Multi Disciplinary Team

Multi Disciplinary Team Introduction This discussion opens with a definition of a therapeutic relationship and the key elements that impact on this. The discussion will focus on the different types of communication and explain the importance. I will also refer to the Multi Disciplinary Team (MDT) in a patients care and how this can strengthen the relationship. The discussion will end with reference to the Nursing and Midwifery Council (NMC) guidelines and the impact on the relationship. Self awareness will also be discussed. A therapeutic relationship is defined as A partnership between clients and nurses, both working together to improve the clients health status (Balzer Riley, 1986). This relationship allows both the nurse and the patient to gain satisfaction, the patient feels supported and listened to and the nurse feels valued in his/her role. One of the significant points in the relationship is that if the patient feels they are being listened to by the healthcare provider they will recover at a much faster rate. The key elements are, attending, hearing, understanding and remembering. Attending is the physical part with both the nurse and the patient being present and keeping up to date with what is being said. Hearing is the part that pays the attention to the patient. Understanding, this is reassuring the patient that what they have said has been understood. This can be done by paraphrasing. Remembering can be very difficult, if the nurse has understood what the patient has said this does become easier. In order to do this the nurse needs to fully attend to the patient, listen to them and then respond to them. According to Barker (1971), the listening process consists of four different elements listed above. By actioning the concepts the nurse can start to empathise with the patient. Empathy is an important aspect of this relationship, Empathy is the act of communicating to our fellow human beings that we understand how they are feeling and what makes them feel that way (Hogan, 1969) Empathy can be shown both verbally and non verbally, the verbal part is to reflect on how the patient is feeling and the reasons why and the goal should be to meet an accurate verbal reflection. The non verbal features of empathy are as much important as the verbal part; the non verbal part should show features of warmth and genuineness does the true caring for your patient come across. To do this verbal and non verbal communication must be used. Summary Questioning is a way of verbal communication between the nurse and the patient, some would say that questioning is a way of helping others to think about their problems (Alder and Rodman, 1982). There are two types of questions that may be asked to patients, open questions and closed questions, Open questions are asking for a more verbal response from the patient whereas closed questions is only encouraging the patient to give a short simple response. Along with questioning there are many other ways of verbal communication, establishing guidelines, acknowledgement, reflecting, paraphrasing, seeking clarification, summarising and planning .Clearly verbal communication is very important as are non verbal skills. Non verbal communication has various components; some of these include Posture, gesture, eye contact, touch, facial expression, appearance, head nods, silence, proxemics and other body language. Egan ( 1977) S.O.L.E.R framework has an important part to play in a therapeutic relationship, all of the points should make both the nurse and the patient is comfortable and in control of the situation, here is a bit of information to elaborate on the soler framework- S Sit squarely this means sit face to face with the patient this does not mean the nurse has to sit directly opposite the patient, the nurse should sit upright not slouching, this will show the patient the nurse has a caring posture. O Open posture this means sit with both arms and legs uncrossed, if both arms and legs are crossed it is said to show an element of defence from the nurse. L Lean slightly forward although this does depend on the conversation, leaning forward without leaning away will lead the nurse into the intimate zone of the patient. E Eye contact is recommended to be constant although this shouldnt be a constant stare as this can be very uncomfortable for the patient. R Relax -the nurse must be relaxed in order to gain the confidence in the patient. This framework can also be used by other healthcare professionals. Professionals other than nurses can strengthen the relationship; this can be another member of the health care team that needs to take part in the patients care. The professionals could include physicians, pharmacists, dieticians, occupational therapists these professionals are known as the MDT. A member of the MDT might need to be involved in the patients care, For example if the patient had concerns about their diet you could introduce the dietician to help. By introducing a member of the MDT it will strengthen the relationship with the patient. The patient however must consent to the involvement of other disciplines. Consent within a therapeutic relationship is very important, obtaining consent is a process and not a one off event. The patient must be told in a sensitive manner and the patient must then make the decision on whether to accept or decline the proposal being offered. The NMC (2008) states that you must