Inter Professional Education Reflective Account Nursing Essay

Inter Professional Education Reflective Account Nursing Essay Throughout my time on the Year 1 Inter Professional Education (IPE) programme, I have compiled this portfolio consisting of a reflective account on my performance in throughout the programme. Included in this file are a number of secondary resources utilised in constructing the account as well as in aid of assembling the team presentation. My IPE group consisted of 4 medical, 2 pharmacy and 3 nursing students. As a multidisciplinary team, we collectively produced a presentation regarding clinical communication and ethical considerations in patient centred healthcare. Our theme was based around the growing issue of underage pregnancies throughout the capital. The wider issues of this topic ranging from the ethical, psychological, and moral implications as well as the great variety of healthcare professionals involved in managing such incidences. We chose this topic as it was something the whole group had differing views on and wanted to explore further. A copy of the article, Policy disaster as teen pregnancy rate rises to its highest in 10 years, is included for the benefit of the reader. This article from the Times Online was the key inspiration behind our choice of topic as it outlines the huge extent of the problems posed by teenage pregnancies. According to the article Britain has the highest incidence of teenage pregnancies in Western Europe. Despite the highly sensationalist tone and the incomprehensive survey of the contributing factors of teenage pregnancy, the article does offer a fascinating introspection into the ethical issues regarding pregnancy among girls below 16, the age of consent. The slideshow utilized during the team presentation, Yvonne at the clinic, is included for the benefit of the reader. As one can see it contains the key concepts the team touched upon during the presentation which was interspersed with a model role-play featuring a consultation at a sexual health clinic. Moreover, the script for the role-play has also been enclosed to help the reader appreciate the teams corroboration in conveying current issues integrated in a model scenario. Please find enclosed further evidence highlighting our effective teamwork comprising of emails, peer review forms and a diary of progress which had been logged between the IPE sessions. The essential features of a team and how it develops have been explained by Tuckmans summary of team development (1965). The model was used as a reference point for the groups progress, evaluate the teams development and to contemplate the next stage of action. The reflective account further vindicates how Tuckmans summary is clearly not exhaustive in describing the great spectrum of team behaviours. Instead, the IPE programme has enlightened the view that group dynamics are variable and so mechanical. Therefore the unpredictability arising amongst different teams, especially multi and possibly more vast amongst inter-disciplinary teams reinforces the belief that there are many contributors which affect group work. To conclude, I hope the reader finds the following account and secondary sources beneficial. In the time that has been allocated, I have tried my utmost to submit an honest account of my contribution to the IPE programme. Sincerely, Reflective Account In this reflective account, I will evaluate and analyse my performance as a team member throughout the IPE programme using the Kolb (1984) cycle1. David Kolb argues that experience is the source of learning and development. The cycle constitutes the following four stages; Concrete Experience, Reflective Observation, Abstract Conceptualisation and Active experimentation. Kolbs cycle suggests it is necessary to reflect on an experience, evaluate it and formulate concepts, which can then be applied to new situations such as working in a multidisciplinary team (MDT) 2. CAIPE uses the phrase interprofessional education (IPE) as a generic term which occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care CAIPE (2007)3. Our team consisted of nine people (four medical, three nursing and 2 pharmacy students). The application of an inquiry based learning (IBL) technique, would allow us to enhance our problem solving and communication skills. Over a period of five weeks, the team managed to present an ethical case study conveying the importance of communicative efficacy and ethical considerations within MDTs in providing patient centred care. In this paper I incorporate theoretical principles to the teams performance4-7 in a bid to divulge a deeper understanding of how and why I improve specific areas of my performance as a team member. Concrete Experience In the first IPE session, our objective was to decide the focus of our inquiry. Right from the onset, to my disbelief, the group was extremely focused and driven to the task at hand. Initially I was hesitant mainly due to the exposure of so many strangers with varying personalities but equally eager to think aloud4. This threatening situation meant that any early communication was difficult and for a considerable amount of time I found myself very quiet8. The reason for this was that my views towards this task were initially sceptical because of previous prejudices held against other disciplines. However, as