my action plan for my transition into clinical practice which covers the first six months of my working as a qualified practitioner. To be more specific, my specialization in my school was mental health nursing. Thus, it is necessary for me to go through the transition from a mental health nursing student to an effective mental health nursing practitioner. A nursing practitioner must meet have ability to work well with other professionals in providing healthcare services to patients or clients. To facilitate my transition, this study provides me with an “action plan” for my transition into clinical practice and “a critical reflection” on skills and knowledge development and my personal and professional strengths and weaknesses. The organization of this study is as follows. An action plan for transition from nursing student to professional practitioner is formulated. It is followed with the critical reflections on my skills and knowledge development as well as my strengths and weaknesses in regard to my professionalism. I. Action Plan To become a professional health care nurse, the following action plan was formulated. The main objectives of this action plan to achieve my personal goals are as follows: To acquire fundamental knowledge related to performing tasks of a nurse To develop technical skills by applying knowledge obtained To reflect on personal strengths and weaknesses To develop in a life-long learning for ever improving professionalism Table 1. Action Plan for Transition from a Student to a Professional Nurse Step Action Description 1 Knowledge development Acquire formal education in a nursing training program 2 Develop clinical skills Develop skills by applying technical knowledge obtained in the formal education program 3 Learning by doing Learn how to collaborate with others in providing health care services in reality 4 Reflection on skills Reflect my skills weakness and strengths 5 Reflection on professionalism Reflect my professionalism by analyzing my strengths and weaknesses in my professionalism 6 Life-long learning and development Upgrade and further develop my skills and knowledge in life-long learning II. Critical Reflection Nursing has been recognized to be a profession. Nicoll (1922) found that the word profession was first used in the mid-fifteenth century and was defined as a learned vocation. Later the term profession was defined as a controlling occupation with a status of superiority and precedence within a division of work (Friedson, 1977). Desired characteristics of a profession are (1) a unique body of knowledge; (2) altruistic service; (3) a code of ethics regulating practice; (4) lengthy socialization; and (5) autonomy of practice (Richman, 1987; Maloney, 1986 and Friedson, 1983). Beech (2007) states that “professionalism” on the other hand is often viewed as a process which certain occupations advance through, with the end state being a profession. The term professionalism was defined by Johnson (1972 p. 32) as: “... a successful ideology and as such has entered the political vocabulary of a wide range of occupational groups who compete for status and income... What must be borne in mind is that the ideology is espoused, either wholly or piecemeal, by occupational groups who have not achieved and are unlikely to achieve control over their own occupations.” To become a professional practitioner of nurse, it is necessary and vital for developing skills and knowledge. 2.1 Skills and Knowledge Development There are certain clinical knowledge and skills developed for providing effective and professional nursing care services. I have formally obtained clinical knowledge in my educational training program as mental health care providing nursing student. Being a nurse, technical, organisational and interpersonal skills are critical to successfully perform the takes of professional nurses. Among the skills, I would like to highlight on interpersonal skills development. It is critically important for a nurse to possess a good communication skill. According to Roberts et al (1977), the area of work for the mental health practitioner involves co-ordination with other health professionals. At work, I am expecting to work in a team which consists of occupational therapists, social workers, speech and language therapists, the pharmacists, the psychiatrists, the general nurses, the dieticians, the psychotherapists and the patients or their relatives. I must carefully develop my interpersonal skills to effectively collaborate with my team members. In my formal educational program in which I was trained to become a nurse over the last past couple of years; I believe that my communication skills were developed in line with the NMC code of conduct. The code of conducts are guidelines set as standard requirements for all registered professional nurses to abide and to follow when providing nursing cares to patients as well as working with other professionals. Communication is an indispensable element in the provision and reception of health care, be it verbal or non-verbal. In applying my communication skills in clinical setting, I understand that, communication does not only involve transmitting verbal information but the ability to observe and recognise signs of agitation in a client and passing it on to the rest of the team or the ability to recognise a potential violent situation and dealing with it before it escalates. This has been supported by, Arnold and Boggs (1995) who argue that, communication involves a give-and-take process of sending and receiving messages through the combination of verbal and non-verbal communication skills. In bringing this skill to the team, I recognize the differences that might exist among the individual professionals, in terms of the use of jargons. I will therefore use a language that will be easily understood by all members of the team. Another skill and knowledge which I have developed is working in partnership with the other members of the team, by respecting, accepting and recognising the contribution of their knowledge