Sunday, May 19, 2019
Collaborative Practice in Health Care Essay
Collaborative employ in health c be occurs when a particle of the health care team consults with another member to take into account uncomplaining care. Collaboration most often occurs between doctors and checks. Collaboration is defined as a relationship of interdependence the ability to work together involves trust and respect not only of distributively other but of the work and perspectives all(prenominal) contributes to the care of the patient of (Phipps and Schaag, 1995, p. 19). Effective collaborative practice amongst on the whole health care team members leads to continuity of care, professional interdependence, quality care and patient satisfaction and lessen costs. Ongoing collaboration between health care members results in mutual respect, trust and an appreciation of what each individual brings to the overall goal in rendering care to the client. The following vignette will leave behind the foundation for the discussion of collaborative care, differentiating bet ween moderate diagnosis and collaborative problems, and potential barriers to successful collaboration.JG is a 74 year old married Hispanic male diagnosed with colon cancer. He had a memorial of prosthesis placement of his left lower leg he is ambulatory. He is a diabetic on oral medications. He worked as a farm laborer. He lives with his wife she does not speak incline she is a homemaker. He has a son who lives nearby and a nephew who periodically visits him. JG can understand round English. He does hasten some difficulty expressing his health concerns to the staff because of his limited vocabulary. His son or nephew brings JG to his clinic appointments. He receives weekly chemotherapy at the egresspatient oncology clinic. The daylight I cared for JG he arrived at the clinic accompanied by his nephew. This was week seven of his treatment. His clothing was dirty, he smelled of stool, his fingernails were dirty, hair uncombed, he appeared to be dehydrated. He reported catgut movements of eight stools per day with complaints of occasional type AB cramping. He denied nausea or loss of appetite. He stated that he was actually tired and was not able to do much at home.His main concern was the frequency of his intestine movements. He reports having to go to the bathroom two to three times during the night and has episodes of soiling the bed. He reports that sometimes he does not feel theurge to go. JG was wearing adult diapers. He expressed concern that it was acquire expensive for him to purchase. The nephew confirmed that JG toileting has created a problem in the home. His nephew verbalized that JG had medication for diarrhea but ran out of it and he did not have the money to purchase the medication. When questioned why he was using a wheelchair he stated that his foot hurt to walk the distance from the lobby to the treatment room. He mentioned that it was probably callable to an ingrown toe nail. He also asked how he could obtain a wheel chair for hi s private use at home. Physical assessment revealed that he had a necrotic area on the formal of his left foot with surrounding redness, lost 12 pounds in six weeks, poor skin turgor, active bowel sounds, and his blood pressure was slightly lower than baseline.In the ambulatory chemotherapy setting, the clients do not ever see their doctor every time they receive treatment. The take in must ascertain when to cooperate with the physician on issues regarding the patients status, response to treatment, or toxicities that may be life threatening. It is prerequisite that the deem is capable to publish in effect her-(Be careful with gender bias, nurses come in both genders.) observations to the physician.Collaborative problems are detected from the nurses assessment of the patient. The nurses monitoring of the patient status is to evaluate physiological forks that may threaten the patients integrity. Management of collaborative problems will include implementing physician pres cribed and nurse prescribed actions to curtail escalation of the problem and preventing patient harm. From the nurses assessment, she also formulates a nursing diagnosis. The nursing diagnoses are stated in the form of the problem, the etiology and the symptoms that the nurse observes. nurse diagnosis can include a current or potential problem, an at risk problem, or a wellness diagnosis. Nursing diagnosis provides the framework from which the nurse begins to devise a plan of care and nursing interventions.In the teddy of JG, there were two collaborative problems identified. Twoproblems I collaborated with physician, these were1. JG is experiencing toxicity from the chemotherapy. There is potential for electrolyte imbalance, circulatory collapse.2. The necrotic area on his foot was a new development in his condition. There is potential complication for infectionThe collaborative problems discussed with JG physician and nurse quickly resolved. JG did not receive his chemotherapy. H e was given an guessing of sandostatin LR to help minimize his diarrhea a stat basic metabolic panel was obtained and he was given intravenous hydration with potassium. The doctor made a referral to JG podiatrist for the next day to assess the integrity of his left foot.Listed are four, but not all, possible nursing diagnosis obtained from my assessment.1. Diarrhea related to chemotherapy manifested by hyperactive bowel sounds and eight loose stools.2. Bowel incontinence related to loss of rectal sphincter control and chemotherapy manifested by fecal odor, fecal staining of clothing, urgency.3. Altered Nutrition related to colon cancer manifested by diarrhea, abdominal cramping.4.Ineffective management of therapeutic regimen related to JG lack of knowledge of his disease manifested by his inability and unwillingness to manage his symptoms.Considering JG comments regarding his finances, his overall physical appearance and the comments from his nephew, I decided to consult with the sociable worker. I tangle that a home visit or a thorough investigation of JG home situation was warranted.The social worker was able to arrange for in home support, and helping the patient with insurance issues so he could obtain the needed supplies. I did not think to enlist the participation of the dietician. In retrospect, the dietician would have been a valuable resource to assess JG caloric intake and recommendations for optimal nutrition.I felt that the preceding(prenominal) calamity demonstrated collaboration amongst health care providers. The physician in this case was receptive to the nurses observations with respect to her capabilities of accurate assessment of the patients condition and potential complications. This is not continuously the case, barriers to collaboration are also inherent in the health care industry. Barriers occur in patient situations where the physician is not sympathetic or does not trust the nurses evaluation of patient condition. The nurse may have feelings of inferiority, lack of confidence and does not appropriately collaborate with the physician make information.Conflicts in the goals desired for the patient is often cited as a barrier to collaboration. I recall an incident of a male patient diagnosed with metastatic breast cancer. His appearance was that of an individual who had been in a national socialist concentration camp. The nurse wondered why the physician was treating this man aggressively. In her mind, this patient was not an appropriate scene to receive the particular treatment that was ordered. She feared the patient would not tolerate such an aggressive schedule and that it was blunt to put this poor man through treatment. The patient was diagnosed two years ago. He is still receiving treatments, he has gained weight and in October of last year he hiked to the summit of Mt. Whitney.Role passage of arms is another major(ip) barrier to collaboration. To deliver cost effective care, many institutions uti lize nurse practitioners and physician assistants. Role conflict arises when practitioners have opposing views or expectations (Blais, Hayes, Kozier, & Erb, 2002). Role conflict and can lead to litigation. According to Resnick, physicians hesitate to collaborate informally with Nurse Practitioners for fear of being held liable for the actions of the Nurse Practitioner (Resnick, 2004). Clear definition of rolesfor practitioners is essential to prevent misunderstanding.In conclusion, collaborative practice is the gold standard that health care practioners should strive towards. The nurse is central in determining the patient issues that warrant collaboration and she must be able to effectively communicate her observations. Collaborative practice minimizes complications that could lead to tragic outcomes. The ultimate goal of collaborative practice is to provide the quality service that each patient under our care deserves.ReferencesBlais, K.K., Hayes, J. S., Kozier, B. & Erb, G. (2002 ). Professional nursing practiceConcepts and perspectives (4th ed.). impudently Jersey Prentice Hall.Phillps, W.J., & Schaag, H.A. (1995). Persepctives for health and illness. In Phipps, W.J, Cassmeyer, V.L., Sands, J. E., Lehman, M.K(Eds.), Medical surgical nursing concepts and clinical practice, p. 19. St. Luis, MO Mosby.Resnick, B. (2004). restrict litigation risk through collaborative practice. Geriatric Times,5(4), 33. Retrieved March 21, 2004 from EBSCOhost database.