Principle of Personnalised Care

Introduction

Personalised care is referred to the nature of support where people are provided the ability to control and choose the way own care is to be delivered by participating in the planning process and mentioning way the care is to be provided. In this assignment, the episode of personal care of L is to be discussed and the importance of partnership working for care planning in relation to the case study is to be discussed. The way interpersonal and communication used by nurses in caring for the patient is to be identified. Moreover, the benefit and weakness of interpersonal working are to be described and way social entire support health of a person is to be discussed.

Summarisation of episode of care

The NMC Code of Practice informs that no personal data of the patients are to be shared in public without their prior permission and actions are to be taken to protect patient’s identity for ensuring their safety from any abuse of harm (NMC, 2018). Thus, the pseudonym L is to be used for indicating the patient in the explanation of the episode of care so as to maintain confidentiality. The episode of care regarding L mentions that she was accessing Mentalisation Based Therapy (MBT) after being diagnosed with borderline personality disorder (BPD) in 2014. However, it was found there was no progress in her health and she found MBT to be unsuitable to meet her intention. Thus, she wished to find alternative which is able to make her assist the way she can manage her difficulties regarding BPD (england.nhs.uk, 2019). .

L was fortunate to find that where she was living a trial for personal health budget that are offered to young people was are facing complex needs during transition from children to adult care services. The psychologist and a colleague of L who was the local health budget lead was found to identify the possibilities of personal health budget for L to help her manage her health needs. The inter-professional working along with participation of L made the health budget to be managed for her and through the budget L was allowed to work with a mentor and provided gym membership. This is because L mentioned that previously working with a mentor to develop routine and structure at work was helpful for her. L mentioned that from her experience she found that many people are not provided the support of health budget. This is because there was only one person present in her locality who was allowed to access health budget whereas many other needy individuals have no information regarding the concept (england.nhs.uk, 2019). . .

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Describing significance of partnership working between nurse and person in relation to

personalised care and planning

The partnership working in healthcare is referred to the involvement of two or more groups or individuals who work collaboratively to execute broad range of actions to achieve the common purpose of health and well-being of patients or service users (Baillie, 2016). As commented by Holding et al. (2019), partnership working between nurse and patient in personalised care is important as it leads to increase autonomy and ability of patients to make choices regarding their care. This is because through partnership the patients are able to aware the nurses regarding the essential care needs to be fulfilled that was otherwise ignored. In case of L, it was seen that her active partnership with the psychologist allowed L to mention that the Mentalisation Based Therapy (MBT) was not working for her and she wishes to opt for personal health budget to allow her independently control her BPD. As argued by Boyle, Thomas & Brooks ((2016), lack of partnership working leads to create hindrance towards accessing proper services for the patients in personalised care. This is because without compliance from partners the nurses are unable to take prompt actions to arrange required resources appropriately and comprehensively to support patient’s personal needs. It indicates partnership working in personal care is essential to create prompt care provision for the patients. This is evident as effective partnership between L’s psychologist and her colleague led them to properly arranger her personal health budget as wished by her within less time.

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In personalised care and support planning, the patients play a major role and the partnership working by the nurses with them is important to help the patient’s access care that is close to their homes (Cunningham et al. 2018). This is because during partnership the nurses are made aware by the patients about the possible services present in the area which are not yet known to the nurse allowing the nurses take appropriate actions to arrange care near homes of the patients. It is evident from case of L where she was seen to make her psychologist aware of personal health budget present in her who then assisted her with L’s colleague to ensure L is able to avail the services near her home. The care services are required to be present near the homes of the patients so that they can be avoided the hindrance of travelling in accessing services that make them irritable and spend additional money other than care for travelling raising their overall expenses (Chen, 2016). Thus, partnership working helped to establish convenient way of delivering personalised care to the patients.

The partnership working in personalised care is important as it helps to develop mutual relationship with participating members on the basis of trust, in turn, improving the quality of care service. This is evident from the case of L where her partnership with the psychologist and colleague who is lead of local personal budget plan for young people led to create a mutual relationship of trust. It made L belief that the personal health budget would be effectively provided and helpful for her to overcome BPD though it is not presently widely available for others in need in the locality. This, in turn, made L avoid stress and confusion regarding availability of personal health budget ensuring her well-being through the personalised partnered services. The partnership working in personalised care is essential as it leads the patients to have autonomy and opportunity to make shared care decision with the nurses regarding their care (Jørgensen et al. 2016). This is because in partnership discussion between the patients and nurses are organised to determine their preferred nature of care to be provided to ensure them satisfaction. It is evident as partnership working of L with her psychologist and colleague regarding personal healthcare budget helped her to mention how the expenses of the budget (gym membership and mentoring) are to be arranged for her to ensure better health.

