Multidisciplinary Approach to Health Essay
Multidisciplinary Approach to Health Essay
Devastation and fear of the known are common feelings for those who receive news of having Cancer. Every year, over a million people will be diagnosed with cancer annually according to the American Cancer Association. When first receiving a cancer diagnosis, it is difficult for clients and loved ones to really understand any information provided immediately after the diagnosis is given. Every cancer is also staged from a biopsy of the site, and as a nurse, it is important to really understand the type of cancer along with the current stage. Multidisciplinary Approach to Health Essay.
There is a multitude of cancer information available, but really the nurse needs to be prepared to provide accurate information to patients and families. This paper will provide a brief description of the stages of cancer, some of the side effects from treatments available, and care of the patient with cancer. Multidisciplinary Approach to Health Essay.
Staging of Cancer
A physician will stage a cancer from 0 to IV to determine just how large the tumor is and how systemic it has become.
“By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors” (National Cancer Institute). The TNM system is often used to determine the current stage of cancer. From the TNM system the size of the tumor, at which length the nodes are involved, and what extent the lymph nodes are exposed are used to determine the stage. Metastasis is the final part of staging cancer, which is spreading of the cancer to other areas of the body that are from the original site of the cancer. This leads to a grading system that helps determine the appropriate treatment plan or prognosis for the patient. Multidisciplinary Approach to Health Essay.
Carcinoma in Situ
Stage 0, also known as in Situ, is the earliest phase of cancer. A cell mutates into a cancer cell along with other cells in the same area, which forms a tumor in that tissue. This is not a diagnosis of cancer in Breast Cancer, but rather indicates an increased risk of cancer. Further treatment varies for those in Stage 0. Some patients may be observed while others may be started on tamoxifen, but there are of course risks associated with this medication such as increased risk of pulmonary embolism, venous thrombosis, stroke and Uterine Cancer.
“The NSABP-P-1 trial of 13,388 high-risk women comparing tamoxifen to placebo demonstrated an overall 49% decrease in invasive breast cancer, with a mean follow-up of 47.7 months” (National Institute of Cancer). Some patients may participate in clinical trials to reduce chances of further spread of the cancer while others may opt for more extreme prophylaxis such as a bilateral mastectomy. Multidisciplinary Approach to Health Essay.
Cancer Stage I, II, III
Stages I, II, and III all stand for disease being actually present. The higher level of staging could indicate a larger tumor. It could also indicate a more systemic disease process involving the lymph system. Once it has spread into the lymph system, the cancer can then spread to nearby organ systems. Along with tumor excision and removal of any effected lymph nodes, concurrent use of medications like tamoxifen in treatment of breast cancer, and the use of radiation and/or chemo therapy are all used in treatment plans at these stages of disease manifestation. Multidisciplinary Approach to Health Essay.
At Stage I, the tumor is small measuring less than 2cm and has not spread into nearby lymph nodes. As the cancer progresses, Stage II has a larger tumor measuring two to five centimeters, but has not inundated the surrounding tissues and has not spread from the current infected tissues, but it can sometimes be found in the associated lymph nodes. Stage III contains not only a larger tumor and is usually found in the nearby lymph nodes.
Stage IV
The final stage is Stage IV, where it is found that the cancer has spread from the original site to another organ system or systems. An example of this would be a primary diagnosis of Lung Cancer, but the cancer is found in the bones or the liver. No stage is great, but this stage is the worst because of the spreading of the disease to other organ systems. Often, the Prognosis is also determined on how much the cancer has spread and how severe the secondary tumors are. Treatment often involves radiation and surgical removal of the tumor. Multidisciplinary Approach to Health Essay.
Side Effects of Treatment
Treatment is often difficult for patients and families as there are some undesirable side effects associated with many treatment options. Side effects will vary depending on the location of the treatment. “Radiation on the lower trunk for gynecologic cancer and cancer in the prostate leads to diarrhea, frequent voiding and pain as well as affected sexuality. When head and neck area are irradiated, mouth dryness, taste changes, swelling, pain in the mouth and throat, loss of appetite and eating problems occur” (Pederson, Koktved, & Nielsen, 2013). Another treatment is Chemotherapy. Patients receiving chemotherapy often experience nausea, vomiting, and poor appetite. Multidisciplinary Approach to Health Essay.
