Emergency Room Nurse Collaborative Care

Emergency Room Nurse

Collaborative care is the collaboration of a range of health service providers, other caregivers, the patients as well as their families and the community. "The essence of collaboration, in Dr. Perrin's view, is having a shared goal through different skills. The goal is optimal development, encompassing social, emotional, cognitive and physical domains" (Henry L. Shapiro). It is being highly accepted and recognized world wide as it supports the patients across a wide spectrum of health related needs. It has also proved itself to be cost efficient especially in cases dealing with depression.

COLLABORATIVE CARE

Collaborative care is provided in a wide range of situations. One such situation is for patients with persistent depression. A study was conducted by a group of doctors where patients suffering from depression were put under primary care. When the period of primary care was over there was an assessment of these patients and of those who were suffering from persistent depression some were put under collaborative care while others were continuing usual care. It was observed that patients who were put under collaborative care "experienced a mean of 16.7 additional depression-free days over 6 months." It was also assessed that the mean progressive cost of the treatment of depression through collaborative care cost $357 (Gregory E. Simon et al.).

In the field of pediatric psychology, collaborative care is used and preferred as compared to individual treatment from pediatric psychologists as their experience is not mature enough as far as early stage problems that are diagnosed in the field of pediatric psychology. Hence the collaboration includes pediatricians, psychologists and psychiatrists who work together to cause effective management and treatment.

Collaborative care has been used in the field of psychiatry for treatment of depression for a very long time. Patients would often consult people who were not doctors like marriage counselors, social workers and then these people in turn would refer them to a psychiatrist. "These referrals would often give rise to collaborative treatment relationships" (Anonymous).

A practical use of intensive collaborative care is seen in the recent Katrina tragedy that the United States witnessed. Patients were being transferred from Kelly Air Force Base to the ER without even being fed due to lack of appropriate services. In addition to this the patients were exhausted and some did not even have shoes or appropriate clothing. The hospital staff started collaborating with the food services advising them to arrange lunch boxes for the starving patients. The staff provided the people, suffered by the hurricane, with articles like soaps, shampoos, combs. Further bathing services were provided for these in the ER. The laundry services were advised to provide these people with some sort of clothing even if it were scrubs. Social workers put in their efforts by assisting the staff in obtaining vouchers for them to call in the medications for those patients who were discharged from the ER. Further vouchers for cab services were also required to bring in the medications from the pharmacy and taking the people back to Kelly Air Force Base. This was because of the lack of the availability of ambulances that were busy in bringing patients to the ER. Only those patients that would not have been able to receive appropriate care in the hangers set up for the victims were being admitted and the rest were discharged after their treatment and prescriptions. There are adults, women, children and orphans at ER and the ER staff has shown a remarkable piece of collaborative care with services like laundry, cab, social workers, pharmacists and housekeeping. Every single person is adding in to the collective effort to ensure that maximum people benefit with appropriate healthcare.

Differentiate between Nursing Diagnoses and Collaborative Problems.

Nursing diagnosis "is an actual or potential health problem that focuses upon the human response of an individual or group that nurses are responsible and accountable for identifying and treating independently" (Anonymous). Nursing diagnosis is to facilitate individualized care, continuity of care and to make available an efficient means of communication and flow of information among health care professionals.

There are different types of nursing diagnosis. A risk diagnosis is the identification of a health problem that a patient is at risk of acquiring. Another statement regarding the health problem of a patient is the possible diagnosis which tends to declare about a problem that the patient most probably has. Although due to lack of information an accurate diagnosis is not possible. Further on there is an actual diagnosis is the diagnosis of a health problem that the patient has and nursing care can be beneficial for the patient. Moreover a syndrome diagnosis and a wellness diagnosis is when multiple nursing diagnoses are observed and to describe the characteristic of the patient when at a high state of wellness respectively (Wikipedia).

Collaborative problem on the other hand "is an actual or potential health problem (complication) that focuses upon the pathophysiologic response of the body (to trauma, disease, diagnostic studies, or treatment modalities), and that nurses are responsible and accountable to identify and treat in collaboration with the physician" (Anonymous).

Hence it should be noted that collaborative problem is where the identification and treatment is not done by nurses independently and is a collaborative effort whereas nursing diagnosis is where the nurses identify and treat the health problem independently without any collaboration.

Potential Barriers to Successful Collaboration