Explaining the way the nurse is to use interpersonal and communication skill in caring for the person

In a person’s episode of care, the interpersonal skill to be used by the nurse is compassion. The compassion in nursing is to be established by the nurse through acting as an empathic person to properly understand needs of the patients and what they are going through as a result of the condition (Hofmeyer et al. 2016). This is because compassion from nurses helps the patients feel comfortable under their care as patients feel their pain is understood by the individual and accordingly appropriate care is to be provided to them. In case of L, the psychologist is to express compassion towards her by being attentive towards understanding how BPD is bothering her and the way MBT is not working to ensure other care to be provided for her well-being. As argued by Tierney, Bivins & Seers (2019), lack of compassion during episode of care makes the patients feel dissatisfactory care. This is because they feel their emotions and pain regarding the health issue is not valued by nurses and they are taken for granted to be offered support. As asserted by Nijboer & der Cingel Van (2019), compassion towards the patients is able to be shown by the nurses through effective communication. This is because through empathetic use of words and continuously asking preferred care as well as health condition of the patients to motivate them in accessing support makes the nurses show compassion towards them. In case of L, the psychologist is to continuously use empathetic communication with her to know her mental condition and probable services to be arranged to ensure her good health.

The attitude of the nurses which is interpersonal skill required to remain positive during episode of care. It is to be established by avoiding negative thoughts such as failure and frustration by the nurses when the patients misbehave with them or show lack of compliance to accept care (Gandhi & Dass, 2018). This is because positive attitude of the nurses makes them have self-confidence in delivering successful support to the patients in the end. However, negative attitude of failure to provide care makes nurses lose confidence in assuring patients to comply in care with them, in turn, making the nurses unable to foster optimism in the patients that is essential for boosting their easy and fast recovery (Saxena & Ukande, 2018). Thus, positive attitude by the psychologist such as patience and confidence is to be shown by the individual even after failing to deliver successful MBT for L to foster optimistic thoughts in the mind of L to hope to overcome BPD through other support such as personal health budget. According to NHS Code of Practice, effective problem-solving attitude as interpersonal skill is to be presented by the nurses in care episode by showing ability to quickly think and act to overcome any problem (NHS, 2018). This is because without overcoming the problem the nurses are unable to deliver fast-paced care environment for the patient to ensure their quick well-being. In case of L, the effective problem-solving attitude of the psychologist is to be expressed by taking early steps in fulfilling the personal health budget needs by ignoring the unsuccessfulness of MBT for L to ensure her speedy recovery from BPD.

According to NHS Code of Practice, active listening is one of the communication skills for effective nursing during episode of the care which is established by the nurses by being attentive to the information shared by the patient (NHS, 2018). The nurses ensure active listening in communication during episode of care by following SOLER model of communication according to which they sit squarely, maintain direct eye contact, present open posture, lean towards the patient to listen and have relaxed attitude (Moorley, Cathala & Corcoran, 2019). This is because the body language mentioned in SOLER model leads the nurses to show positive intention and attitude towards the patients that their needs and information are actively heard. However, lack of active listening by nurses in episode of care makes them unaware of the specific and vital needs of support as well as current health performance of the patients, in turn, making them deliver hindered and unsatisfactory care (Williams et al. 2018). In case of L, her psychologist is to actively listen to her needs in proper manner by following SOLER model so that her priority needs are understood and accordingly care can be developed. The interprofessional teamwork is to be established in episode of care for the person so that various experienced professionals from diverse field are able to assess the patient’s condition through their individual expertise to mention different prioritised support to be provided for their enhanced well-being (Li et al. 2018). Thus, in case of L, the psychologist is to involve interprofessional teamwork to assess essential needs of L that are then to be fulfilled through collaboration with the team to ensure quality well-being of the person.

Describing one advantage and disadvantage of interpersonal teamwork

The benefit of interprofessional teamwork in personalised care is that it helps to develop a comprehensive patient-centred care approach by the nurses by closing of communication gaps in care which in turn lower relapse and readmission rate of the patient’s health condition (Poghosyan, Norful & Martsolf, 2017). This is because interprofessional teamwork includes experts who collaboratively assess the patient's condition to analyse the best interventions for them, in turn, avoiding gaps in care communication created out of lack of expertise to analyse and inform patient's condition. The benefit of inerprofessional teamwork is evident from the episode of care of L with the involvement of the psychologist and the lead of personal health budget services. This is because the psychologist who has expertise in delivering psychological support therapy mentioned that the personal health budget is to be allocated for the person so that other care services according to her preference can be accessed as the psychological therapy has no effect on improving the person's BPD. It made the leads of personal health budget in the locality with the psychologist arrange proper services for L's health condition. .