Breast Cancer, as previously mentioned, in the early stages like In Situ, is often treated with tamoxifen or an aromatase inhibitor. “Tamoxifen is used in situations in which the cancer is a hormone receptive positive cell growth which accounts for over 75% of all breast cancer diagnoses” (Corter, Findlay, Broom, Porter, & Petrie, 2013. The possible adverse side effects are frightening and life altering happen to anyone. Multidisciplinary Approach to Health Essay.
It is important to not forget about the psychological toll these side effects can play. Patients have lives outside of their cancer diagnosis and treatment such as work and family responsibilities, or are just starting to enjoy retirement. Cancer does not pick and choose who it effects, so anyone could potentially suffer from this disease. “Emotional distress is common among cancer patients as a result of the diagnosis of a life-threatening disease, aggressive medical treatments, changes in lifestyle that occur, and the direct effects of the tumor” (Meijer, et al., 2013). Life can be stressful alone because of all the requirements, adding on stress to life such as diagnosis and treatment plans needed to combat cancer puts these patients at a high risk of Depression. Those providing care must always assess patients for depression at each appointment. Multidisciplinary Approach to Health Essay.
Not every patient will be the same, experience the same side effects, or respond the same to the treatments. Providers must be aware of this and be ready to provide information to patients and families related to the diagnosis and treatment.
Conclusion
There is hope at some point there will be a database with all the information of all patients’ cancer cell mutations to help improve treatment. “Even within the same tumor, cells may be altered in different ways, so a therapy that works for many patients may be utterly ineffective for the one sitting in the doctor’s office” (Edwards, 2014). Every patient is an individual, a person, not a number. The provider may have given the same diagnosis a hundred times, for that patient, it is probably the first time, and it is devastating. If providers can think of it as the first time, hopefully there will be an increased sense of empathy to this patient’s situation. The patient will have to endure a multitude of physical and psychological symptoms that may forever change their life because of their cancer diagnosis. Multidisciplinary Approach to Health Essay.
As a nurse, provide information on support available in the community and online patients and families. This diagnosis involves all in the family and is not just centralized for the patient. There may be support groups for patients and for families or caregivers available within the community. The American Cancer Society is a online support that has a vast amount of easy to understand information on numerous forms of cancers, stages of cancer, typical treatments, and support resources for patients and care givers. By providing this information early during the diagnosis is important, because after the intial shock of the diagnosis, this is an easy resource for people to start looking at information that is specific to their diangosis. This helps patients and families become advocates of their own care, whether it be to aggressive treatment or to improve the quality of end stages of cancer, rather than quantity. Multidisciplinary Approach to Health Essay.
References
Corter, A. L., Findlay, M., Broom, R., Porter, D., & Petrie, K. J. (2013). Beliefs about medicine and illness are associated with fear of cancer recurrence in women taking adjuvant endocrine therapy for breast cancer.
British Journal of Health Psychology, 18(1), 168-181. Retrieved from http://eds.b.ebscohost.com.library.gcu.edu:2048/eds/detail/detail?vid=8&sid=89dc87e3-ef39-4bfe-a28a-b07f6af34781%40sessionmgr111&hid=116&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=s3h&AN=84763245 Edwaryds, C. (2014). Using patient data for personalized cancer treatments. Communications of the ACM, 57(4), 13-15. doi:10.1111/j.1471-6712.2012.01085.x Meijer, A., Roseman, M., Delisle, V., Milette, K., Levis, B., Syamchandra, A., . . . Thombs, B. D. (2013, July). Effects of screenign for psychological distress on patient outcomes in cancer: A systemic review. Journal of Psychosomatic Research, 75(1), 1-17. Retrieved from http://www.sciencedirect.com.library.gcu.edu:2048/science/article/pii/S002239991300038X Pederson, B., Koktved, D., & Nielsen, L. L. (2013). Living with side effects from cancer treatment-a challenge to target information. Scandinavian Journal of Caring Sciences, 27(3), 715-723. doi:10.1111/j.1471-6712.2012.01085.x
This essay will relate to an observation of professional social work practice in a Crisis Centre, for people with mental health issues who require support, and short-term accommodation, with the goal of returning home or to a new environment. This essay will focus upon the role of multi disciplinary collaboration regarding the Crisis Centre staff, and Crisis Resolution Home Treatment Team (CRHTT), and to discuss why collaboration appears to play an important and fundamental role within social work practice. The essay will also aim to demonstrate good practice and possible strengths and weaknesses of multidisciplinary working. Multidisciplinary Approach to Health Essay.
