Nursing and Health Care Essay Example for Free

Nursing and Health Care Essay 1. In 1200 B.C., the ill were treated with a mixture of physical, prayer, and magic spells. Temples were health centers. From the 1st-10th century initial care was at the local bishop’s house. They had deacons and deaconesses. In the 19th century, nurses cared for patients while at the risk of exposure to disease. Nursing in hospitals expanded in the 19th century, but nursing the communities did not increase significantly until 1893 when the Henry Street Settlement opened and focused on the health needs of poor people who lived in tenements in New York City. 2. 3. Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, communities, and populations. 4. She saw the role of nursing as having â€Å"charge of somebody’s health† based on the knowledge of â€Å"how to put the body in such a state to be free of disease or to recover from disease.† She was the first nurse epidemiologist who connected poor sanitation with cholera and dysentery. 5. There were no standards to help control disease. Nursing was not a distinct profession. 6. Florence Nightingale-implemented methods to improve battlefield sanitation, which ultimately reduced illness, infection, and mortality. Clara Barton- 1st woman to gain employment in the federal government and is the founder of the American Red Cross and tended to soldiers on the battlefield, cleansing their wounds, meeting their basic needs and comforting them in death. Dorothea Lynde Dix-School teacher, founded schools, advocate for the mentally ill, formed an army nursing corps, and organized hospitals and ambulatory services. Mary Eliza Mahoney- 1st African-American RN in the USA, concerned with relationships between cultures and races, Cofounder of The National Association of Colored People. Isabel Hampton Robb- founder of modern ANA and American nursing theory, established nursing standards, develop a grading policy, author of nursing textbooks. Lillian Wald and Mary Brewster opened the Henry Street Settlement. 7. Theories are designed to explain a phenomenon such as self-care or caring. A nursing theory is a conceptualization of some aspect of nursing that describes, explains, predicts, or prescribes nursing. It helps to identify the focus, means, and goals of practice. Theories give us perspective for assessing our patients’ situations and organizing data and methods for analyzing and interpreting information. Integration of theory into practice is the basis for professional nursing. PROFESSIONALISM 1. Caring, Competence, Collaboration, Critical thinking, Commitment to Holistic care, Integrity, Responsibility, and Accountability. 2. A profession requires a basic liberal foundation and an extended education of its members, it has a theoretical body of knowledge leading to defined skills, abilities, and norms, it provides a specific service, members of a profession have autonomy in decision making and practice, and the profession as a whole has a code of ethics for practice. 3. LPN Associate Degree in Nursing (ADN)- 2 year program that focuses on the basic sciences and theoretical and clinical courses related to the practice of nursing. Bachelor of Science in Nursing (BSN)- 4 year programs that focuses on the basic sciences; theoretical and clinical courses; and courses in the social sciences, arts, and humanities to support the nursing theory Master’s Degree- is important for the roles of a nurse educator and nurse administrator, and it is required for an advanced practice registered nurse Doctoral * Doctor of Philosophy (PhD)- Emphasize more basic research and theory and research-oriented * Doctor of Nursing Practice (DNP)- practice-focused and provides skills in obtaining expanded knowledge through the formulation and interpretations of evidence-based practice 4. Caregiver- help patients maintain and regain health, manage disease and symptoms, and attain a maximal level function and independence through the healing process. Advocate- protect your patient’s human and legal rights and provide assistance in asserting these rights if the need arises. Educator- explain concepts and facts about health, describe the reason for routine care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient’s progress in learning. Communicator- it allows you to know your patients’ strengths, weaknesses, and their needs. Without it you cannot give comfort and emotional support, make decisions with patients and families, give care effectively, protect patients from threats to well-being, coordinate and manage patient care, assist in patient rehabilitation, or provide patient education. Manager- uses appropriate leadership styles to create a nursing environment for the patients and staff that reflect the mission and values of the health care organization. 5. Licensure- Must pass NCLEX to receive license. This provides a standard minimized knowledge base for nurses. 6. Certified by national nursing organizations in about 20 specific areas of nursing practice. After passing an exam, maintain certification by completing CEU’s. 7. According to Benner, an expert nurse passes through five levels of proficiency when acquiring and developing generalist or specialized nursing skills. Novice-beginning nursing student learns via a specific set of rules or procedures. Advanced Beginner-Nurse has had some level of experience, may be observational, but is able to identify meaningful aspects or principles of nursing care. Competent- establish long-range goals, and has been in the same position for 2-3 years with an understanding of organization and specific care required by the type of patient. Proficient- Same clinical position for 2-3 years, focuses on managing care, and is able to assess an entire situation and can readily transfer knowledge gained from multiple previous experiences to a situation. Expert-can focus on multiple dimensions of a situation and has an intuitive grasp of an existing or potential clinical problem. Skilled at identifying patient-centered problems and problems related to the health care sys tem. 8. 