respect and support peoples rights to accept or decline treatment and care (NMC code May 2008). Usually the professional who is going to perform the procedure will gain the consent although it is possible this task could be delegated to another professional who has the capability of meeting the required standards, Consent maybe obtained in a number of different ways, Verbal consent this is explaining everything verbally to the patient and the patient replying with a verbal answer, written consent this is normally obtained if the procedure has any risk or is lengthy and complex, the written consent is a record of what has taken place or could be of what has been offered and not taken p lace as the patient decline the opportunity. The NMC is the code that should be adhered to all times, some of the guidelines under the code includes Privacy, dignity and confidentiality, as part of the NMC code of conduct nurses are to work within their limitations. This is about the nurse being self aware. Self awareness is about recognising, accepting, challenging who we are, what we feel, and what we can and can not do (Rungapadiachy, 1998). In a therapeutic relationship it is also important to be in control of your own self awareness, be aware of your own values and beliefs. According to Rokeach (1968),a value is an important life goal or societal condition which is despired by a person. Beliefs are subjective statements used by individuals to describe something they believe as being true. Values are seen as the central core that reflects on ones attitude this is also know to affect ones attitude. Fishben and Ajzen (1975) define beliefs as statements which indicate a persons subjective probability that an object has a particular characteristic. Conclusion The Johari window is a model that is used to explore and develop self awareness; this model concentrates on interpersonal skills that are applied to interaction, it deals with awareness in the human behaviour (Luft 1969). There are four aspects to the Johari window, open, blind, hidden and unknown. The open part is the part that is known to self and others, the blind is the area that is unknown to self but know to others, the hidden part is the area that is known to self but unknown to others and the unknown is the area that is unknown to self and unknown to others. Through communication the open self is made more accessible. This strengthens the therapeutic relationship. This Essay has defined what a therapeutic relationship is and the key elements that impact on this. Different types of communication have been discussed and explanation given to show their importance. The role of the MDT in a patients care and how this can strengthen the relationship has also been discussed. NMC guidelines have an impact on the relationship and discussed a key issue from the guidelines, with special reference to consent. This essay has also explained why self awareness is important within a therapeutic relationship

Human Suffering: Preventing Humans From Achieving True Happiness Essay

There is a very commonly held belief that life is difficult. More to the point, life consists of a lot of suffering. It is common to hear comments such as, life is a constant struggle, life is an uphill battle, a never-ending fight. These comments raise many questions about the nature, or even the very existence of absolute happiness. Is it possible for a human being to ever achieve complete happiness? Answering this question completely is impossible because humans are very complex and each one of us has a different definition of happiness. Sigmund Freud took a different approach to the question of human happiness. In an excerpt from his book, which is titled Civilization and Its Discontents, Freud identified what he felt were the three main sources of human suffering. He says â€Å"...the three sources from which our suffering comes: the superior power of nature, the feebleness of our bodies and the inadequacies of the regulations which adjust the mutual relationships of human being in the family, the state and society† (Zwann, Junyk, & Zielinski, 2010). That is to say that Freud identified the origins of human suffering in rejecting and controlling our natural human instincts, the limitations of our human bodies, and the conflict between being true to ourselves and being a civilized individual. Furthermore, Freud was of the opinion that though we eventually accept, though are dissatisfied with the first two components of struggling, we are constantly at war with ourselves due to the last attribute. I find that I can agree with Freud on quite a few topics in his discussion, but that a lot of questions are ultimately raised from his thoughts. I plan on discussing and addressing all of these issues in this paper. Let us take a loo... ...ence with hardly a moment's notice. Suffering also arises in the knowledge of our own mortality and our physical limitations. The human being is well aware that the body will one day fail in one way or another. Finally, there is the suffering that comes from the struggle between the individual existence trying to fit with the existence of civilization. Due to the fact that human beings require social connections for both protection and emotional support, the formation of societies and civilizations is inevitable. Human suffering is ultimately an unavoidable aspect of life. Works Cited taboo. (n.d.). Dictionary.com Unabridged. Web. 23 November 