Reflection on mental health nursing placement using Gibbs (1988) model of reflection

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This is a reflective essay based on my attendance at a multidisciplinary team (MDT) meeting whilst on my two-week placement at a local mental health day hospital. The aim of this essay is to discuss the importance of the multidisciplinary team within the mental health environment and discuss factors that can influence the success or failure of multidisciplinary teams.

Mental health teams generally comprise of psychiatrists, clinical psychologists, nurses, occupational therapists and social workers, but other therapists such as family therapists, psychotherapists and counsellors might also become involved in the care of the patient (Perkins & Repper 1998).

Multidiscipline involvement is important within mental health nursing as people with mental health problems have multiple needs, so a variety of expertise is required to meet the needs of these people (Darby et al 1999).

Multidisciplinary mental health teams can been defined as:

"A group of practitioners with different professional training, employed by more than one agency, who meet regularly to coordinate their work providing services to one or more clients in a defined area" (Ovretveit,1993: 9 cited in Onyett 2003)

The advantage of a multidisciplinary team approach is that all professionals work together by collecting the facts and by bringing information together, to obtain as complete a view as possible of the problems of each individual patient. In doing this they are able to make sure that the proper range of treatments are used in a properly planned way (Onyett 2003).

One of the disadvantages of a multidisciplinary team is that problems can be encountered when different professionals work together, there can be unclear goals, lack of direction and poor leadership (Darby et al 1999).

In order to structure this reflection I have chosen Gibbs (1988) as the model to help with my reflective process. This model comprises of a process that helps the individual look at a situation and think about their thoughts and feelings at the time of the incident. Reflective skills help us to think about what could have been done, so that if a similar situation occurs again the experience gained can be used to deal with the situation in a professional manner (Burns et al 1997).

To enable me to use this situation for my reflection the patient will be referred to as "Kate". This is in order that her real name is protected and that confidentially maintained in line with the NMC (2002) Code of Professional Conduct.

Description

Kate is a 66-year-old lady, retired from her job as a nurse 10 years ago. She has lived alone since the death of her husband 7 years ago, and has one very supportive son who lives locally and visits 2-3 times a week. Kate was referred to the hospital by her doctor after presenting with an 18-month history of memory problems and it was decided that she should attend the day hospital for a period of six weeks to be assessed and to be involved in therapeutic activities whilst there.

Whilst attending the day hospital she was observed, and found to be repetitive with obvious evidence of fabrication, very disorientated, with poor concentration and very poor short-term memory. The consultant asked the mental health nurses to assess Kate and tests indicated that she may be suffering from a moderate degree of dementia. Dementia is a mental disorder caused by structural changes in the brain and affects around ten per cent of people aged over sixty-five (Newell & Gournay 2000).

An MDT meeting was then arranged to discuss the package of care needed for this lady, to enable her to continue living safely in her own home. The Consultant chaired the meeting by bringing the team to the attention of Kate's medical history and the problems herself and son had been experiencing. He felt she would benefit from medication to help her memory problems.

The community psychiatric nurse (CPN) then discussed to the team the concerns of Kates son, he had...
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