Question

How might nursing collaborate with social services to enhance communication and visits between individuals with mental illness and family/friends? How can volunteers be involved in the care of those with mental illness? How can nursing work with the activities department/therapeutic recreation to provide recreational activities for individuals with mental illness? How can nurses work with nursing assistant/personal care attendants to provide diversion activities in off hours? What non-pharmacological interventions can the nurse offer to the individual with mental illness when anxious at night.

Answer 1

In today’s health care system, delivery processes involve numerous interfaces and patient handoffs among multiple health care practitioners with varying levels of educational and occupational training. During the course of a 4-day hospital stay, a patient may interact with 50 different employees, including physicians, nurses, technicians, and others. Effective clinical practice thus involves many instances where critical information must be accurately communicated.Team collaboration is essential.When health care professionals are not communicating effectively, patient safety is at risk for several reasons: lack of critical information, misinterpretation of information, unclear orders over the telephone, and overlooked changes in status.Lack of communication creates situations where medical errors can occur.These errors have the potential to cause severe injury or unexpected patient death.Medical errors, especially those caused by a failure to communicate, are a pervasive problem in today’s health care organizations.According to the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations, JCHAO), if medical errors appeared on the National Center for Health Statistic’s list of the top 10 causes of death in the United States, they would rank number 5—ahead of accidents, diabetes, and Alzheimer’s disease, as well as AIDS, breast cancer, and gunshot wounds.More specifically, the Joint Commission cites communication failures as the leading root cause for medication errors, delays in treatment, and wrong-site surgeries, as well as the second most frequently cited root cause for operative and postoperative events and fatal falls.Traditional medical education emphasizes the importance of error-free practice, utilizing intense peer pressure to achieve perfection during both diagnosis and treatment.Errors are therefore perceived normatively as an expression of failure. This atmosphere creates an environment that precludes the fair, open discussion of mistakes required if organizational learning is to take place.In the early 1990s,Donald Berwick wrote about patients needing an open communication system instead of experiencing adverse events stemming from communication failures.More than a decade later,this concept still has profound implications on our method of health care delivery.As such, this chapter will review the literature on the important role of communication and team collaboration in helping to reduce medical errors and increase patient safety.Webster’s Dictionary defines communication as “the imparting or interchange of thoughts, opinions, or information by speech, writing, or signs.” It is important to consider that communication is not just verbal in form. One study states that 93 percent of communication is more affected by body language, attitude, and tone, leaving only 7 percent of the meaning and intent based on the actual words said.Whereas the spoken words contain the crucial content, their meaning can be influenced by the style of delivery, which includes the way speakers stand, speak, and look at a person.1 However, critical information is often transmitted via handwritten notes, e-mails, or text messages, which can lead to serious consequences if there is miscommunication.Collaboration in health care is defined as health care professionals assuming complementary roles and cooperatively working together, sharing responsibility for problem-solving and making decisions to formulate and carry out plans for patient care.Collaboration between physicians, nurses, and other health care professionals increases team members’ awareness of each others’ type of knowledge and skills, leading to continued improvement in decisionmaking.Effective teams are characterized by trust, respect, and collaboration.Deming is one of the greatest proponents of teamwork.Teamwork, he believes, is endemic to a system in which all employees are working for the good of a goal, who have a common aim, and who work together to achieve that aim.When considering a teamwork model in health care, an interdisciplinary approach should be applied.Unlike a multidisciplinary approach,in which each team member is responsible only for the activities related to his or her own discipline and formulates separate goals for the patient, an interdisciplinary approach coalesces a joint effort on behalf of the patient with a common goal from all disciplines involved in the care plan.The pooling of specialized services leads to integrated interventions. The plan of care takes into account the multiple assessments and treatment regimens, and it packages these services to create an individualized care program that best addresses the needs of the patient.The patient finds that communication is easier with the cohesive team, rather than with numerous professionals.Mange the patient is a compilation of some of the components found in the literature of a successful team work model.

2. Family and friends of someone living with a mental illness often share similar experiences. People living with mental illness can be helped in many ways by family and friends. It is not uncommon for family and friends to focus a large portion of their attention and energy on their loved one.However, it is important to look after yourself too.Don’t ignore warning signs of mental illness in a family member or friend.The sooner the person receives support and treatment, the better the outcome is likely to be. It can help to:- Encourage the person to speak with doctor about their concerns.Speak with your own doctor about your concerns and what options might be available if the person is reluctant to see their doctor.

Mental illness often has a ‘ripple effect’ on families, creating tension, uncertainty, stress and sometimes significant changes in how people live their lives. Different family members are likely to be affected in different ways. It's normal to feel a whole range of emotions, such as guilt,fear, anger and sadness.Acknowledging these feelings can be the first step towards working through them.No one is to blame when a person is affected by mental illness.

3. Call or visit a local treatmentfacility or hospital. Contact Mental Health America. Check out Volunteer Match.org. Use state or local government resources.Volunteering provides manybenefits to both mental and physical health. Volunteering helps counteract the effects of stress, anger, and anxiety. Thesocial contact aspect of helpingand working with others can have a profound effect on youroverall psychological well-being.

4. Playing the music of the person's choosing.One-on-one interaction.Playing videotapes of family members.Walking and light exercise.Pet therapy.Recreational therapy, also known as therapeutic recreation, is a systematic process that utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illnesses and/or disabling conditions, as a means to psychological and physical health, recovery and well-being.

5. Mental health activities might include mindfulness or meditation, Cognitive Behavioral Therapy worksheets, Psychotherapy worksheets, and even mood trackers.

6. Cognitive behavioural therapy(CBT),Interpersonal therapy (IPT),Mindfulness-based cognitive therapy (MBCT),Psychodynamic therapy (PDT).The psychological interventions used to treat depressed patients include acceptance and commitment therapy, cognitive therapy, cognitive behavioral therapy, interpersonal therapy, psychodynamic therapies, and other talk therapies.