and skill, to improve the care given to clients. This has been supported by Waterman and Waterman (2002) who argue a détente relationship as necessary for a true collaboration and that, power among members of the team, should be valued by all, by recognising and accepting the separate but combined areas of activity ,responsibility and to mutually, safeguard the legitimate interests of all stakeholders, with a common goal recognised by the collaborating team. Another important skill that I need to develop is assessment which plays critical role in sharing my skills with other members in collaborative team. The assessment of patient’s health includes (1) health promotion, (2) health protection and (3) disease prevention. This skill is essential for nurses especially those wo are in transition stage. With the effective assessment skill, nurses can identify the patient’s needs regarding his health as well as can provide guidance and counseling to needy patients. A nurse in mental health may need to identify the patient’s needs which are not directly related to the category of nursing. For example a schizophrenic might also have a secondary impairment (Stein et al, 1980). This may make many day-to-day activities difficult to perform, like cooking, shopping, using public transport. When I am having difficulties with this kind of task, as Forster (2001) suggests I may need to seek assistance from other specialists such as social workers, occupational therapists. In my formal educational nursing training, I have developed a skill called record keeping. Records are important sources of social, personal, and clinical information that relates to patients, requiring a specific or any form of nursing care. (Bowie et al, 2004). According to the NMC regulation, it is stipulated that client records should not contain abbreviated words, acronyms or jargons that are meaningless. However, it is not uncommon to see abbreviations such as p.r.n. (prescriptions to be taken when necessary), q.d.s. (four times daily) and BD (twice daily) in client’s documents. Although, I have not come across its impact on client care, it breaches the NMC regulation. Also, care records that are kept for patients can sometimes be requested, and used as evidence in court for the purpose of investigating a complaint or criminal proceedings. NMC A-Z advice sheet (2006), however, if best care records are said to be a product of conferences and debates among all members of the collaborating care team and the patient, and record keeping is seen very important in promoting high standard care. NMC, (2007) argues that it is the responsibilities and accountability of professionals who jointly produced the records. Learning from problems and reflections help both patients and nurses for improving problem solving. To do so, it requires regular and guided opportunities to learn from problems and experience. It is based on comprehensive learning package of actual case studies. I found this a good base for me in transiting from the student phase to the practitioner’s phase. If a student studies a few cases and analyses it from nursing, medical and other allied health professional’s point of view, he can draw his own reflections. If he finds any gaps between various agencies in the field of mental health, he can point them out and find solutions to overcome them. His reflective learning strategies will assist him to develop himself and handle real life cases in more efficient manner (Cooke et al, 2005). I may have to interpret the diagnostic findings and identify the psychological disorders in typical and atypical form. There is therefore need to develop a differential diagnosis based on the data collected, and find the psychiatric disorders (Morgan, 1998). I am unsure of this process. Sometimes, one needs to find the possibility of suicide or self-harm, to create an atmosphere in the family which is safe but non-restrictive (Morris et al ,1999, p.77-83). I feel comfortable with this task. Nursing care should help maximize the level of wellness of the patient. I had to plan the therapeutic intervention for patient’s health management. I had to develop a treatment plan and also do individual and family counselling. I had to educate the patient to get his co-operation in the therapy process. I also had to determine the risk level and be prepared to initiate and co-ordinate emergency care. In performing all these tasks, I had to understand the patient by his verbal as well as non-verbal communications. Often, I also had to refer to other healthcare professionals (Dept of home & health office,1999). Through establishing a well co-ordinated therapeutic environment, best possible treatment can be delivered. A regular and uniform education is required for smooth inter professional working. It has been found that most of the hospital trusts in UK did not provide relevant training to their staff and there was a considerable variation in whatever little training was provided to them (Davies et al, 2001). A regular standardized inter professional training, as done by Salford and Manchester since 1998, helps develop coordination among different professionals related to mental health. These kinds of trainings reduce the cases of suicide and other self-harm behaviour in mental disorder patients. The need for inter-professional working has been felt and many universities like Keele University, provide such specialized trainings (CAIPE, 1996; Finch, 2000; Roberts & Priest, 1997). It has multiple benefits like developing mutual understanding and respect among various professionals. It also helps understand different theoretical perspectives and reduces misunderstanding once the terminology is shared. This encourages inter professional awareness and empathy. I felt a dire need for such trainings. Although, by attending programmes on inter-professional trainings, I realised the lack of uniformity. Every one was working in isolation. Had this been in a more uniform and standardized manner, it would have made inter-professional working even smoother and more effective. 