Within the field of social work practice it does seem evident that ‘multidisciplinary working is work undertaken jointly by workers and professionals from different disciplines or occupations’ (Pearson & Thomas, 2010:342) and has evolved at varying speeds over the past 30 years, in response to imperatives of central government. (What evidence)?Evidence suggests that the area mental health was among the first professions to adopt teams of workers from different professions, and the Community Mental Health Team is widely regarded as the model for multidisciplinary working (Community Care, 2010). It seems that , in relation to social work, the distinctive quality that has to be demonstrated is anti discriminatory practice and a holistic approach, by working with a range of situations and people having an attribute for developing multidisciplinary and partnerships (Higham,2006:). Multidisciplinary Approach to Health Essay.
The Crisis Centre that has been observed is run by a Local Council????,Can u not say Liverpool and is a National Health Service Trust based in the community. The centre also corresponds (look up meaning in dictionary)does this word apply here??.-The centre works within the— or to the guidelines set down in the with the 1975 White Paper entitled ‘Better Services for Mentally Ill’. This highlight’s the importance of professions, working together to provide a community based service (Social Care Institute for Excellence (SCIE), 2010) demonstrating that collaboration is fundamental to social work. The Crisis Centre provides beds for adults suffering from mental health issues who have been referred to them from the CRHTT, for instance by referral from their Doctor or health department. The next step is to complete an assessment in line with local authority guidelines and procedures, then produce a care plan and risk assessment. If they decided the service user is in crisis and cannot return home contact will be made to the Crisis Centre. Average sentence length is 15/20 words long.Have a look at your’s. Multidisciplinary Approach to Health Essay.
CRHTT use numerous ways and methods of contact to inform social workers, such as, E-mail, telephone calls and home visits. This can demonstrate collaboration through good practice and communication which is essential to social work. Effective collaboration between staff at the ‘front-line’ is a crucial ingredient in delivering the government’s broader goals of partnership between services’ (Whittington, 2003). Also, in the audit commission 2002 it seemed evident that service users who seem to require social workers, will, and can, collaborate with other professionals to provide appropriate service. Multidisciplinary Approach to Health Essay.
During this observation multidisciplinary working was witnessed between the Crisis Centre staff, and the CRHTT regarding a service user in the centre through a telephone call. The CRHTT seemed to be following the National Occupational Standards key roles section three, by ‘supporting the individual, representing their needs, views and circumstances by acting as an advocate’ (Higham 2006: 98) and had been informing the Crisis Centre of what was happening. The Crisis Centre staff asked questions in a way that was treating the service user as an individual, by listening to their individual case, respecting and maintaining dignity by only asking questions relevant to the Crisis Centres needs and criteria. Staff spoke clearly and discussed the dynamics of other service users (respecting confidentiality) already in the centre, declaring any conflict or positive interactions that had arisen since their last visit (General Social Care Centre (GSCC), 2010).These skills are seen as fundamental to social work practice as they are valuing the individual and provide a holistic approach. This will also ensure the social worker is not using their power in an inappropriate way.
Furthermore, in the 1990’s the New Labour government recognised that problems cannot be addressed by people and organisations working in isolation. As a result the Department of Health (DH) (1998) intruded the White Paper ‘Modernising Social Services’, which had multidisciplinary working as a key objective (Wilson, et al. 2008:388). The DH (2000) No Secrets legislation actively promoted that multidisciplinary teams will empower, and promote, well-being of vulnerable adults through the services they provide and the ‘need to act in a way which supports the rights of the individual to lead independence’ (DH, 2000).
