Interprofessional working is a very important aspect of patient care in the field of learning disability nursing (Adshead, Collier and Kennedy, 2015). Patient care encompasses more than nursing care, therefore the collaboration of all professions in a hospital and the community is required for optimal care. Inter-professional care is very challenging, because of the different nature of work, in different fields in the medical field. Learning disability nurses should work in close collaboration with other medical fields and the social workers to ensure quality care is provided to their clients and quality of life is improved.
The objectives expected to be met are; to appraise factors that enable or inhibit inter-professional working, to explain factors that enable or inhibit collaborative working between clients and service providers, to understand and critically reflect on the principles of inter-professional working and appropriately use examples of both effective and ineffective inter-professional working.
Many factors such as communication, hierarchy, influence the inter-professional working relationship between health care professionals some of which will enable while others inhibit the relationship (Nanacarrow, Booth, and Ariss et al 2013).
Learning disability nursing is mainly based at the community level; however inter-professional working is very important because the nurse cannot make a diagnosis on their own they need the collaboration of professionals working in the hospital to make nursing care a success (Miler and Catherine, 2016).
Inter-professional working is the interdisciplinary relationship between professionals who come together to share knowledge, skills and expertise in provision of patient care Inter-professional working is the key element in the success of organization; where by different professionals from different fields come together and work in collaboration to meet the vision, mission and objectives of the organization (Nanacarrow, Booth, and Ariss et al 2013). This type of relationship is very vital in learning disability nursing.
Learning disability nursing is a field which deals with the provision of specialized healthcare to support clients with a learning disability (Turnbull,2008), and includes their families in the provision of care to help them achieve quality life (Sellman and Snelling, 2017).
Learning disability is a neurological disorder, which results to slow processing of information, leading to an interference with learning basic skills such writing and reading, high level skills such as abstract thinking, time planning and organization, attention span and impaired long term and short term memory can also be impaired in some type of learning disability (Porter and Taylor, 2015). There are different types of learning disabilities and with each type there is a modality of care specific to it. It is important to isolate the impact of learning disability on the client’s life and come up with care modalities to improve their lives; which can be made possible by inter-professional working (Mangan, Miller and Ward, 2015).
Inter-professional working benefits both the client and the service provider through; empowering team members to provide quality care, patient care is not decided by one person but a team of professionals who come together and decide the way forward; closing communication gaps, because when team members are working together communication is easy and distortion of message is very rare; enabling comprehensive patient care due to the collaboration of different professions ensuring that the patient gets holistic care; minimizing the rate of readmission because of the quality of care accorded to patients and increased patient satisfaction; promoting team mentality, when working as a team, professionals will be more close and share ideas more often leading to a better outcome for the patient, also the team learn to work together despite their difference and diverse opinions for the good of the patient; inter-professional working promotes patient-centered care, because the patient is the priority unlike the resource centered care, whereby care is given according to the resources available (Minister and Parish, 2015).
When working as an interdisciplinary team some principles should be exhibited for team work to be successful. These principals should be adjusted according to the hospitals vision and mission, the learning disability condition the clients has, the environmental setting of their home and schools, family relations and the community at large. Studies have shown that not there is a difference in status quo in the community, those of the upper class have unlimited access to resources, but those of the middle and lower classes have a limited access to resources. Some characteristics were isolated in a study (Nanacarrow, Booth, and Ariss et al 2013) and they included:
A team leader; the team should have a leader who provides a clear direction for the team and at the same time supervising the team.
A standard set of rules; there should be a standard set of values put in place to guide the teams operation.
A team culture; the team should have a culture which is in support of the final decisions and respectful of the diversity of opinions and trusting of each other.
Appropriate infrastructure and processes; there should be an appropriate set of processes and infrastructure which enables the team work optimally.
Effective and appropriate communication; the team should also utilize effective and appropriate communication strategies to facilitate the providence of quality patient care.
Availability of staff; there should be sufficient staff both technical and auxiliary which results into improved patient care.
Respect; role interdependence and respect to individual opinions should be promoted and personal development should be promoted via training, rewards, and provision of opportunities for career developments, like provision of grants to individuals to further their studies. All of these principles should be employed and identified in any inter-professional working.
Learning disability nursing requires all of these components because the nurse has to collaborate with the, doctors, pharmacist, laboratory technicians, physiotherapist, neurologist counselors, parents, teachers and social workers in order to provide holistic care to the affected individual (Matiti, 2015). The teachers should be able to understand the uniqueness of the child they are dealing with and teach them at a pace appropriate for their processing speed, same applies to parents who should ensure a loving and caring environment despite the challenges experienced, for instance such a child will take long to respond to complete milestones such as speaking and these can be very frustrating to the parents, that is why they should be taught about their child’s condition and given reassurance to minimize anxiety. The social workers also ensure that no harm is done to the client especially the children and provide alternative homes to children who suffer from learning disabilities and their living conditions are not appropriate for their condition (Mash and Barkley, 2014). Studies show that health care professionals should collaborate together to provide appropriate care to the client, because they have a deeper understanding and are trained to understand the different types of learning disability and their mode of management (Mackleprang and Salgiver, 2016).
There are many factors that may hinder or enhance this type of relationship. Some of the factors that may hinder or enhance inter-professional working are:
Communication; it can be internal within the team or external between the team and the managerial board, it can also be between the team and other auxiliary parts of the clients life such as teachers, family members and friends proper communication results into proper care provision (Yeung, Wong and Macarthur, 2015). Misunderstandings and misinterpretation of messages may arise within the team as information is passed from one level to another, resulting into poor care provision, therefore appropriate communication styles should be incorporated in such a team, because what you discuss with the parents should not be the same information discussed with the teachers and friends so as to maintain patient’s confidentiality (Nancarrow, Booth and Ariss et al,,, 2013).
