Nursing criminal justice drugs team - Lab Report Example

SUBSTANCE MISUSE NETWORK TITUS ROCK MANICKAM 18 JANUARY 2008 Job Nursing criminal justice drugs team SUPERVISOR: Titus Rock Manickam Introduction The Lancashire Care Trust Substance Misuse Network is a community based treatment service. The network aims to meet the needs of people with problematic drug and / or alcohol use. The network covers the Fylde Coast, East Lancashire and Central & South Lancashire from eight base offices: Blackburn Substance Misuse Service Reid House 61 Preston New Road Blackburn Tel 01254226203 Blackburn Criminal Justice Service Penny Street Blackburn Tel:01254672204 Blackpool Substance Misuse Service Hope House 162 Whitegate Drive Blackpool Tel: 01253651440 Burnley Substance Misuse Service 60 Westgate Burnley Tel: 01282657270 Chorley Substance Misuse Service West Street Chorley Tel: 01772645780 Leyland Substance Misuse Service 6 Golden Hill Lane Leyland Tel: 01772773540 Preston Substance Misuse Service Bickerstaff house 53 Garstang Road Preston Tel:01772676003 West Lancashire Substance Misuse Service Westgate Skelmersdale Tel: 0169550740 The services include criminal justice teams, shared care and core services managing clients with more complex needs, alcohol services and a Homeless Team. The network aims to provide effective, efficient, accessible services which reduce the impact of drug and alcohol related harm, both for the individual their family and the wider community. The network is committed to providing a comprehensive induction to all levels of staff joining the team. Goals of the Induction Programme 1. To assist new employees to settle into their new role within the Substance Misuse Network 2. To assist new employees to understand the responsibilities of their role and what is expected from them 3. To ensure the new employee has the required capabilities, knowledge, skills and confidence to work with substance misusers in the capacity of their new role 4. To assess that the new employee performs to the required standard 5. To assist the new employee in assessing their own levels of knowledge, skills and confidence The Induction aims to provide all staff with a clear understanding of their role and responsibilities within the Substance Misuse Network. It should clarify processes and procedures, structures and standards and ensure that new employees have a clear understanding with regard to their legal and ethical responsibilities. The Induction should be time limited (2 months in duration). It is envisaged that the initial 4 weeks would cover external visits and a general introduction to the functioning of the team. The second month would encompass building up a client caseload and taking on more elements of the new post. Whilst on Induction, the new employee should be given a minimum of thirty minutes supervision a week. On completion of the Induction, the new employee should have an initial Personal Development Programme, identifying areas for further development, to carry forward with their line manager and clinical supervisor. They will also have a record of their training and accomplishments to date. The aim of this workbook is to provide a structure to your introduction to the network and to ensure that you acquire the relevant skills and local knowledge to provide a safe and comprehensive service to clients of the team. Visits to other organisations Write about each place you visit and the knowledge you have gained which will help you in your work e.g. Relevant contact details How the services may work in partnership Services offered The application of models of care Referral criteria Information sharing Visits should include local drug and alcohol services, mental health services, and other relevant agencies Mentor's comments: Communication Effective communication Listening skills Non-verbal communication Checking that others understand what you have communicated to them Understanding the impact of good and bad communication within a Team Dealing with issues of confidentiality Give an example of how you have communicated effectively Give an example of how you have listened effectively Spend a session working as receptionist by end of session to be running reception. Describe your experience Take part in office duty. Describe your experience Chair a Team Meeting. Describe your experience Give an example of good and bad communication that you have observed What do you see as the strengths and weaknesses in your own ability to communicate How do you think you can overcome any weaknesses Mentor's comments CONTRIBUTION TO THE WORK OF THE ORGANISATION This section can be achieved by practical experience, and reflective practice on hypothetical scenarios. Contribute to the prevention and management of abusive and aggressive behaviour (DANOS AB3) Contribute to the development of organisational policy and practice (DANOS BA3) Effectively carries out tasks related to evaluating services when asked Demonstrate an understanding of good leadership skills Use supervision and appraisals to prioritise and manage own professional development On completion of Risk Assessments in relation to both clinical and environmental risks, what are the main issues you feel should be taken into account Attend a Post Incident Review. Give a critique of the process What contribution can you make to the prevention and management of abusive and aggressive incidents or emergency situations What role do care plans play in the evaluation of services provided Provide an agenda for a supervision session Attend: Clinical Governance Subgroup Locality Models of Care Implementation Group Team Meetings Comment on your experience: Give constructive comments on a network protocol Identify your training needs and provide information on relevant training opportunities. Discuss this with your mentor. Legal and Ethical Requirements This section can be achieved by practical experience, and reflective practice on hypothetical scenarios. Demonstrate an understanding of the rational for respecting individuals choice regarding confidentiality as far as possible and situations in which this would be breached Demonstrate an understanding of the regulations and legislation which may affect the clients you work with and their possible impact on the way you work e.g. child protection, criminal justice Demonstrate an operational understanding of good communication and the role of confidentiality Demonstrate knowledge of the guidelines and legislation relating to standards for client case notes Reflect on a request for client related information and how you dealt with it Give an example of two pieces of legislation, which may impact on your work with clients and the form that effect might take. How do national policies translate into local action Evaluate your case note entries for two clients with your mentor Demonstrate an example of good interagency working you have been involved with Demonstrate your understanding of national legislation and local protocols in relation to the management of prescriptions How might you respond if a client discloses sensitive information for example a crime they have been involved in or third party allegations in relation to child protection. Confidentiality can be breached: - to protect children at risk of significant harm as defined by the Children Act 1989 - To protect the