the meeting progressed, I learnt that such presumptions had no basis and had arisen due to a lack of contact between the disciplines. A consensus was reached within the group to carry out our task along the lines of teenage pregnancy among girls below 16 and the wider implications it acquires. The session also included a simulated patient interview, which proved very informative and clearly highlighted the fundamental concepts of a consultation; rapport, empathy, body language, active listening and question styles. By the second session the group had conducted some research on loosely related material regarding the growing problem of teen pregnancies in the UK. In this student led session, we made a decision to commence the planning of the actual task. This was a very time consuming step to achieve as fellow members failed to comprehend the purpose of the goals we had set, since our task had a large scope and appeared vague. I felt it was my duty to urge the group to clear any misconceptions at this early stage and to channel our broad research into three specific concepts which are imperative to portray to our aud ience. I put particular emphasis on the current NHS guidelines, ethical issues and relevant multidisciplinary team approaches concerning the scenario5. Our concrete material which would provide the foundational premise for the duration of the course was provided by an article claiming Policy disaster as teen pregnancy rate rises to its highest in 10 years9. This article presents great scope for discussion including the ethical issues and the role of MDTs in managing such a growing problem. According to Bruce Tuckman (1965) there are a number of key issues relating to effective team discussion and behaviour10. Stage 1 is the forming phase and it depicts a teams natural instinct for guidance. Therefore, the premise for advancement for a particular group resides in the election of a leader. When discussing and deciding the topic for our presentation it became clear that certain individuals were more confident than others and my substantial contributions during the second session5, led me to assume leadership. Although my position involved delegating specific tasks to individuals, the group as a whole was very diplomatic and hence there was no need for an autocratic leader. As a result of this, the storming phase, which Tuckman described as the episode where decisions are most challenging, was a much rapid and unproblematic phase. This was because we all had a genuine interest in the topic and felt we each could contribute to the issue. The allocation of roles was carried out based on prior research. For instance, the individual whom had researched the healthcare team had the task of producing their own slide for the PowerPoint presentation. In addition the norming process of Tuckmans model was also coming into the fore as our keen actors6 were making great progress in their role-play of a consultation at a sexual health clinic. My contribution to the presentation consisted of a brief explanation of the importance of consent and whether a minor can consent to their own treatment (i.e. Gillick case, Fraser guidelines) 11, 12. Overall, continual discussion and communication between members mainly via emails enabled the presentation to evolve into the polished product which portrayed the efficient performing (final) phase of Tuckmans model. The team worked in an efficient manner after a sluggish start. The initial reservations were quickly diminished which helped us to progress towards our goals. During the days leading to the final presentation, I and a colleague realised some discrepancies in the script and the issue of a dress code for the team presentation was brought up6. Such concerns were clarified by email communication13, but unfortunately such enthusiasm was only shared amongst a few peers. Nevertheless, it was very satisfying to see that everyone had contributed something to the final presentation which was a sentiment to my effective delegation of roles14. I felt that a certain member had not contributed much throughout the course and was continually seeking a minimalist approach which could have been detrimental to the teams performance. I voiced my opinions in her peer review form so she could improve in the future as the potential adverse consequences of a breakdown of communication within the MDT can be damaging to the patients care. The roles conducted by the team members varied from communication, ethical issues and the role-play. Margerison and McCann (1995)15 constructed a teamwork model stating a successful team encompasses individuals with a variety of skills, hence fulfilling diverse roles. All the team members were, to differing extents, creators innovators as we each contributed something constructive. I believe certain members whom had thought of the idea of a role-play were more creative and others whom had continually produced their contributions on time were deemed concluders. Another individual whom had taken the responsibility of merging the slideshow together expressed her practical skills as an assessor, whilst another member helped to support me in my leadership role. Her efforts were invaluable in making by duties more proficient and constantly reminding me to book the library rooms for scheduled meetings. She was classified, according to the teamwork