23, 2014. http://dictionary.reference.com/browse/taboo Zwann, V., Junyk, I., & Zielinski, G. (Ed.). (2010). Cust 1000Y Introduction to the study of modern culture. Toronto, Ontario: Canadian Scholars' Press Inc Human Suffering: Preventing Humans From Achieving True Happiness Essay There is a very commonly held belief that life is difficult. More to the point, life consists of a lot of suffering. It is common to hear comments such as, life is a constant struggle, life is an uphill battle, a never-ending fight. These comments raise many questions about the nature, or even the very existence of absolute happiness. Is it possible for a human being to ever achieve complete happiness? Answering this question completely is impossible because humans are very complex and each one of us has a different definition of happiness. Sigmund Freud took a different approach to the question of human happiness. In an excerpt from his book, which is titled Civilization and Its Discontents, Freud identified what he felt were the three main sources of human suffering. He says â€Å"...the three sources from which our suffering comes: the superior power of nature, the feebleness of our bodies and the inadequacies of the regulations which adjust the mutual relationships of human being in the family, the state and society† (Zwann, Junyk, & Zielinski, 2010). That is to say that Freud identified the origins of human suffering in rejecting and controlling our natural human instincts, the limitations of our human bodies, and the conflict between being true to ourselves and being a civilized individual. Furthermore, Freud was of the opinion that though we eventually accept, though are dissatisfied with the first two components of struggling, we are constantly at war with ourselves due to the last attribute. I find that I can agree with Freud on quite a few topics in his discussion, but that a lot of questions are ultimately raised from his thoughts. I plan on discussing and addressing all of these issues in this paper. Let us take a loo... ...ence with hardly a moment's notice. Suffering also arises in the knowledge of our own mortality and our physical limitations. The human being is well aware that the body will one day fail in one way or another. Finally, there is the suffering that comes from the struggle between the individual existence trying to fit with the existence of civilization. Due to the fact that human beings require social connections for both protection and emotional support, the formation of societies and civilizations is inevitable. Human suffering is ultimately an unavoidable aspect of life. Works Cited taboo. (n.d.). Dictionary.com Unabridged. Web. 23 November 23, 2014. http://dictionary.reference.com/browse/taboo Zwann, V., Junyk, I., & Zielinski, G. (Ed.). (2010). Cust 1000Y Introduction to the study of modern culture. Toronto, Ontario: Canadian Scholars' Press Inc

Customer Service Plan Essay

The National Institutes of Health (NIH), founded in 1887, is one of the world’s foremost medical research centers, and the Federal focal point for medical research in the United States. 26 Institutes and Centers comprise the NIH, which has the primary research goal of acquiring new knowledge to help prevent, detect, diagnose, and treat disease and disability from the rarest genetic disorder to the common cold. The NIH mission is to uncover new knowledge that will lead to better health for everyone. In 1993, President William J. Clinton issued Executive Order 12862 challenging Federal agencies to improve customer service. Further, Executive Order 12862 tasked agencies to survey their customers to identify what kinds of services they really want and to gather ideas from front-line employees on how to better deliver those services. The goal of this Customer Service Plan is to convey to you, the customer, a realistic, achievable approach for improving customer service at the National Institutes of Health. NIH is committed to improving the way it offers high quality services that are easily accessible to every American citizen. With this in mind, this Customer Service Plan is organized for your convenience. Customers may look at Attachment 1 to find some examples of activities going on at NIH that are organized by customer groups, consumers, health professionals, other governmental agencies, and grantee organizations. We want the plan to be as user-friendly as possible, and we welcome your comments and suggestions. Read more: Essay on  Present Proposals for Improvements to Customer Service ________________________________________ EXECUTIVE ORDER Executive Order 12862, â€Å"Setting Customer Service Standards† requires Federal agencies to: †¢Identify customers who are, or should be, served by the agency; †¢Survey customers to determine the kind and quality of services they want and their level of satisfaction with existing services; †¢Post service standards and measure results against them; †¢Benchmark customer service performance against the best in business; †¢Survey front-line employees on barriers to, and ideas for, matching the best in business; †¢Provide customers with choices in both the sources of service and the means of delivery; †¢Make information, services, and feedback systems  easily accessible; †¢Provide means to address customer feedback; and, †¢Provide feedback to our customers on what improvements we have made. [ Return to Menu ] ________________________________________ PRINCIPLES This