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Description


In one of the recent incidents, I had to provide care to an 80-year-old patient with schizophrenia who was admitted to the facility following a fall and was admitted to the facility for observation. To assess the health of the patient, I had to collect the vitals of the patient and undertake the GCS assessment. At the same time, the patient had to also be assessed by a mental health nurse for her current mental health status. The patient was not cooperative and was not assisting with her background information. To mitigate this, I focused on ensuring that I coordinated with the mental health nurse. I also ensured communication of the patient needs with other members of the staff and outlined a program for healthcare assessment and patient monitoring. This allowed individuals from different clinical backgrounds to work together and create a comprehensive report for the patient. I also ensured the involvement of the patient family in the collection of patient history and relevant patient information. This helped in ensuring the collection of relevant background information about the patient and achieving an understanding of patient care needs. I also ensured that I engaged in therapeutic communication with the patient and promoted her participation in the process of healthcare assessments. This helped the patient participate in the process of assessment and complete the observations and patient assessment successfully. Finally, the observation of the patient was complete, and she was discharged with recommendations and precautions that she needed to apply to reduce the risk of falls.
 

Feelings


I have worked with several patients, and I was confident that even with the given case, I would be able to meet the assessment and care needs of the patient. However, when I approached the patient to collect the vitals and conduct additional assessments such as falls risk assessment and to conduct the GCS assessment, the patient was reluctant. This made me concerned because patient cooperation is essential for completing the nursing assessment. When I was informed by the mental healthcare team that the patient also has a history of complex mental health complications such as schizophrenia and that additional assessments were required, I realized the need to chart the patient assessment needs. I took this decision as it would help me in effective management of time and outline how the patient care needs could be managed and understood holistically. When I received the cooperation of fellow staff members as well as the patient family, I was happy and content because it was essential to meet the care needs of the patient holistically. I was also relieved that I was able to convince the patient to cooperate and participate in the process of care. I was happy that the care needs of the patient were addressed, and adequate patient education was also provided, ensuring complete care for the patient.
 

Evaluation


Many patients require multidisciplinary care (Brennan, 2018). This is needed as patients have different complications that need to be mitigated with effective patient support and care from individuals belonging to different professional backgrounds. However, when providing multidisciplinary care, it is important that the care is coordinated and aligned with the personal needs of the patient (Peterson et al., 2019). The same was taken into consideration when providing care to an elderly patient in the facility.
 
 
Identification of various needs of health assessments such as falls risk assessment, physical health assessment, cognitive assessment, and mental state assessment allowed for outlining the different needs of the patient in the care facility. It also assisted in coordinating care so that the assessments did not overlap and the procedures were prioritized when providing care. This was an essential aspect of care and prevented conflicts in the process of care. Decision-making and nursing leadership are crucial for providing good quality care to patients (James & Bennett, 2022). In a care facility, when multiple professionals work with a patient, it can lead to conflicts and thus impact the process of care. In the given case, I was able to chart the patient's needs and develop a coordinated health assessment plan for the patient. This can be aligned with the theory of situational leadership. This asserts that the management style was adopted to manage the situation (Ossenberg et al., 2020). This helped in reducing any form of ambiguity and ensured that quality care was provided to the patient.
 

Another essential aspect of the quality care of a patient is communication (Farrelly, 2021). Therapeutic communication helps in the engaging patient in the process of care and promotes their coordination and adherence (Kwame & Petrucka, 2019). Communication is also important in the management of the teams and ensuring there is effective coordination for managing the needs of the patient (Arnold & Boggs, 2019). In the given case, it was possible through communication between the staff that care for the patient was coordinated and healthcare staff was managed. Effective communication also led to the development of a therapeutic relationship with the patient and helped in ensuring improved care for the patients. 
 

Analysis


The Nursing and Midwifery Board of Australia has developed professional standards that highlight the individual action and practices to be adopted to advance as a competent professional (Ossenberg et al., 2020). The standards of registered nurses highlight that it is important for nurses to think critically and analyze their nursing practice (Standard 1) (Nursing and Midwifery Board of Australia, 2017). In the given case, this standard was applied as I ensured assessment of the situation and took a prompt decision to develop a chart of required patient assessments. The developed practice was also in alignment with the fifth standard of the registered nurse standards, that is, the development of a nursing plan (Standard 5) (Nursing and Midwifery Board of Australia, 2017). This is focused on the identification of care needs and planning them to meet the needs of the patient. This was crucial as it helped in the development of a concise plan of health assessment and care. The development of strong communication techniques and strategies is also encouraged by the Nursing and Midwifery Board of Australia (Ossenberg et al., 2020). Standard two of professional nursing practice highlights that it is an essential responsibility of the nurse to develop and engage in therapeutic relationships (Nursing and Midwifery Board of Australia, 2017). In the given case, this was of prime importance. The patient was non-cooperative and also had a severe mental health disability. Poor coordination and support of the patient could not have been achieved without the application of principles of therapeutic communication and the development of a rapport with the patient. This helps in ensuring compliance of the patient in the process of care. It was only through the application of effective communication and leadership skills that the patient assessment was completed on time, and effective outcomes were achieved. This allowed successful completion of assessments and discharge of the patient from the facility with required additional education and formalities (Hassmiller & Pulcini, 2020). 
 