2.2 Personal and Professional Strengths and Weaknesses Nursing has been striving as a profession in the health care. Professions in health care services are demanded to balance between keeping their professional conducts up to the standards and difficulties attendant to their role. During the 20th century, the number of professions and its members has been increasing. This implies that there is an ever growing need for professionals to make many more decisions in the society. The power has been shifted from individuals and political representatives to those professionals. With such important role they place in the society, the importance of professional ethics was highlighted by Rutty (1989: 9) as: “professionals not only purport to choose the best means for the given ends of their clients and the public; they help define the ends themselves: the lawyer and accountant shape our ideas of security; the physician, of health; the priest, of salvation”. Professional ethics are so important to individuals and it is seen as a central part of their life. Thus they need to practice a work ethic so that they could professionally function in an imperfect society. Without a valid professional ethics, individual practitioner could not develop their moral which is critical for carrying out professional duties in a work place (Rutty, 1989). It is found that the nursing is at its disadvantage in regard to professionalism because it is difficult to find an exact meaning or description of nursing including its activities (McKenna, 1993). However others view nursing which (1) involves practical activity and communicative interaction which constitutes central essence of nursing profession; (2) includes the scientific framework that underpins nursing practice; (3) involves helping others to maximize their function within varying states of health; (4) mainly constitutes a unique “caring” aspect (Sarvimaki, 1988; Smith, 1981; Hall, 1980; Raya 1990 and Van Maanen, 1990). The nursing profession has been on debate saying a science and an art with science meaning an intellectual activity relating to knowledge and art as skilful practice. Therefore, nurses including health care providing professionals must uphold their morality with discipline of ethics while they are providing their professional services to clients. Nurses are required to keep the confidentiality of patients if they are to behave ethically. “Confidentiality” in health care is defined as a legal obligation that is derived from statutory and case law as well as forming part of the duty of care to a patient. This requirement is included in the nursing professional codes of conduct which is also spelled out in the NHS employment contracts. Those who breach the contractual agreement is subjected to disciplinary procedures and punishment (Beech, 2007). Trust and respect are also important in nursing care. In the health care system, confidentiality is crucial to everyone who is involved in providing health care. Patients have placed trusts in professionals and practitioners of health care service providers and they are expected that their information will be kept confidential. The information should not be misused without any consent of patient. Otherwise, patients will be deterred from seeking the professional health care services and treatment with a fear that their information will be used without authorization or consent. Provision 1 of the American Nurses Association code begins: “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual . . . (p. 4)” The preamble to the International Council of Nurses code emphasizes respect in relation to rights: “Inherent in nursing is respect for human rights, including cultural rights, the rights to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status.” My professional strengths included abiding the code of conducts, building trust, developing my integrity and respect to the patients. My weaknesses are sometimes, not familiar with applying skills in the nursing practices. When my skills are not fully developed their potentials, then I may need to collaborate with other professionals and receive their assistance in developing them to realize their potentials. III. Conclusion This action plan has outlined steps or actions to be taken in order to transform from a student in nursing care to a professional nurse practitioner. There are certain skills and knowledge which are vital for successfully and professionally performing as a nurse. Nursing as a profession, my professionalism must be fully realized. Thus, my weaknesses must be corrected and improved in a timely manner. References: Nicoll, L. H. (1992) Perspectives on Nursing Theory 2nd ed. J.B. Lippincott, Philadelphia. Freidson, E. (1977) The futures of professionalisation. In Health and the Division of Labour (Stacey M., Reid M. & Dingwall R. eds), Croom Helm, London, pp. 14-40. Freidson, E. (1983) The theory of professions: state of the art. In The Sociology of the Professions (Dingwall R. & Lewis P. eds), Macmillan, London, pp. 19-37. Beech, M. (2007). Confidentiality in health care: conflicting legal and ethical issues. By: Nursing Standard, 1/31/2007, Vol. 21 Issue 21, p42-46, Johnson, T. (1972) Profession and Power. Macmillan, London. Minjoon, J., Peterson, R., and Zsidisin, G. (1988)"The Identification and Measurement of Quality Dimensions in Health Care." Health Care Management Review 23, no. 4 (1998):81-96. Larrabee, J. H. and L. V. Bolden. (2001). Defining patient-perceived quality of nursing care. Journal of Nursing Care Quality, Oct. 2001, 16, 1. 34-60. Sower, V., J. Duffy, W. Kilbourne, G. Kohers, and P. Jones. (2001). The dimensions of service quality for hospitals: Development and use of the KQCAH Scale. Health Care Management Review, Spring 2001. 26 (2), 47-59. American Nurses Association. (2001). Code of ethics for nurses with interpretative statements. ANA, 2001. International Council of Nursing. Code of ethics for nurses. ICN, (2005). Retrieved 6 January, 2007, from: http://www.icn.ch/icncode.pdf Read More