Multidisciplinary Team Conference: Critical Reflection on Role Play - Essay Example

Critical Reflection on Role Play MDT Case Conference Module Nursing and Collaborative Practice Module Cohort: Febr. ID student number: The word count: Module Leader: Module Tutor: Introduction Communication is an integral part of nursing care and various guidelines have recommended the need for effective communication during the process of care giving(www.nursingtimes.net).This essay is a critical reflection (based on my experience) on communication and the results of working collaboratively, during a role play within Multidisciplinary Team (MDT) case conference. In my essay I will use Gibb’s model of reflection (1998) (Appendix 1). I will describe the event and the feelings associated with it and more importantly I will evaluate the positives and negatives of the event through reflection (Callara, 2008) which will help me in the process of care giving in future. Reflection is an integral method of self reviewing in healthcare professionals which will help them professionally to deliver care in the future (Aveyard et al., 2011). To consider reflection healthcare professionals should be open minded, must have innovative thinking, and open to criticism (Johns, 2009; Bulman and Schutz, 2008 and Aveyard et al., 2011). In the end I will identify my learning needs which I can improve in the future practice (Aveyard et al., 2011). Background The scenario involved a 16 years old child named Sarah, who was recently admitted to the Accident and Emergency (A&E) department for the treatment of hyperglycemia. She was well known to the staff of the pediatric ward as she is frequently admitted to the ward with recurring diabetes which also leads to depression in her. We were arranged in a group of twelve people and asked to complete a role play on a MDT meeting. The health professionals who were included in MDT conference were the chair person, the diabetes pediatric nurse specialist, the pediatric nurse specialist, the adult consultant, the ward manager, one nurse from the adult ward, two dietitian specialized in diabetic management, one nurse specialist, two psychologists specialized in the care of chronic disease, one school nurse and a social worker. The patient and her mother were also present at the meeting; consent was given as per the protocol of Nursing and Midwifery Council [NMC], 2008.The rationale for choosing these roles was to establish and offer Sarah an integrated care by a multidisciplinary pediatric diabetes care team. To optimize the effectiveness of care we included members who were appropriately trained and had requisite knowledge on the clinical, psychological and lifestyle issues for children and young adults as per the guidelines of National Institute for Clinical Excellence [NICE], 2004. I took over the role of the social worker after discussing with my team for providing holistic care to Sarah along with my other team members. I took up such role as I learnt that social work promotes: social change, problem solving ability in human relationships, empowerment and liberation of people to enhance well-being (Dominelli, 2009). Reflections Initially I was much stressed and nervous because I was not acquainted with the members of MDT very well. I was also afraid to speak in public which I think may have affected my overall performance and contribution. Individually I felt that my contribution was quite limited as I only tried to reassure Sarah and her mother on the issue that adolescent diabetes can be managed with appropriate care giving (Jones and Hamilton, 2008) and there is no need to get worried. However I was very happy with the feedback we received from Sarah and her mother after the role play after considering the performance of my entire MDT team. I think one of the best approaches we took was to invite Sarah and her mother in the meeting. This helped us to take into account their views on the issues of health care needs and other desirable supports (Department of Health [DH], 2004). Several studies have explored the usefulness of involving the children and adolescents in care and decision making process (Coyne, 2006). However many nurses have varied views about this approach, although such requirements have been specified by the National Service Framework (DH, 2004). The other approach i felt beneficial was to involve a family-centric care approach. Family centric care should be viewed differently for different families considering the aspects of cultural, social and individual preferences. Our aim was to work together as an interdisciplinary unit to promote family- centric care (Smith and Coleman, 2010). The ward manager offered the option to Sarah’s mother to stay overnight with her. The dietician provided a tailor made advice about the diet for Sarah and implicated Sarah’s mother on the issue regarding the principles of food intake for the entire family. I noticed that Sarah looked a bit intimidated by the large number of people attending the meeting; however she was able to feel that everybody was very supportive and empathetic. I realized the need to communicate to Sarah with a “humanitarian approach” involving warmth rather than purely a professional approach. This helped Sarah to express her concerns and feelings. I learnt the importance of building up of a relationship (Smith and Coleman, 2010) not only with my other healthcare professionals but also with Sarah and her mother to impart effective care giving. Health care professionals must possess active listening to be able to develop a relationship with the patient and their family to initiate a family-centric care approach (Smith and Coleman, 2010). Thus I realised the importance of communication in the form of listening, questioning and responding to the needs of such children/young adults as because communication is not just about the words but it involves the body language that provides an appropriate feedback regarding the satisfaction level of the patient (Lefevre, 2010). However I felt that the role of the key worker was not appropriately defined in our MDT team. The key worker is essential to coordinate care, to listen, to advocate and to act like a