Customer Service Plan is based on ideas, suggestions, and feedback received from our customers as well as an extensive best practices search. It defines our customer service standards and processes for building and maintaining high quality services to meet those standards throughout the country. The following principles drove the process for developing the plan: Customers Know What They Want – Rather than sitting back and assuming that we know what customers wanted and needed, our agency is going out and asking. Through formal surveys, focus groups, and conversations, we are listening to what our customers think about the types and quality of services and products we offer. What we learn is helping to shape the ways in which we strive to redirect our services to ensure that we continuously improve our ability to meet your needs. Customer’s Needs Are Paramount – Based on feedback from our customers, NIH must respond to comments and suggestions about improving the way we deliver products and services. Communication Is Key to Our Success – Developing effective tools to maintain lines of communication with our customers will help us do our jobs better. By developing more effective ways to direct information to our customers and by providing clearer paths to receive feedback, our agency will better address customer needs and concerns. [ Return to Menu ] ________________________________________ APPROACH/SCOPE NIH is diligently working to address the spirit of Executive Order 12862. A dedicated group of representatives from across the agency is convening to form an on-going Customer Service Management group to implement the customer service program and to ensure that the agency enhances its customer focus as it improves current services and develops new initiatives. The agency has gathered information from customer service surveys, focus groups with  front-line staff, and conversations with key external partners, to ensure that initiatives address issues important to our customers. This plan presents an opportunity to share with our customers our commitment to providing quality service. NIH is committed to protecting, promoting, and enhancing the health of the American people and to improving its processes to offer high quality services that are easily accessible to the public. The Customer Service Plan establishes a broad framework to address customer issues. The customer service standards address issues our customers have told us are important to them. The primary focus of this document is to ensure that we are continuously listening to our customers and making certain that their needs are being met or exceeded. While the focus is on our outside customers, it does not diminish the need to ensure that our internal NIH customer needs are also being met. It is imperative that an integrated view of all our customers’ needs be pursued in order to ensure that the needs of our entire customer population are met. If we do not provide outstanding service to our internal customers, we will be unable to provide outstanding support to our external customers. [ Return to Menu ] ________________________________________ OUR CUSTOMERS The NIH serves four primary external customer groups–the general public, health professionals, other governmental agencies, and grantee/contractor organizations. These four broad categories encompass the populations that we serve and work with most often. When the agency embarked on this process, we felt it was necessary to define and limit our primary groups. As we continue with our customer service initiatives, we may include additional customer groups. [ Return to Menu ] ________________________________________ STANDARDS The standards described in this report represent the NIH effort to identify the needs and concerns of our customers and to establish measurable processes to address these needs and concerns. The standards have been  developed from information gathered from surveys/focus groups, and benchmarking with other outstanding organizations and are based on measured performance attributes – a set of criteria that expresses customer requirements and expectations. Performance attributes are organized into two categories. 1.Process attributes — transaction-related characteristics represented by internal operations, such as procedures, policies, and functions – the primary focus is continuously improving our internal operations so we can deliver our products and services quicker, better and cheaper; and 2.Quality attributes — image-related characteristics that describe the contact between the customer and the organization. The overall standard of quality we seek is customer service for the American people that is equal to or better than the best in business. The following attributes were used to develop the standards: Process Attributes †¢Consistency in policies and procedures – holding to the same principles across the organization †¢Convenient feedback mechanisms – feedback that are easy to use and access †¢Frequent communication – including follow-up – any form of communication on a regular basis, where taking action following that communication enhances the effectiveness of that communication †¢Managing resources well – careful control and use of resources, human as well as fiscal, to maximize their impact and effectiveness †¢Problem solving and attempts to remove barriers – proposed solutions or considerations to resolve something that is an obstruction