Essay Barriers in Working with a Multidisciplinary Team – Nursing Assignment Help

Assignment Task :

INTRODUCTION

Reflection is an effective tool which provides an opportunity for nurses to look into the situation, evaluate them and develop learning through experiences gathered during practicing their profession (Redmond, 2017). The Gibb’s reflective cycle is an effective framework which guides nurses to reflect upon their experiences and learn from comprehensive analysis of situation with the help of literature (Bassot, 2016). In this paper, Gibb’s reflective cycle has been used to reflect upon various clinical issues encountered by me during clinical placements. The various steps of Gibb’s reflective cycle are description, feelings, analysis, evaluation, conclusion and action plan which has been used in this assessment (Bassot, 2016). The objective of this assessment is to develop an understanding of various professional standards and code of conduct to which a nurse is required to comply for the provision of best possible care to the clients.  This paper is structured into three themes based on clinical issue to learn from these issues and promote evidence-based practice.

Theme 1: Barriers in working with a multidisciplinary team.

   During a clinical placement, I was working in a multidisciplinary team for the provision of post-operative care to a 68-year-old patient who had medical history of type 2 diabetes mellitus (T2DM) and COPD. The patient underwent an amputation surgery of her first toe followed anaesthesia due to complicated diabetic foot ulcers.  During a round to post-op wards, I was monitoring the vitals of patient as routine and I found that the patient was feeling anxiousness and helpless because of her amputation and she was clueless about managing her complications by himself. She was looking emotionally distressed and that why she required counselling sessions. As I was junior to all of them, I was not able to advocate the needs of the patient to the concerned members of multidisciplinary team. 

          I felt really bad and helpless when observed that patient’s needs were not addressed by multidisciplinary team adequately. It was not able to cope up with my hesitation and fear of sharing my perception with my seniors because of which I was very distressed. 

          From the evaluation of situation, I have realized that to enhance my competence to work in a multidisciplinary team to address and advocate all the physical, emotional and social needs of my client irrespective of my position and power distribution within a multidisciplinary team. According to Babiker et al. (2014), it is essential for a nursing professional to engage in multidisciplinary teamwork and demonstrate appropriate cooperation, coordination, collaboration, integration and leadership within the team to maintain the reliability and continuity of care provided to the patients.

          From the analysis of situation, I have found that it was my hesitation which was restricting me from the patient advocacy. According to James and Mill (2018), the lack of confidence, hesitation, power distribution and fear of penalty are certain barriers in the practice of novice nurses which limits their skills of effective patient advocacy. It is legal obligation for nurses to engage in a compassionate practice where they can provide high-quality patient-centered care to their clients and can respect their autonomy and rights in the decision making process (NMC, 2010). 

          I will improve my competence to work in a multidisciplinary team through education, training and engagement in evidence-based practice to attain the skills required for fulfilling this objective. According to Nancarrow et al. (2013), effective communication, understanding of roles, developing team coherence, effective decision making, cope up with hesitation and development of theoretical and practical skills are certain strategies which can help the nursing students to engage in effective multidisciplinary team work. It will be apply these strategies in my future clinical placements for patient advocacy.

Theme 2: Role of effective communication in nursing practice

   Once in a clinical placement, I need to provide education for self-management to the patients having complication of diabetes mellitus after their consultation with the endocrinologists. I was instructed to provide information to the patients about their timely and healthy diet, smoking cessation, exercise and other physical activity and medication for self-management of the complication. There were around 15 patients in the wards and everything was going smooth. I already communicated to nearly 10 patients and then an aboriginal patient came to me. When I interacted with the patient for the provision of self-management information, he behaved weirdly and just left the ward without asking anything.

 From the incident, I felt embarrassed because this was weird for me as well and shared the incident with RN. She told me that because of my inappropriate communication skills patient would not able to understand anything and just left without asking anything. 

          After the evaluation of situation, I have found that effective communication with the clients is a founding principle of nursing practice. Before the incident, I was not aware about the impact of communication in nursing practice.  Kourkouta and Papathanasiou (2014) stated that it is essential for nurses to engage in effective and culturally appropriate communication with the clients as it facilitates development of therapeutic relationship with the patients for understanding their needs and expectations from the care provided to them. 

          From the analysis of situation, I have realized that in need to enhance my skills of effective communication and provision of culturally competent care to my clients to meet their expectation and enhancing their health outcomes. It is the legal obligation of the nurses to engage in effective t communication with patients and should show respect for their culture, values, preferences, rights, autonomy and ethics with the help of communication (Riley, 2015).

     I will develop the skills of effective verbal and non-verbal communication and then implement these skills in my future clinical placement for appropriate patient education.  According to Aebersold, Tschannen and Sculli (2013), SBAR tool, DATAS tool and escalation process tools can be used by nurses for improving their communication skills. I will use these tools for enhancing my communication skills. Also, maintenance of professional boundaries, use of posters, avoidance of slangs, use of simple language, patience, calmness and empathy can be used for effective therapeutic communication in nursing (Vermeir et al., 2015).

Theme 3: Medication errors in nursing practice

     During a clinical placement, I was assisting RN for providing care to Mrs. X who underwent a right leg ORIF followed anesthesia.  The RN administered morphine for the management of severe pain of the patient and instructed me to take her vitals after some as a routine of post-op care. In the evening shift, during a round to the wards of patient I noticed that she was lying unconscious on her bed, restless, pale and not responding to my voice. I made a MET call immediately as it was difficult for me to handle the situation. 

          After noticing the patient in horrifying condition, I became afraid as it was the first time I saw a patient in such a critical condition. I was not aware of what to do exactly and I got very nervous after knowing that it was an adverse event because of medication error committed by RN.