model, as an upholder. Finally, the indiv iduals involved in the role-play were concluders due to their quality standards and reporters because they were capable of incorporating prior knowledge to help answer questions following the presentation. I feel that I was a thruster because as a democratic leader it was my duty to organise and motivate other members, whilst continually involving them in the decision making process. Reflective Observation After the presentations, we took part in a peer review exercise, where our observations of each others performance throughout the course had to be reflected. The irony of teamwork is that a team is made up of individuals. These individuals will have different experiences, knowledge, expectations and priorities. Thus it is important that our team developed a keen interest in the performance as a whole, as this will influence individual contributions. Amongst the majority of peer review forms, I noticed many positive comments ranging from being knowledgeable on the subject of consent8, good at arranging ideas and has good delegation skills ensures everybody has an equal role to play14. This was extremely pleasing to learn because it illustrates that my fellow team members fully appreciated the effort that I put into the project. Also, my contribution to the presentation as a team player was also acknowledged stating I had contributed the knowledge and understanding of capacity and cons ent which helped to explain the patients rights in our role-play helped the nurses learn about the Gillick test, which until then we had no understanding of16. I believe this statement portrays my effective communication amongst the team throughout the programme enabling the group to maximise our potential to work in an MDT approach. Amongst the very few negative comments, a team member justifiably observed that I was a bit quiet at the start of the IPE session8. In retrospect, I believe I should have been more expressive and honest with my group and have confidence in making alternative suggestions ultimately benefiting the group. Furthermore, another team member felt I could have taken more control/been more decisive so that people were clear of what to do17. It was interesting to note that he/she had also written that I was good at sorting out the details i.e. what exactly each person was going to go away and research17. Nonetheless, I felt that I delegated the tasks suitably because I had ensured that each member understood and had ownership of their tasks for the next session. Although the issue had never been brought up nor had I been emailed of any confusion in the allocation of roles, I believe that I should have utilized the luxury of emailing each member clearly what they had to do. Abstract conceptualisation From this experience, I have gained a lot of knowledge both on the issues regarding underage pregnancies as well as the skills required to work effectively in a team. My fellow members had enlightened me of the growing problem of teen pregnancies in certain boroughs around the capital and we all felt the government was failing this young generation. According to the article mentioned earlier, The expansion of confidential contraceptive services for young people under 169 was the main causal factor. I learnt through an inquiry based learning approach the importance of effective clinical communication and ethical considerations in managing the issue. Furthermore, a fellow member also enlightened the group on the vital role of the sexual health centres in providing education and advice for the younger generation. I have also discovered the challenges associated with controlling large teams of varying disciplines. Apart from the logistical constraints, each member of the team had their own schedule and hence the proposition of extra sessions was difficult to attain. However, many challenges and complications were dealt with very effectively via email13, thus eliminating the scheduling and logistical constraints in place. Coordinating nine members of a team demanded good organisational and most importantly time management skills. This is enormously beneficial for me because as I progress through my medical career, there is an increasing demand for efficient teamwork. Active experimentation On reflection it is clear that our team worked very well together and expressed ourselves to construct an effective presentation of the chosen scenario. The Egalitarian atmosphere during the meetings was admirable, where every decision involved a vote of confidence. Nevertheless I feel as group leader I should have struck a balance between collective decision making and being more abrupt, as well as ensuring that all the tasks are being conducted well. Also in the future, fewer people could have presented the final task. A solution could have been to make a video for the role play, thereby freeing up more space for other members of the team on the stage. Overall, the IPE programme has been an incredible learning curve which has provided an insightful experience as well as an understanding of the significance of effective communication between professionals. Lastly, this experience has emphasized my weaknesses, but I have appreciated that others may have different ways of working; different skills and knowledge, which in practice contribute to the patients healthcare.

