For the focus of this essay I will be discussing the concept of collaborative working within the professional area of adult nursing. Using appropriate literature this essay will examine the definition and rationale of collaborative working, a small introduction to nursing and how collaboration is applied in this area of care. This essay will conclude by looking at the influencing factors and outcomes of collaborative working in nursing practice.
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McCray, 2007 defined collaboration as a respect for other professionals and service users and their skills and from this starting point, an agreed sharing of authority, responsibility and resources for specific outcomes or actions gained through cooperation and consensus. (use ref)
Collaboration may be seen as a process by which members of different disciplines share their skills and expertise to provide a better quality service to patients/clients/service user. (Hughes, Hemingway & Smith, 2005).
Collaborative working involves interaction of various group or organisations to achieve a common goal, which normally in the health care setting is the patient. As a result of problem solving, open, flexible approach to the roles and tasks of individual team members provide a more patient focused healthcare.
The Department of Health (GB DOH 2001) published a strategic framework for lifelong learning for the NHS,’ Working together, Learning Together’ Learning and development are key to delivering the Government’s vision of patient centred care in the NHS. Lifelong learning is about growth and opportunity, about making sure that our staff, the teams and organisations they relate to, and work in, can acquire new knowledge and skills, both to
realise their potential and to help shape and change things for the better. Lifelong learning is inextricably linked with the wider agenda for building, rewarding and supporting the NHS workforce for the future.( www.dh.gov.uk) http://www.dh.gov.uk.assetRoot/04/05/88/96/04058896.pdf
Barr (2004) points out that interprofessional working enables professional benefits, with reference being given to the sharing of knowledge and the opportunities to experience areas of work outside one’s own remit. It is suggested that professionals may have levels of improved job satisfaction and increased levels of confidence in dealing with difficult situations. Barr (2004) also expresses a view that interprofessional education is collaborating learning in order to enable collaborative practice.
Collaborative working in health care is often referred to as interprofessional working (IPW). Rationales for collaborative work in is to cope with the problems that exceed the capacity of any one profession (Hughes, Hemingway & Smith, 2005)
In nursing it is important to remember that providing holistic care often involves the use of other professionals and this concept should be encourage in order to facilitate the provision of patient care.
Standards have been set by the Nursing and Midwifery Council (NMC) to safeguard the welfare of both the patient and the nurse. These standards identify that the nurse must work with others to protect and promote the health and wellbeing of those in your care, their families and careers, and the wider community.
It has been said that to fully explore the place of the nurse in the multi professional team you must first understand the role of the nurse. McCray (2009) as the health care system grows and changes rapidly, the role of the nurse also changes, but the well being of the patient is always the main focus. A good nurse will strive to develop good relationships with other professionals, when the care of a patient depends on collaboration of various health professionals. Collaborative effectively is often vital in the achieving a holistic healing process, which involves treating the patients biological psychological and social needs.
Patient centred care (PCC) is a widely used model in the modern health care system; it places the patient at the centre of all care. PCC improves continuity of care and integration of health care professionals collaborating on behalf of their patient. (Pence, 1997)
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To be able to give a patient the best possible care its imperative to work alongside other healthcare professionals to come to a joint care plan some times in the form of a package of care which can be mutually agreed to meet every care needs of the patient. Each professional has to show mutual respect to each other.
An example of effective collaborative working may be; Mr B is due for discharge after having suffered a severe stroke which has affected his right side, leaving him with severe expressive and perceptive dysphasia. As a Nurse in charge of the care of Mr B must collaborate with other health care professionals, such as doctors, occupational therapists, physiotherapists, speech therapists and of course Mrs B, in order to fully assess the level of care he may require on discharge, and provide a gradual return home. This would prove beneficial, since the patient has mobility and communication problems, so was going to need physiotherapy, speech therapy and adaptations to the family home. Maintaining good professional relationships is imperative amongst not only other health care professionals, but also the patient and family members. (Molyneux 2001)
In this example effective collaborating ultimately had a positive impact on the successful outcome. This in turn improved the service being offered to the patient.
Unfortunately collaboration does not always have positive effects and Interpersonal conflict can sometimes occur, a number of various reasons which could cause this, old, new team members, power issues, time management and funding
Conflict may occur for example in the case of lung cancer, doctors wish to treat a patient who has lung cancer when the chances of success are low and the treatment has side effect. Nurses on the other hand may feel the results of treatment are so bad it outweighs any benefit; this could be when things can become complicated.
The NMC states that; you must always work cooperatively within teams and respect the skills, expertise and contributes of your colleagues. (2008) in some case following this may prove extremely difficult.
Building a successful collaborative relationship requires good communications skills, which in turn allows the development of trust which will benefit the patient in the holistic care they will receive. I believe that any thing we can do to make a difference must be a good thing.
As Florence Nightingale once said, unless we are making progress in our nursing every year, every month, every week, take my word for it we are going back (Alexander, Fawcett & Runciman (2006)
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