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Multi-Agency Working in Nursing

This essay will focus upon a critical incident analysis in the context of multi-agency team work and inter-professional working. The details of the incident will be drawn from the authors recent experience with the Community Housing Support Team, in particular from Care Programme Approach meetings. The names of both clients and staff, as well as details pertaining to their locale have been changed or omitted to comply with the UKCC's Code of Professional Conduct, Clause 10, (UKCC, 1992).

The situation used within this assignment is based upon two clients who co-habit in a first floor maisonette as common law husband and wife. Mr Client has a diagnosis of paranoid schizophrenia which is controlled with xenobiotics and is the main carer for Mrs Client who has a diagnosis of chronic schizophrenia also controlled by xenobiotics that are administered by Mr Client. Mrs Client also has a prolapse of the uterus which causes her to suffer from double incontinence. Arrangements have been made for Mrs Client to have the required operation to repair the problem, however prior to admission Mrs Client becomes very anxious and has twice refused to have the operation. Both clients have a poor dietary intake, poor personal hygiene, high caffei


The solutions to nearly all the crisis encountered by the care team can be or could have been solved or at least minimised through the effective use of communication. It is felt that it would also be important in interprofessional collaboration to have shared values and cultures, while a mismatch along these lines between health and social services has been well documented. (SMITH, 1993).

LYTTLE.J, (1994) Mental Disorder - Its Care & Treatment. Bailliere Tindall, London.

Power causes conflict when there are relationships within organisations between individuals of unequal power, the classic example being the doctor/patient relationship, or the nurse and the consultant. This can cause additional conflict where there are differently structured organisations working together as the power differences between individuals then become unclear. For example the power relationship between the community psychiatric nurse and the social worker.

The main sources of conflict within an organisation and inter-professional collaboration are communication, power, goals, values, resources, roles and personalities. As mentioned previous a major source of conflict is the misunderstanding or breakdown of communication. However communication can also be used as a tool for clarifying opposing views. It is the authors observation that most values within an organisation are internalised and are therefore difficult to change, but they can be clarified through communication so as not to become a barrier. This kind of logic is a skill that can only be learnt through the application of common sense and the wisdom of experience, (BILLIS & HARRIS, 1996). Conflict situations often arise suddenly, the author has observed that the more people that attend a meeting or that are involved in a decision regarding care organisation the more potential there is for conflict to occur.

Within healthcare as a whole there is an interdependence between its members. The multi-disciplinary team breaks down into multiple care providers each relying on the other to carry out a portion of the work. For example a member of the housing support team can not monitor a clients medication if the clients community nurse has not organised the Doset box from the pharmacy.



Some common words found in the essay are:
BILLIS HARRIS, Arrangements Client, COWART SEROW, Building Bridges, Department Health, FARLEY STONER, Conduct Clause, , Politics Volume, Programme Approach, housing support, housing support team, support team, care team, community psychiatric, interprofessional collaboration, agencies professions, community psychiatric nurse, psychiatric nurse, mental health, care programme approach, agency profession, care programme, macmillan publishers ltd, schizophrenia controlled xenobiotics,
Approximate Word count = 2773
Approximate Pages = 11 (250 words per page double spaced)


  

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