Bringing hydrocephalus

The history of hydrocephalus dates back to the time of Hippocrates (he died c. 375) and even further to medieval times when physicians believed that it was caused by an extractable (sic) accumulation of water. Surgical evacuation of superficial fluid in hydrocephalus children was first described in detail by Balalaikas AY Zachary in 1744 (Scoff, Kramer, Hashish & Sunken, 1999).While there have been many great strides, both in research and treatment, it seems the great pool of knowledge resides not thin the medical community, but in the adult survivors of the condition. One can only wonder if this is due, at least in part, to a perception by the medical community that it is not a survivable condition. Actually the exact opposite is now true. With proper medical treatment (done in a timely manner) and LOTS of love and support from the patient's family, many hydrocephalus children can go on to live near normal lives.Introduction The modern era of hydrocephalus research began with the st udies of Dandy and Blackman in 1914 (Grittier, 2007). To this day their work is considered an unsurpassed nutrition toward the understanding of hydrocephalus. While I applaud their work, it has been ninety-nine (99) years since any work of a similar scope or caliber has been undertaken and it is beginning to show. As an example, when I was born in 1963, I showed the early stages of congenital hydrocephalus and my family was basically told â€Å"take him home to die†.Needless to say, I didn't die and have become – even according to the local medical community – one of the best sources of information in our area when it comes to hydrocephalus. Although I feel honored to eave such distinction, it's not enough – the medical community – especially pediatricians – need to possess that same knowledge and that is my purpose in writing this paper. L. 20-Year decline in the mortality rate for hydrocephalus Before getting too involved in why hydrocepha lus research needs to be brought into the 21st century, an explanation of the condition is needed.Hydrocephalus is defined as â€Å"A condition marked by an excessive accumulation of cerebration's fluid (SF) resulting in dilation of the cerebral ventricles and elevated interracial pressure; (it) ay also result in enlargement of the cranium and atrophy of the brain† (Williams, 2006). It can take one of two forms. It can be either communicating (meaning there is not visible cause for the blockage of SF) or non-communicating (meaning it results from an abnormal flow of SF in and around the brain. It is also known as pediatric hydrocephalus since it is normally present from birth. (â€Å"Nervous system diseases,† 2008). When I was born in 1963, the life expectancy for a child with this condition was approximately two (2) years and the only known treatment, placement of a shunt, was still in its infancy. Since that time, shunt surgery has been refined and could almost †“ depending on the individual patient – be considered an almost routine procedure. In an article published in the August 2005 issue of the Journal of Neurosurgery, Dry. J. H. Chi, ET. AY. Stated â€Å"Congenital hydrocephalus has an estimated population incidence of 0. To 0. 8/1,000 live births† (Chi, Fullerton & Guppy, 2005). They credit this to improvements in techniques for SF shunting; however, they state that data describing mortality from congenital hydrocephalus – or that demonstrate improvements in the mortality rate are scarce. For those not familiar with shunt implantation surgery, it involves making a small incision in both the top of the head and the abdomen (in the case of a ventricular-peritoneal (UP) shunt) to insert the shunt which drains excess fluid from the brain (Goodman, 2013).To validate their hypothesis, the doctors performed an electronic search of the National Center for Health Statistics death certificate database to identify deaths f rom 1979 to 1988 directly attributable to congenital hydrocephalus, spins biffed with hydrocephalus, and acquired hydrocephalus in all children in the United States aged one (1) day to 0 years. There were 10,406 deaths attributed to childhood hydrocephalus during the 20-year period reviewed. This translates to an overall mortality rate of 0. 71 per 100. 000 person-years.Additionally, their research showed infants had the highest mortality rate with 3,979 deaths. Overall during the period deaths from acquired hydrocephalus – meaning that it occurs after birth and is the result of a tumor, injury, or disease that blocks the uptake of SF – decreased 67. 5%, deaths from congenital hydrocephalus declined 66. 3 %, and deaths from spins biffed with hydrocephalus declined 30. 