Essay on Collaboration in Practice
In the past, nurses provided care and comfort as they carried out specific nursing functions, but changes in nursing have expanded the roles of nurses to include health promotion, illness prevention, and concern for the client as a whole. The evolving nature of the health care industry have changed the scope of nursing practice from assisting the physician and providing primary nursing care to collaborating with other professionals in different disciplines in the healthcare field. The American Nursing Association (1992) described collaboration as “a collegial working relationship with another health care provider in the provision of patient care”. Although the physician is usually considered the head of the health care team, the nurse serves an important role in coordinating the efforts of all team members in meeting the client’s goals. As a collaborator in the clinical setting, the nurse is continually involved in promoting communication among all people affected by the patient’s need. Nurses are involved in team conferences or interdisciplinary meetings with members of the health care team to discuss patients’ cases and set specific goals geared towards rehabilitating the patients to their pre-admission health status or better functional level.
Members of the collaborative or multidisciplinary team include the Physical therapists, Physicians, Social workers, Occupational therapists, Discharge planner, Pastoral worker, Case worker and patients’ families. Each member of the collaborative team is fully aware of his or her roles by contributing their unique expertise information regarding the optimal patient’s health. The involvement of the collaborative team is utilized in all health care settings. Collaborative care is provided in the inpatient hospital settings where the medical team strives to treat the sick patients. Other settings where collaborative care is required include; Home health care setting, Clinics, Long Term Care Facilities and Public Health Services. The nurse plays the role of coordinating information about the patient while maximizing effective communication skills between each member of the collaborative team.
An important benefit of the collaborative team includes providing the patient with first class information so that the patient can make informed decision about his overall health care. Blais et. al (2002) confirmed that when patients are empowered to participate actively and professionals share mutually set goals with clients, everyone including the organization and health care system ultimately benefits. When quality improves, adherence to therapeutic regimens increases, lengths of stay decrease, and overall costs to the system decline. Improved communication between members of the health care profession fosters a supportive work environment where members work together to establish priorities of the patient health care and collaborate to achieve a common set of patient goals. It is important to state the goals in clear concise manner that can be understood and measured by all health care team members. After determining the goals, the nurse coordinates the team effort to develop strategies to accomplish them The collaborative team joins the nurse to determine appropriate nursing diagnosis based on the nurses’ holistic assessment of the patient. Carpenito (1991) defined the nursing diagnosis as “ a clinical judgment about an individual, family, or community response to actual or potential health problems /life process, such as aging or death. A nursing diagnosis is the summary statement or judgment made by the nurse upon interpreting the data gathered in the nursing assessment. The nurse’s diagnosis serves as a guide for planning, organizing, implementing, and evaluating nursing care. The nursing diagnosis is also a label that communicates the nature of a patient’s existing or potential problems that the nurse, through the implementation of nursing interventions can solve. The evaluation nursing process is the last process where patient health problems are reviewed to determine if the goals are achieved.
CASE STUDY
Mrs. G. passed out on the floor. The last she can remember was that she developed shortness of breath as she attempted to climb the staircase leading to her bedroom in her house. Nursing assessment at the Hospital ER revealed that Mrs. G. was bleeding profusely. She had altered level of consciousness therefore; she could not answer any admission question. The ER physician assessed her and ordered IV fluid for hydration, MRI and CT scan of the head was performed .The Radiologist discussed with the physician to confirm that Mrs. just had a stroke. The laboratory results revealed abnormal levels of her cardiac panels, clotting factors and electrolytes. She was admitted to the ICU where the ICU charger nurse and medical team consisting of the Physician, Respiratory therapist, Neurologist, radiologist and patient’s family to determine that she was stabilized and can be transferred to med-surgical floor. During her three weeks stay at the med-surgical floor, the Physical therapist assisted her to learn how to ambulate and perform active range of motion to exercise her wasted leg muscles. The Occupational therapy assisted her to perform activities of daily living (ADL) with minimal assistance. The Speech Therapist spent quality time with Mrs. to help her identify and use words correctly. The Speech therapist worked together with the Dietitian and Nurses to determine the best diet for her, which consisted of pureed diet. The nurses had to maintain Dysphasia Protocol to prevent aspiration and relapse into respiratory problems. Meanwhile, the respiratory therapist was coordinating with the nurses to wean her off oxygen therapy. The Primary Physician and Neurologist collaborated with nursing staff to adjust the patient’s medications. To effectively collaborate with other members of the health care; the nurse manager coordinated the multidisciplinary meeting that was held every week to monitor patient’s progress. Finally, the Physician discharged Mrs. G. home unfortunately; she needed help at home after discharge so that she can continue functioning at her pre-admission level. The Discharge planner collaborated with the nurse to determine that Mrs. would require a front wheel walker, Physical therapist and home health nurses to assist her at home. When it was time to leave the hospital premises, Mrs. G was satisfied about her quality of care during her hospital stay. She was glad to finally go home because she knew that the social worker had already arranged for some volunteers to visit her and assist her with errands too. The Case manager gave her a taxi voucher that will take her home. This scenario clearly demonstrates the importance of collaboration between healthcare members. Obviously, every member played a role for successful execution of collaborative goals based on the nursing processes
In conclusion, the changing scope of nursing practices demands that nurses collaborate with health care professionals to provides satisfactory level of patient care in all medical settings. Differentiating between the collaborative problems and nursing diagnosis will help the collaborative team to focus on the patient, set measured goals and work together to provide quality patient care.