Conclusion


Through this experience, it can be concluded that working in multiple teams and understanding the importance of multidisciplinary team action is essential to achieving suitable care outcomes for patients. Through this experience, it can also be concluded that effective communication can help in directing the improved quality of care for the patients and help in the management of clinical situations. I also learned the importance of the involvement of family in the process of care and how it can help in gaining the required knowledge about the patient and assist in achieving suitable care outcomes. 
 

Action Plan


To advance as a competent nurse, it is essential that an individual work through their skills and knowledge and develop them further for more competent practice. To advance my practice further as a professional, I will ensure improvement in my practice in alignment with the individual care needs by enhancing my communication skills. I will focus on improving my communication skills by ingraining practices like active listening. This will assist me in improving my relationship with the patients and also promote inter-professional communication in the care setting. This will allow for better management of teams and working in a systematic approach, ensuring improved outcomes and better care coordination in the facility (Hafsteinsdóttir et al., 2019). In my future practice, I will ensure that while working with patients with mental health complications, I am more vigilant and use a sensitive language. I will also ensure that I engage the family of the patients so that a clear understanding of patient needs is derived and quality care is provided to the patients. It will also make my practice more sensitive and informed (Hassmiller & Pulcini, 2020).
 

In the future, I will also work on my leadership skills and team management skills. This will be beneficial as it will assist me in working with multidisciplinary teams and help me ensure holistic care outcomes for the patients. As a professional, I will engage in the practice of continuous development and skill enhancement and develop my knowledge by participating in different seminars and workshops and gaining theoretical knowledge by indulging in research and practice (Ossenberg et al., 2020). This will help me advance as a competent professional and enhance my practice.
 

References

 
Arnold, E. C., & Boggs, K. U. (2019). Interpersonal relationships e-book: professional communication skills for nurses. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=XC2GDwAAQBAJ&oi=fnd&pg=PP1&dq=Communication+in+nursing+book&ots=NqWn2_XMRX&sig=35RNSLGJjvKZPzaqm8C6xUYc0gU 
 
 
Brennan, E. J. (2018). Chronic heart failure nursing: integrated multidisciplinary care. British Journal of Nursing, 27(12), 681-688. https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2018.27.12.681 
 
 
Farrelly, M. (2021). Communication in mental health nursing: The power of the words we choose. In Improving Communication in Mental Health Settings (pp. 158-174). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9781003024330-10-12/communication-mental-health-nursing-mary-farrelly 
 
 
Hafsteinsdóttir, T. B., Jónsdóttir, H., Kirkevold, M., Leino-Kilpi, H., Lomborg, K., & Hallberg, I. R. (Eds.). (2019). Leadership in nursing: Experiences from the European Nordic countries. Switzerland: Springer International Publishing. https://link.springer.com/content/pdf/10.1007/978-3-030-10964-6.pdf 
 
 
Hassmiller, S., & Pulcini, J. (Eds.). (2020). Advanced practice nursing leadership: a global perspective. Cham: Springer. https://link.springer.com/content/pdf/10.1007/978-3-030-20550-8.pdf 
 
 
James, A. H., & Bennett, C. L. (2022). Effective nurse leadership in times of crisis. Nursing Management, 29(3). https://journals.rcni.com/nursing-management/cpd/effective-nurse-leadership-in-times-of-crisis-nm.2020.e1936/pdf 
 
 
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1-10. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-021-00684-2 
 
 
Nursing and Midwifery Board of Australia (2017). Professional standards. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx 
 
 
Ossenberg, C., Mitchell, M., & Henderson, A. (2020). Adoption of new practice standards in nursing: revalidation of a tool to measure performance using the Australian registered nurse standards for practice. Collegian, 27(4), 352-360. https://www.sciencedirect.com/science/article/pii/S1322769619303841 
 
 
Peterson, K., Anderson, J., Bourne, D., Charns, M. P., Gorin, S. S., Hynes, D. M., ... & Yano, E. M. (2019). Health care coordination theoretical frameworks: a systematic scoping review to increase their understanding and use in practice. Journal of General Internal Medicine, 34(1), 90-98. https://link.springer.com/article/10.1007/s11606-019-04966-z 
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