DH No Secrets (2000) legislation was carried out by the service user, Crisis Centre and CRHTT via staff communicating throughout the day, and providing an environment where service users can come and go freely, yet still have support during their crisis. An example of encouraging independence was allowing the service user to cook and clean for them selves. Ryan’s (2010) evaluation of Crisis Centre and CRHTT asked service users what they valued best about their stay. Their responses included ‘I was on the lowest rung of the ladder in terms of depression and self esteem’. ‘Now I can cook and iron’. It has restored my ‘get up and go’ and ‘it is given me a sense of life back and helped me to find myself. I could not have gone on any longer’. ‘Staff have taught me to cope better and manage my panic attacks.’ This seemed to demonstrate partnership working with the service user and multidisciplinary working. Multidisciplinary Approach to Health Essay. The 2006 White Paper Our Health, Our Care, Our Say emphasises the importance of people having more control over their lives and access to responsive, preventative services by working together in multidisciplinary teams (DH, 2006). The Crisis Centre appears to fulfil this.(Empowerment) u could mention this if u think it would help
Throughout the day through discussions, and observations, it appeared that the Crisis Centre staff and CRHTT encouraged emancipatory practice by involving the service user in their support. This shows good practice and also that staff were not routinized as each day was different, for example, they discussed how each individual was unique. If social workers become oppressed by working in routines this does not always benefit the service user, it is not good practice and is not fundamental to social work values.Who says this?? An example of this was observed when a member of the CRHTT came to the Crisis Centre and completed a visit with a service user. During her visit she was contacted from her office through telephone calls, one of which was a new service user needing to be assessed urgently. She had to re-evaluate her cases as the new referral seemed more of a priority. She did this by speaking to her manager on the telephone and re -arranging for another colleague to see her service user, then asked the office to let the service user know about this change showing collaboration, good practice. Multidisciplinary Approach to Health Essay.
This commitment demonstrates multidisciplinary working and partnership working with the service users are fundamental and collaboration is needed for social work and the interpretation from the staff involved demonstrates good practice. ‘Collaborative working is required by government. To show partnership working with service users in the Crisis Centre, Ryan (2010) Is this reference in the right place or should it be after-required by Government ???. asked service users how they felt about staff. Service user’s responses included ‘any questions or anything you are upset over, you can go and ask the staff’ and ‘staff are very supportive and helpful.’ Social work is about working with people to help them sort their own problems out. Kaggs read this highlighted part again, does it sound right, were u sleepy ????
This essay has aimed to demonstrate positive multidisciplinary working through observation at the Crisis Centre. However, it appears that multidisciplinary working can be negative and dysfunctional. When a group of diverse people with varied skills come together into a team, things do not always go accordingly (Community Care, 2010). Cree (2003) cites ‘multidisciplinary working can also be positive, but also frustrating and isolating (Dalrymple & Burke, 2006). Wilson, et al. (2008) agrees multidisciplinary working does not always work effectively and as a result failures have been documented, such as, Victoria Climbie enquiry and Baby Peter. In addition Thompson (2005) believes multidisciplinary can also appear to do more harm than good and can make situations worse. Multidisciplinary Approach to Health Essay.
During the day it was bought to attention through a staff handover that one of the service users in the Crisis Centre had experienced a negative experience of multidisciplinary working. Consequently, this seemed due to the breakdown of communication between, his social worker, CRHTT, Crisis Centre staff and medical staff. According to Thompson (2009) without effective communication the notion of multidisciplinary becomes unobtainable. Staff at the Crisis Centre believed it was due to lack of budgets and lack of communication. During this handover reflective practice was witnessed and as a team they spoke about what, why and how things had gone wrong for the service user and how they could approach the situation to get the best outcome. Staff at the Crisis Centre spoke about how they valued supervision meetings as it gave them chance to voice any concerns they had and gave the manger chance to deal with any systematic practice that was leading staff to become unfocused (Thompson and Thompson, 2008). Supervision meetings demonstrate good practice and are part of social work codes of practice to develop through opportunities to strengthen skills and knowledge. Multidisciplinary Approach to Health Essay.
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This essay has demonstrated through observation the important of working with other professionals as one person cannot solve another person’s problems alone (Thompson and Thompson, 2008). Also that multidisciplinary working is integral for social workers and many other professionals. This essay has aimed to provide a balanced outlook on multidisciplinary working as it demonstrated positive points, as working with other professional’s by pooling skills together is essential. Correct use of legislation and commitment to social work practice can all enrich a service user’s life. Problems do occur though when multidisciplinary teams do not always communicate effectively and this can be frustrating. Through observation it became apparent that lots of people contributed to multidisciplinary teams and showed that collaboration, good practice and communication were not always ideally used within practice. Multidisciplinary Approach to Health Essay.