or prevents progress †¢Prompt handling of customer feedback – immediate or quick management of customer dissatisfaction by empowering employees to fix problems †¢Flexible options – sending and receiving information using a variety of methods, including greater use of e-commerce solutions †¢Continuous Improvement – striving to do everything quicker, better and cheaper Quality Attributes †¢Accessible – ability or freedom to approach, communicate with, or make use of †¢Courteous – respect or consideration  Ã¢â‚¬ ¢Flexible – capability to adapt to or change requirements †¢Knowledgeable – familiarity with or understanding of facts and/or conditions †¢Listens well  Ã¢â‚¬â€œ gives attention and/or careful consideration to what is said †¢Reliable and Trustworthy – dependable, confidence in character, abilities, and truth †¢Timely – information and/or responses are provided early or on time [ Return to Menu ] ________________________________________ AGENCY-WIDE STANDARDS The following standards apply to all customer groups. All NIH Customers are entitled to: †¢fair, courteous and professional treatment †¢information that is accurate and current †¢timely responses to requests †¢reasonable access to appropriate staff †¢two-way communication †¢opportunities for collaboration and partnerships, as appropriate and †¢consideration of their opinions and concerns by the agency in the decision making process †¢use of plain language for all communication with the public (Attachment 2) In addition: †¢The General Public is entitled to accurate and timely health information about research being conducted. †¢Health Professionals are entitled to timely information that will assist them in advancing and protecting the public health. †¢Other Government Agencies are entitled to: ocooperation from the NIH in maximizing efficient use of resources, eliminating duplication of efforts and carrying out collaborative efforts; otechnical assistance, training and guidance †¢Grantee/Contractor Organizations are entitled to: otimely review of applications and awards; oprofessional treatment in resolving disputes; ofair application of laws, regulations and policies; ofair and consistent application reviews; orespect in the performance of duties and responsibilities; and otimely payment. [ Return to Menu ] ________________________________________ FUTURE EFFORTS NIH will continue to embark on a variety of initiatives to ensure that it continues to address customer needs. The on-going Customer Service Management group will coordinate these activities. Ensuring that quality service is provided is an on-going process that requires changes in the way we do business by increasing emphasis on listening to our customers and by learning from the best in private industry. The agency will strive to reinvent itself — to become more efficient and effective–and to provide the types of services the public expects. Over the coming months, the agency will: †¢develop programs and initiatives that address customer needs. The agency, as a whole, and the individual centers and institutes will use the information gathered from the survey and focus groups to develop and enhance services. †¢benchmark against the best-in-the-business. The agency will determine what internal processes need to be improved, benchmark with leading industries, and establish performance standards. †¢establish processes to improve customer feedback. Systems will be established to receive and address customer suggestions and feedback.

Crime Is A Major Social And Political Problem Within Our...

Research Proposal Introduction Fear of crime is a major issue within our society with Farrell et al stating that ‘it is commonplace to assert that fear of crime has become a major social and political problem, perhaps bigger than crime itself’. With Leeds being known as a high risk area for crime in the UK with Leeds University and Leeds Beckett coming 6th and 7th respectively for the highest crime rate on The Complete University Guide students here are likely to have a strong fear towards becoming a victim of crime. Previous research has shown there are differences in the type of crimes that the different genders fear becoming victims of. (Rountree 1998) This research aims to investigate those differences and find out if they affect the lives of students in Leeds. The main aims are as follows: To establish whether their are differences in gender and fear of crime in Leeds. To know if these fears will affect a students life and behaviours. Literature Review Research in to students and fear of crime has found surprising results, with Universities considered fairly safe, it is surprising that students report high levels of fear towards crime. (McConnell 1997) As well as this high level of fear towards crime from students, previous research has shown us that there are many differences in the male and female fear of crime. Females have been repeatedly found to fear crime more than males (Fisher Sloan, 2003) even though men are much more likely to become a victim of crimeShow MoreRelatedControlling Organized Crime Paper1206 Words   |  5 Pagesï » ¿ Controlling Organized Crime Tina Martin-Fleming CJA/384 February 19, 2015 Charles Davis Organized crime groups have been around since the 1900’s. The mafia who came from Italy and other countries to the United States started their business and became a nuisance over a period. 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