Members of the collaborative or multidisciplinary team include the Physical therapists, Physicians, Social workers, Occupational therapists, Discharge planner, Pastoral worker, Case worker and patients’ families. Each member of the collaborative team is fully aware of his or her roles by contributing their unique expertise information regarding the optimal patient’s health. The involvement of the collaborative team is utilized in all health care settings. Collaborative care is provided in the inpatient hospital settings where the medical team strives to treat the sick patients. Other settings where collaborative care is required include; Home health care setting, Clinics, Long Term Care Facilities and Public Health Services. The nurse plays the role of coordinating information about the patient while maximizing effective communication skills between each member of the collaborative team.
An important benefit of the collaborative team includes providing the patient with first class information so that the patient can make informed decision about his overall health care. Blais et. al (2002) confirmed that when patients are empowered to participate actively and professionals share mutually set goals with clients, everyone including the organization and health care system ultimately benefits. When quality improves, adherence to therapeutic regimens increases, lengths of stay decrease, and overall costs to the system decline. Improved communication between members of the health care profession fosters a supportive work environment where members work together to establish priorities of the patient health care and collaborate to achieve a common set of patient goals. It is important to state the goals in clear concise manner that can be understood and measured by all health care team members. After determining the goals, the nurse coordinates the team effort to develop strategies to accomplish them The collaborative team joins the nurse to determine appropriate nursing diagnosis based on the nurses’ holistic assessment of the patient. Carpenito (1991) defined the nursing diagnosis as “ a clinical judgment about an individual, family, or community response to actual or potential health problems /life process, such as aging or death. A nursing diagnosis is the summary statement or judgment made by the nurse upon interpreting the data gathered in the nursing assessment. The nurse’s diagnosis serves as a guide for planning, organizing, implementing, and evaluating nursing care. The nursing diagnosis is also a label that communicates the nature of a patient’s existing or potential problems that the nurse, through the implementation of nursing interventions can solve. The evaluation nursing process is the last process where patient health problems are reviewed to determine if the goals are achieved.
CASE STUDY
Mrs. G. passed out on the floor. The last she can remember was that she developed shortness of breath as she attempted to climb the staircase leading to her bedroom in her house. Nursing assessment at the Hospital ER revealed that Mrs. G. was bleeding profusely. She had altered level of consciousness therefore; she could not answer any admission question. The ER physician assessed her and ordered IV fluid for hydration, MRI and CT scan of the head was performed .The Radiologist discussed with the physician to confirm that Mrs. just had a stroke. The laboratory results revealed abnormal levels of her cardiac panels, clotting factors and electrolytes. She was admitted to the ICU where the ICU charger nurse and medical team consisting of the Physician, Respiratory therapist, Neurologist, radiologist and patient’s family to determine that she was stabilized and can be transferred to med-surgical floor. During her three weeks stay at the med-surgical floor, the Physical therapist assisted her to learn how to ambulate and perform active range of motion to exercise her wasted leg muscles. The Occupational therapy assisted her to perform activities of daily living (ADL) with minimal assistance. The Speech Therapist spent quality time with Mrs. to help her identify and use words correctly. The Speech therapist worked together with the Dietitian and Nurses to determine the best diet for her, which consisted of pureed diet. The nurses had to maintain Dysphasia Protocol to prevent aspiration and relapse into respiratory problems. Meanwhile, the respiratory therapist was coordinating with the nurses to wean her off oxygen therapy. The Primary Physician and Neurologist collaborated with nursing staff to adjust the patient’s medications. To effectively collaborate with other members of the health care; the nurse manager coordinated the multidisciplinary meeting that was held every week to monitor patient’s progress. Finally, the Physician discharged Mrs. G. home unfortunately; she needed help at home after discharge so that she can continue functioning at her pre-admission level. The Discharge planner collaborated with the nurse to determine that Mrs. would require a front wheel walker, Physical therapist and home health nurses to assist her at home. When it was time to leave the hospital premises, Mrs. G was satisfied about her quality of care during her hospital stay. She was glad to finally go home because she knew that the social worker had already arranged for some volunteers to visit her and assist her with errands too. The Case manager gave her a taxi voucher that will take her home. This scenario clearly demonstrates the importance of collaboration between healthcare members. Obviously, every member played a role for successful execution of collaborative goals based on the nursing processes
In conclusion, the changing scope of nursing practices demands that nurses collaborate with health care professionals to provides satisfactory level of patient care in all medical settings. Differentiating between the collaborative problems and nursing diagnosis will help the collaborative team to focus on the patient, set measured goals and work together to provide quality patient care.
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