bridge between services. Moreover the key worker has an important role to smoothen out the transition from child health services to adult health services. This transition knowledge was not discussed in the meeting. Transitions can be potentially stressful times for children/young adults and a poor planned transition to adult health services can increase the risk of non-adherence, which can lead to serious consequences (Royal College of Nursing [RCN], 2007). Hence as a social worker I think is very important to have an effective knowledge about adolescent transition. A social worker alongside the other healthcare professionals should be instrumental to empower Sarah and her mother to make health decisions and to give healthcare through partnership, both in hospital and in community. This will help the families to identify the problems which are important in their settings. Measures should be formulated to prevent healthcare professionals from making assumptions regarding specific family problems. Without these measures family and the patient could left disempowered as they will feel that their financial, psychological and social constraints are not being considered by the healthcare professionals and this may lead to noncompliance to treatment guidelines (Smith and Coleman, 2010). Hence empowerment is important as it inculcates the feelings of power and control to the family of the patient, which makes them confident enough to participate in the aspects of health care and for playing an active role in making decisions about their care (Smith and Coleman, 2010). Learning’s and Action Plan for Future A clear understanding of the roles and function of healthcare professionals’ is the key for an effective multidisciplinary care approach (NICE, 2013). Regular communication is central for such inter-professional practice. Teamwork is another aspect that facilitates such effective partnership (Smith and Coleman, 2010). However, often such s inter-disciplinary system fails due to improper communication and role ambiguities (Department for Education, 2003) After reflecting on MDT case conference, my future action plan is to increase my confidence to speak in public or to a large group of people, to improve my communication skills and to have a better understanding of other healthcare professional’s role not just in theory but also in practice (DH, 2013). For this I will try to attend as many as possible MDT meetings to gain more experience from my colleagues. I would seek regular feedback from my mentor and the other healthcare professionals on the process of effective care giving. I would adhere to a learning development plan (Sully and Dallas, 2005) which has been set up in order to aid my learning goals, and provide feedback on my performance. Further analyzing the positive end negatives I realized the importance of collaborative learning which creates knowledge, empathetic behavioural approach and team building qualities which all potentiates the quality of care giving (Bolton, 2010) (Thistlethwaite, 2012). Apppendix-1: The reflective cycle (Gibbs 1988) References: Aveyard, H., Sharp, P. and Woolliams, M., (2011) A Beginner’s Guide to Critical Thinking and Writing in Health and Social Care. Maidenhead: Open University Press. Bolton, G. (2010) Reflective Practice: Writing & Professional Development. 3rd ed. London: Sage. Bulman, C. and Schutz, S. (2008) Reflective Practice in Nursing. 4th ed. Oxford: Blackwell Publishing Ltd Callara, L. (ed.) (2008) Nursing Education Challenges in the 21st Century. 1st ed. New York: Nova Science Publisher. Coyne, I. (2006) Consultation with Children in Hospital: Children, Parents and Nurses Perspectives. Journal of Clinical Nursing.15, pp. 61-71. Department for Education, (2003) Every Child Matters [online] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/272064/5860.pdf [Accessed 23 May 2014]. Department of Health, DH (2004) National service framework: children, young people and maternity services. [online]. Available from https://www.gov.uk/government/publications/national-service-framework-children-young-people-and-maternity-services [Accessed 22 May 2014]. Department of Health (2013). Report of the Children and Young People’s Health Outcomes Forum. (Chairperson: Ian Lewis). Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216852/CYP-report.pdf [Accessed 23 May 2014]. Dominelli, L. (2009) Introducing Social Work. Cambridge: Polity Press. Gibbs, G. (1998) Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Further Education Unit. Johns, C. (2009) Becoming a Reflective Practitioner. 3rd ed. Oxford: Blackwell Publishing Ltd. Jones, S. and Hamilton, S. (2008) The Missing Link: Paediatric to Adult Transition in Diabetes Services. British Journal of Nursing. [online], 17(13), pp.842-847. Lefevre, M. (2010) Communicating with Children and Young People: Making a Difference. Bristol: The Policy Press National Institute for Clinical Excellence, NICE (2004) Type 1 Diabetes: Diagnosis and Management of Type 1 Diabetes in Children, Young People and Adults. Available from: http://www.nice.org.uk/nicemedia/live/10944/29390/29390.pdf [Accessed 20 May 2014]. National Institute for Health and Care Excellence (2013) New collaborative aims to increase NICE guidance uptake [online] Available from: http://www.nice.org.uk/newsroom/news/NewCollaborativeIncreaseNICEUptake.jsp [Accessed 10 May 2014]. Nursing and Midwifery Council (NMC) (2008) The code: standards of conduct, performance and ethics for nurses and midwives. NMC London. Available from: http://tinyurl.com/6kdup6 [Accessed 20 May 2014]. Royal College of Nursing, RCN (2007) Adolescent transition care. Guidance for nursing staff. [online] Available from: http://www.rcn.org.uk/__data/assets/pdf_file/0011/78617/004510.pdf [Accessed 20 May 2014]. Smith, L. and Coleman, V. (2010) Child and Family-Centred Healthcare: Concept, Theory and Practice. 2nd ed. London: Palgrave Macmillan. Sully, P. and Dallas, J. (2005) Essential Communication Skills for Nursing. London: Elsevier. Thistlethwaite, J. (2012) Values-Based Inter-professional Collaborative Practice: Working Together in Healthcare. Cambridge: Cambridge University Press. www.nursingtimes.net Read More