Whilst on placement on an adult rehabilitation ward, I had the opportunity to work in partnership with a multi-disciplinary team and attended a multi-disciplinary team meeting. Gorman (1998) describes a multi-disciplinary team as “…bringing together the wisdom and skills [and] …differing expertise, different value systems and different organizational hierarchies” of the various areas of knowledge. Whilst on this placement, I have worked alongside and assisted nursing Sisters, staff nurses, auxiliary nurses, physiotherapists, consultants, clinical fellows and house officers.
I have assisted clinical fellows and house officers to insert a cannula into a patient’s vein. I have assisted the physiotherapist to transfer and mobilize patients. I have discussed the progress of patients with the physiotherapist. I have assisted the auxiliary nurses with the washing, bathing, dressing and toileting of patients. I have also assisted staff nurses and sisters with their nursing duties, for example, dressing patient’s wounds, administering medications and injections, writing kardexes and care plans, participated in shift handovers and admitting and discharging patients. There are many benefits of a multi-disciplinary team.
One such benefit is a better quality decision can be made. Decisions regarding treatment can be very complex and serious. Decision-making using information from all members of the care delivery team ensures that important information about the patient is not ignored or missed. Another benefit is that the allocation of roles and responsibilities is clearer and easier to understand when all of the team members are together in a meeting. Also, one team, one voice: the whole team working towards the same plan of treatment, speaking to the patient and their family with one voice rather than disagreement (Gorman, 1998).
Whilst on my placement on the adult rehabilitation ward, I attended a multi-disciplinary team meeting. Present at this meeting was the Consultant, two staff nurses, the physiotherapist and the occupational therapist. Each patient was discussed in turn. Each member of the team gave their input and perspectives about the patients. The progress of each patient was discussed by the different members of the team, such as the status of the patient, questioning the success of treatments, results of investigations or the need of, and so on.
The discussion would result in a conclusion, such as is a case conference required, is the patient ready for discharge, if so plans are made, and does the patient need to be referred to a social worker, occupational therapist, physiotherapist, Rehabilitation Day Unit and so on. Another benefit of a multi-disciplinary team is a greater commitment to the care plan. Ownership of decisions is better when people have participated in the choice of treatment. Also, a multi-disciplinary team can offer support and encouragement to each other in an environment that can often be stressful and pressurized (Gorman, 1998).
An example of support in the stressful environment of the rehabilitation ward presented whilst I was working with the team. On two separate occasions, I was unfortunate to be present when two patients’ died. They were most unpleasant, however, the support of the clinical fellows and nurses was invaluable to me to help me carry on with my duties and get through what were distressing times. A vital component of an effective multi-disciplinary team is communication, that is to say, sharing understandings and expertise, listening to each other, understanding and respecting the particular point that is being made (Gorman, 1998).
Each member of the multi-disciplinary team has a responsibility to communicate with other members of the team with respect as equals. Effective communication is vital in the interests of patients. For example, nurses rushing to dress a patient for an occupational therapy visit at 9. 30a. m. to assess the dressing skills of the patient is silly. Another example of poor communication could be the physiotherapist encouraging the patient mobilize with minimal assistance and then a nurse taking the patient everywhere in a wheelchair.
Communication is essential for continuity of care (Squires, 1988). When multi-disciplinary teams work well together, they offer better treatment for patients and better quality of working life for the members of the care delivery team (Gorman, 1998). When I first participated in shift handover, I was very nervous, and although it did get easier, I still worried that I was not conveying enough relevant information to the oncoming shift. I need to learn to distinguish between which information is relevant and which is not, for the purposes of handover and care plans.
Gorman, P. (1998) Managing Multi-Disciplinary Teams in the NHS. London: Kogan Page Limited.
Squires, A.J. (1988) Rehabilitation of the Older Patient. A Handbook for the Multi-Disciplinary Team. London: Croom Helm Limited.