4%. What does it all mean? It means that the medical community needs to re-think their position on hydrocephalus as well as what they tell patients and their families.It means saying â€Å"Take him/her h ome to die,† is no longer an option. Does it mean re-inventing the wheel? For an older doctor it could very well mean that although, in most cases, it will not be quite so drastic. The Hydrocephalus Clinical Research Network (HCI) makes the following recommendations to its members: Reduce risk of infection associated with shunt surgery Approximately 8% – 10% of shunt operations result in an infection. A study is currently underway for a quality improvement technique that will reduce surgery- related shunt infection(s). (Woolens, 2013).The result will be a reduction in the infection rate thereby reducing the length of hospitalizing as well as patient morbidity. Management of hydrocephalus in premature children The HCI is investigating two (2) surgical procedures that are commonly used to manage IV-induced hydrocephalus in premature children. A sublease reservoir is an implant consisting of a tube which goes into the ventricle attached to a silicone bubble that sits under the skin. As fluid accumulates in the ventricle, it can be removed by a needle puncture through the skin and into the silicone bubble.The second procedure is an s sublease shunt, which is similar to the reservoir except that the silicone bubble under the skin has a reservoir has an opening in the side that allows fluid to flow out under the skin. The fluid is then absorbed into the tissues. Understanding the epidemiology and outcomes of Endoscopies Third Ventriloquist's or TV Endoscopies Third Ventriloquist's (TV) is a surgical procedure where a small perforation is made is made in the thinned floor of the third entrance allowing movement of SF out of the blocked ventricular system and into the intracellular cistern which is a normal SF space.The objective of this procedure, known as a interracial SF diversion, is to normalize pressure on the brain without using a shunt. Although TV is widely used in Europe to treat hydrocephalus, its use in North America is much less common. The H CI is working to understand when the procedure is indicated as well as its associated outcomes and possible complications. The use of TV is attractive due to the fact that infection s very rare as are other complications such as slit ventricles.Conclusion Our knowledge of hydrocephalus has come a long way since medieval times when it was believed that hydrocephalus was the result of extractable (sic) accumulation of water. It has even made significant strides since the groundbreaking work of Dandy and Blackman in 1914, but the medical community must not rest on its laurels. In order to fully bring the treatment of hydrocephalus into the 21st century, they must embrace research being done by organizations like the Hydrocephalus Clinical Research Network.I feel this increased awareness is long past due because, even though it has been almost [emphasis added] a half-century since I was born with the condition, the amount of information available to the medical community remain largely unchanged. I think that is due – at least in part – to the misconception that there is not a high survival rate, therefore, why waste the money? My research has shown that over the past twenty (20) years, the mortality rate for hydrocephalus has actually declined with 0. 71 per 100,000 errors/year (Chi, 2005).The vast majority of the deaths were the result of congenital hydrocephalus – meaning that it is present to some degree when the baby is born. Here is how the AC can help to make my â€Å"big idea† (the name given by our instructor to our project) a reality. Publish more articles about the condition, research into it, and current treatment such as shunting and Endoscopies Third Ventriloquist's. Do feature stories about both child and adult survivors because we have a story we would like the world to know about!

Poverty Case Essay

Question: Choose an issue of importance to you—the issue could be personal, school related, local, political, or international in scope—and write an essay in which you explain the significance of that issue to yourself, your family, your community, or your generation. My parents had a life where there were no three meals a day, no electricity and so many other things. They used to tell â€Å"you never know how bad poverty is until you experience it†. Poverty is the leading cause of death in every developing county. We all know about poverty but we do nothing to stop it. According to UNICF more than 22000 kids die every day because of poverty. The food that we waste everyday will be enough to remove world poverty. My parents and grandparents came from world of utter poverty. When I talk about poverty I know how bad it is and I want the new generation to everything they can to remove poverty. Have anyone gone hungry for a day or two? We all eat at least three meals a day but there are people in the world who don’t even have a single piece of bread to eat. Mahatma Gandhi once said â€Å"there are people in the world, so hungry that god cannot appear to them except in the form of bread.† We all are living in a country where we have everything but there are people in the world who have to drink dirty water to slake their thirst. In Africa more than 5000 kids die each day because of drinking dirty water. We all know about this but we do nothing to stop world poverty. Remember that today’s kids are tomorrow’s future. If we put the all the billionaires in the world together they may be able to remove world poverty from this world. According to human nature if we want to do something we have the ability to do it but no one is there to take the lead. As a 17 year old teenager I care about my fellow citizens and the coming generation. I don’t want them to see a world of poverty and death. I want them to see a world of evergreen sunshine. Poverty is not something that we can remove in two or three days. It takes time to remove world poverty. As a member of the new generation let’s all make sure that we show our kids that we are living in a country with no poverty.

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