The benefit of interprofessional teamwork in personalised care is that it helps to develop a comprehensive patient-centred care approach by the nurses by closing of communication gaps in care which in turn lower relapse and readmission rate of the patient’s health condition (Poghosyan, Norful & Martsolf, 2017). This is because interprofessional teamwork includes experts who collaboratively assess the patient's condition to analyse the best interventions for them, in turn, avoiding gaps in care communication created out of lack of expertise to analyse and inform patient's condition. The benefit of inerprofessional teamwork is evident from the episode of care of L with the involvement of the psychologist and the lead of personal health budget services. This is because the psychologist who has expertise in delivering psychological support therapy mentioned that the personal health budget is to be allocated for the person so that other care services according to her preference can be accessed as the psychological therapy has no effect on improving the person's BPD. It made the leads of personal health budget in the locality with the psychologist arrange proper services for L's health condition.

Describing the way social prescribing support health of person

The social prescribing is able to support improved health of the patients because they offer information to the patients based on their health condition regarding the varied choices present for them to be selected to avail improved support (nationalvoices.org.uk, 2018). This is because voluntary and social enterprises work with variety of locally rooted communities which offers varied services to control various health conditions. Thus, the use of social prescribing for L would offer her opportunity to make more refined choices of support to manager her borderline personality disorder (BPD) within less time and greater efficiency. The social prescribing allows the patients to access immediate peer support which is the initial step to help them determine what is required by the patients as opportunity to normalise their health condition (Tang, McBride & Potts, 2019). This is because the peers help the patients think and analyse to identify specific needs required to be fulfilled for improving their current health condition. Thus, it indicates that social prescribing would provide L peer support to allow access to early services and avoid delay in actual care as faced with MBT by initially assisting the person to identify that psychological therapy is not going to help her overcome BPD.

The social prescribing done through voluntary, community and social enterprise supports health of the patients by creating proper communication link between the service users and their clinicians. This provides opportunity for the patients to discuss and understand test results as well as health assessment before participating in the care and support communication planning (nationalvoices.org.uk, 2018). Thus, the social prescribing could have helped L to analyse her test results regarding BPD in more efficient manner before taking steps to determine the way the personal health budget to be used in supporting her care. The voluntary, community and social enterprise (VCSE) has the key role to review the health matters regarding an individual to determine what is going well and the things to be changed for better health condition of the patient (Briggs et al. 2020). This indicates that social prescribing for L would lead to review the current benefits and limitation of the care being offered to the individuals. This, in turn, would help professional supporting L to be aware regarding alteration to be made in current support practices for better health and well-being of the person through satisfactory services.

The social prescribing done through voluntary, community and social enterprise supports health of the patients by creating proper communication link between the service users and their clinicians. This provides opportunity for the patients to discuss and understand test results as well as health assessment before participating in the care and support communication planning (nationalvoices.org.uk, 2018). Thus, the social prescribing could have helped L to analyse her test results regarding BPD in more efficient manner before taking steps to determine the way the personal health budget to be used in supporting her care. The voluntary, community and social enterprise (VCSE) has the key role to review the health matters regarding an individual to determine what is going well and the things to be changed for better health condition of the patient (Briggs et al. 2020). This indicates that social prescribing for L would lead to review the current benefits and limitation of the care being offered to the individuals. This, in turn, would help professional supporting L to be aware regarding alteration to be made in current support practices for better health and well-being of the person through satisfactory services. .

For the present case, the physician conducted the tests for Urine albumin: creatinine ratio, Total cholesterol, AST, ALT and Alkaline phosphatase.

Conclusion

The above discussion informs that L is suffering from borderline personality disorder (BPD) and after one year of unsuccessful Mentalisation-based Therapy (MBT) has currently opted for personal health budget to avail gym services and working with a mentor to overcome the health issue. The partnership working in case of L has helped her to avail autonomy and ability to make choice regarding care, mention her needs to psychiatrist for avoiding MBT, avail care close to home and others. The nurses are to maintain active listening attitude in communication with L by following SOLER model. Moreover, nurses are to be empathetic to show compassion, patient to show positive attitude and others toward the patient L to ensure her better care. The social prescribing supports health of patients and their families by ensuring their access to proper resources of care and developing confidence among the family and patients about the success of the chosen care. .

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