Hierarchy; there will be conflicts between different professions associated with care to clients with learning disability that is why different hierarchical levels should be in good terms. Respect to the uniqueness of team members and their opinions should be paramount. Unity exhibited by the different hierarchical members should be maximized to provide quality medical care (Sawar and Devlin, 2017). These members should come up with a unified decision regarding patient’s care and way forward after a thorough analysis of the client’s condition.
Availability of staff and resources; this is a major determinant of inter-professional working success, resources could be available but there is a shortage of staff, alternatively the qualified staff could be available but there are no adequate resources. These two components should be available for inter-professional working to be a success. For effective inter-professional care resources and qualified personnel should be provided in every hospital (Nancarrow, Booth and Ariss et al,,, 2013).
Relationships between colleagues in different aspect of care; this can impact positively if the colleagues can work together with minimal feuds; however it can be challenging and impact negatively if colleagues don’t see eye to eye with each other because it might result in poor quality of care ,biased care for instance the laboratory technologist can feed wrong findings into the patients file to get the nurse they are in feud with fired and unhealthy competition which can result in misdiagnosis or inappropriate care provision (Sarwar and Devlin, 2017). As a nurse in the field of learning disability, you should ensure that personal differences are put aside and emphasis on the importance of patient care.
Patient’s specific condition; the severity and type of the learning disability determine the type inter-professional care provided some types need not involve the entire team, however they can be consulted if the conditions worsens for example if the client has only a learning disability with no resulting physical disability there would be no need to involve a physiotherapist. Some types can be successfully managed at home with minimal hospital visits; however other types require repeated visits to the hospital for consultation because of the complications associated with them.
Environmental settings; where the client live determines the modality of care, a nurse should ensure that all their clients have the appropriate living conditions (Schwatz, 2017). Some people live in very poor conditions with limited resources; this necessitates the intervention of a social worker to ensure that the client is provided with the appropriate living conditions. Others live in very good environmental conditions with availability of all the resources (Sims, 2011).
Beliefs; people have different religious beliefs, which can hinder or enhance inter-professional working, some people don’t believe in conventional therapies and as a nurse you should ensure they are appropriately counseled, or therapy is provided without altering their belief, such as use of behavioral therapy and omission of pharmacological therapy.
Conclusion
Inter-professional working is a very important tool which should be embraced by learning disability nurses when providing health care services (Smith, Ooms and Marks-Maran, 2016). It will help in the sharing of ideas, knowledge and skills all for the good of the patient. This tool has been associated with very many benefits when it comes to patient care. Studies show that patients who have received inter-professional care, have a better disease prognosis and outcome and they are more satisfied with the consequences of their condition which can either be negative or positive (Schwatz, 2017).
In learning disabilities the extent of the condition can be so severe such that the outcome is not very encouraging but with the use of inter-professional care, the patient has a better chance of survival, they can learn skills that could be impossible if a multidisciplinary team approach was not used. Despite the many challenges facing inter-professional working, it is documented as the best tool for client care (Minister and parish, 2015).
References
Adshead, S., Collier, E., & Kennedy, S. (2015). A literature review exploring the preparation of mental health nurses for working with people with learning disability and mental illness. Nurse education in practice, 15(2), 103-107.
Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby, P., & Roots, A. (2013). Ten principles of good interdisciplinary team work. Human resources for Health, 11(1), 19.
Matiti, M. R. (2015). Learning to promote patient dignity: An inter-professional approach. Nurse education in practice, 15(2), 108-110.
Mackelprang, R. W., & Salsgiver, R. (2016). Disability: A diversity model approach in human service practice. Oxford University Press.
Mangan, C., Miller, R., & Ward, C. (2015). Knowing me, knowing you: Inter-professional working between general practice and social care. Journal of Integrated Care, 23(2), 62-73.
Mash, E. J., & Barkley, R. A. (Eds.). (2014). Child psychopathology. Guilford Publications.
Minster, R., & Parish, S. (2015). Simulation as innovation: Designing courses for psychiatric nursing education.
Miller, R., & Catherine, M. (2016). Crossing the tracks: continuing inter-professional development in social and primary care. International Journal of Integrated Care, 16(6).
Porter, M., & Taylor, A. (2015). Hull JSNA Toolkit Release 6: Mental Health and Learning Disabilities.
Sarwar, A., & Devlin, A. (2017). Struggling to Maintain Professional Identities When Engaging in Inter-professional Teamwork to Deliver Integrated Care. International Journal of Integrated Care, 17(5).
Schwartz, I. (2017). Putting the child at the centre of inter?professional cooperation in out?of?home care. Child & Family Social Work, 22(2), 992-999.
Sellman, D., & Snelling, P. (Eds.). (2016). Becoming a Nurse: Fundamentals of Professional Practice for Nursing. Taylor & Francis.
Sims, D. (2011). Reconstructing professional identity for professional and interprofessional practice: A mixed methods study of joint training programmes in learning disability nursing and social work. Journal of Interprofessional Care, 25(4), 265-271.
Smith, P., Ooms, A., & Marks-Maran, D. (2016). Active involvement of learning disabilities service users in the development and delivery of a teaching session to pre-registration nurses: Students’ perspectives. Nurse education in practice, 16(1), 111-118.
Turnbull, J. (Ed.). (2008). Learning disability nursing. John Wiley & Sons.
Yeung, M. Y., Wong, H., & Macarthur, M. J. (2015). eMR Pharmacy Reviews promote inter?professional collaboration. Journal of Pharmacy Practice and Research, 45(3), 378-379.
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