This account will reflect on the skills of a nurse, observed at an older person's functional mental health unit. It will focus on the organization of care, and skills used when dealing with a Multi Disciplinary Team. (MDT) It gives an understanding of the skills used to clearly establish and provide the needs of a patient, promoting a patient led approach. Attention will be given to the style of introduction and the effective use of non- verbal communication skills. Observations will be discussed from the event and justification of its learning will be supported by extensive, documented research.
It will conclude with a reflective account and critical assessment of the shortcomings of the process, and provide supporting recommendations in an attempt for excellence. In order to respect the patient's confidentiality, and comply with the Nursing and Midwifery council code of conduct, the precise location and name of the patient has been changed, Nursing and Midwifery Council (2002). A pseudonym called Mrs. Patel will be used.
[...] Forchuk, C. (2002). People with enduring mental health problems described the importance of communication, continuity of care, and stigma. Evidence'Based Nursing, Herrman H., Trauer T. & Warnock J. (2002) The roles and relationships of psychiatrists and other service providers in mental health services, Australian. Australian and New Zealand Journal of Psychiatry Hizar,D (1997). When touch is not the best approach. Journal of clinical nursing 6(3):203-206 Holland,K Hogg C(2001) Cultural awareness in nursing and health care.London:Arnold. Hoening J. & Hamilton M. [...]
[...] Without a good understanding of the patients profile, and needs from the nurse, the process simply becomes mechanical and does not reflect on the patient centered, holistic approach that the service of Mental Health Service strives for. The nurse becomes the central focal point for the patient. Studies have shown that a patient may be concerned or uncertain about their treatment and turn to a nurse for clarification and advice (Dickinson, Hargie and Morrow 1997). Engaging clients in discussions about their problem and how it is best dealt with is highly regarded by clients, and leads to improved ability to cope, improved compliance and better outcomes, Kemp (1996). [...]
[...] (2004) On phenomenology and classification of hoarding: a review. Acta Psychiatrica Scandinavica Martyns-Yellowe I. (1992) The burden of schizophrenia on the family. A study from Nigeria. British Journal of Psychiatry McCann K. & McKenna H.P. (1993) An examination of touch between nurses and elderly patients in a continuing care setting in Northern Ireland. Journal of Advanced Nursing McPherson A. & Jones R.G. (2003) The use of sections 2 and 3 of the Mental Health Act with older people: a prospective study. Aging and Mental Health Meehan [...]
[...] The discussion became somewhat agitated, at one stage, when a family member began to shout and demand that his mother be kept in hospital. The nurse was confident to not react unprofessionally, Kinney (1994), identifies this event closely, but agrees with his concerns for his mother, but highlight some key reasons for transfer of care to a specialist residential unit. The family was left feeling comforted that the nurse had the best intentions for their mother and a patient centered focus of care was in operation. [...]
[...] She leant slightly forward in her chair, maintained an open posture and remained relaxed through the whole period of discussion. These characteristics have been well explained by Farley (1992), and have been proven to facilitate communication and focus on the patients concerns. Brief periods of general talk commenced, this was used to break the ice and create some warmth to the discussion. This introductory phase is also referred to as the orientation or pre helping phase. The three stages of this introduction are, opening the relationship, clarifying the problem and structuring and formulating the contract. [...]
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