public from acts of terrorism as defined in the Prevention of Terrorism Act 1971 - As a duty to the Courts - Under the Drug Trafficking Offences Act 1986 - To prevent or detect a crime. Section 115 of the Crime and Disorder Act 1998 gives public bodies the power, but not a duty, to disclose information for the prevention or detection of crime - to ensure the service provides a duty of care in a life-threatening situation (e.g. serious illness or injury, suicide and self-harming behavior). This includes when a service user continues to drive against medical advice, when unfit to do so. In such circumstances relevant information should be disclosed to the medical advisor of the Driver and Vehicle Licensing Agency (DVLA) as soon as possible 4 To protect the service provider in a life-threatening situation (e.g. calls to police regarding a violent service user). The Department of Health has published guidance on the issue of violence against staff. A decision to disclose confidential information without the consent of the service user should not be made lightly and only after consultation between the drug worker and their line manager. criminal proceedings. All decisions should be recorded in the service user's case notes. There is no legal obligation to breach confidentiality in order to protect third parties or when a crime has been committed, unless and until instructed to do so by a court. However, a drug service may decide to disclose confidential information about a service user in the event of serious offences or risk to public. A drug service will need to be clear about its attitude to illegal activities and it is good practice The following sections cover areas of observed practice Triage Assessment Observed by supervisee Date Observations and reflective practice Observed by Preceptor Date Signature Observations reflective practice areas for development Comprehensive Assessment Observed by supervisee Date Observations and reflective practice Observed by Preceptor Date Signature Observations reflective practice areas for development Risk assessment Observed by supervisee Date Observations and reflective practice Observed by Preceptor Date Signature Observations reflective practice areas for development DIR assessment Observed by supervisee Date Observations and reflective practice Observed by Preceptor Date Signature Observations reflective practice areas for development Information sharing protocol Observed by supervisee Date Observations and reflective practice Observed by Preceptor Date Signature Observations reflective practice areas for development Doctors clinic Observed by supervisee Date Observations and reflective practice Observed by Preceptor Date Signature Observations reflective practice areas for development Care Planning Complete a care plan for a client Reflective practice Mentors comments Prescriptions Demonstrate understanding of the guidelines governing the issuing of prescriptions and organising changes to dose Reflective practice Mentors comments Demonstrate understanding of the following medications Understanding of effective and side effects and obvious interactions contraindication Medication Effects Side effects Interactions Contraindications Comments Methadone Prescribed as methadone mixture 1mg/ml. Prescribed 40mg or less as initiation dose; usually supervised consumption. Titrate to optimal dose 60-120mg. Can be titrated by 10mg per week after discussion with doctor; possibly larger increments at Dr's discretion. Buprenorphine Naltrexone Lofexidine Benzodiazepines (including use in alcohol detoxification) Cyclazine Dexadrine Dihydrocodiene Morphine Sulphate/ Morphine sulphate slow release Diamorphine Week Planner Monday Tuesday Wednesday Thursday Friday AM PM Guidance for use of Induction workbook The content of the workbook is generic; the role of the supervisior is to guide the new starter to complete it in accordance with the Knowledge and Skills Framework / DANOS level appropriate to their role The Induction should be time limited (2 months in duration). It is envisaged that the initial 4 weeks would cover external visits and a general introduction to the functioning of the team. The second month would encompass building up a client caseload and taking on more elements of the new post. It should be noted that 8 weeks is the maximum time period envisaged for induction, however due to levels of knowledge and previous experience some new starters may satisfactorily complete the induction workbook in a shorter time. The supervisor should be identified prior to the new employees start date. The supervisor should be a more senior member of the team than the new post holder Whilst on Induction, the new employee should receive a minimum of thirty minutes supervision a week. The supervisor should guide the supervisee to work to the expected knowledge and skills of the post The supervisor should assist the supervisee to Identify areas for further work as appropriate The evidence required to complete the workbook can be acquired through observation, practical experience, discussion of scenarios, reflective practice It is the responsibility of the supervisee to complete the workbook It is the responsibility of supervisor to assist and guide the supervisee in the completion of the workbook and report to the line manager on progress and any concerns The supervisee will provide a copy of the completed work book to the line manager to be kept with their personnel record and maintain a copy for their own reference The documentation will provide a paper trail for audit purposes Completion of workbook sections: 1. Visits Ensure the new starter selects relevant agencies to visit and are creative in their choices i.e. mental health services probation etc On return discuss with the new starter what they achieved from the visit and relevant information they have gathered discuss how they could share this with the rest of the team if relevant 2. Communication; Contribution to the work of the organisation; Legal and ethical requirements: The workbook is a generic tool. It is the role of the preceptor to guide the new starter to complete the reflective practice to a level concomitant to their new role. If in doubt the Knowledge and Skills Framework or DANOS competencies provide a useful guide 3. Observed practice All new starters should observe more senior/experienced staff in the performance of key tasks. The number of times they may need to do this will be dependent on their own level of knowledge and previous experience All new starters should be observed by more senior/experienced staff in the performance of key tasks. The number of times they will need to be observed will be dependent on their level of skill and experience, and their ability to respond to guidance given It is the role of the preceptor to provide constructive advice and guidance on the completion of key tasks to ensure they are able completed to a standard expected both of that post and that post within the service Week planner A weekly template is provided for the preceptor and supervisee to timetable the week productively Commencing Personal Development Programme On completion of the induction period and satisfactory completion of the workbook the preceptor and supervisee should develop a preliminary Personal Development Programme in line with network guidelines Read More