9. Advanced Practice Nurse-most independent nurse, has master’s degree in nursing; advanced education in pathophysiology, pharmacology, and physical assessment; and certification and expertise in a specialized area of practice-clinical nurse specialist, certified nurse practitioner, certified nurse midwife, and certified RN anesthetist. Nurse Educator-works primarily in schools of nursing, staff development department of health care agencies, and patient education departments. Must have experience in clinical practice to provide them with practical skills and theoretical knowledge. Nurse Administrator- manages patient care and the delivery of specific nursing services within a health care agency. Examples: assistant nurse manager, nurse manager, house supervisor, director of nursing, and chief nurse executive or vice president. Nurse Researcher- investigates problems to improve nursing care and further define and expand the scope of nursing practice. 10. National League for Nursing-advances excellence in nursing education to prepare nurses to meet the needs of a diverse population in a changing health care environment. American Nurses Association- improves standards of health and availability of health care, to foster high standards for nursing, and to promote the professional development and general and economic welfare of nurses. International Council of Nursing- promote national associations of nurses, improving standards of nursing practice, seeking higher status for nurses, and providing an international power base for nurses. National Student Nurses Association/ Student Nurse Association of PA- consider issues of importance to nursing students such as career development and preparation for licensing. Specialty Organizations- seek to improve the standards of practice, expand nursing roles, and foster the welfare of nurses within specialty areas. Publish journals and present educational programs. 11. 12. Problem-solving approach to clinical practice that involves the conscientious use of current best evidence, along with clinical expertise and patient preferences and values in making decisions about patient care. 13. Ask a clinical question that is problem focused. Collect the most relevant and best evidence. Critically appraise the evidence you gather. Integrate all evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change. Evaluate the practice decision or change. Share knowledge. LEGAL ISSUES IN NURSING PRACTICE 1. Statutory Law- written by state legislature and U.S. Congress-may be a civil or criminal offense. Civil laws protect the rights of individuals within our society and provide for fair and equitable treatment when civil wrongs or violations occur. Fines or community service and examples are malpractice or negligence. Criminal laws protect society as a whole and provide punishment for crimes, which are defined as municipal, state, and federal legislation-felony or misdemeanor. Administrative Law (Regulatory Law)-reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations. Common Law-results from judicial decision made in courts when individual legal cases are decided-informed consent, patients right to refuse treatment, negligence, and malpractice. 2. Federal laws- body of laws that were created by the federal government of the country. Emergency Medical Treatment and Active Labor Law (EMTALA)- when patient comes to emergency department an appropriate medical screening occurs within the capacity of the hospital- cannot discharge or transfer patient until they are stable. The Health Care Quality Improvement Act of 1986. Patient Bill of Right- became patient care partnership given out to patients. The Americans with Disabilities Act (ADA)- prohibits discrimination and ensures for persons with disabilities equal opportunities in employment, state and local government services, public accommodations, commercial facilities, and transportation. People with HIV do not have to disclose their disability. Patient Self-Determination Act (PSDA)-requires health care institutions to provide written information to patients concerning their right under state law to make decisions including the right to refuse treatment and formulate advance directives. Patients records need to document whether or not the patient has signed an advance directive. For living wills or durable powers of attorney for health care to be enforceable, the patient must be legally incompetent or lack to the capacity to make decisions regarding health care treatment. Health Insurance Portability and Accountability Act (HIPAA)-protects individu als from losing their health care insurance when changing jobs by providing portability. These rules create patient rights to consent to the use and disclosure of their protected health information, to inspect and copy one’s medical record, and to amend mistaken or incomplete information. State Laws-Mandatory Reporting Laws-communicable diseases, school immunizations, suspected neglect and abuse, legal immunity provided to the reporter, may face civil or criminal action if nor reported. Good Samaritan Laws-limit liability and offer legal immunity if a nurse helps at the scene of an accident. Nurse Practice Act- describe and define the legal boundaries of nursing practice within each state. Scope of Practice-perform a procedure in which you have training for, distinguishes between nursing and malpractice. 3. RN-licensed and educated in nursing process and critical thinking; responsible for who you delegate to. LPN- licensed but does not cover assessment of patient. Can collect data but must give to nurse. NA/PCT- not licensed 4. Standards of care are set by ANA and are the legal requirements for nursing practice that describe the minimum acceptable nursing care. Nurse practice act defines scope of nursing practice, distinguishing between nursing and medical practice and establishing education and licensure requirements for nurses. Internal-Standards defined within hospital. External- developed by ANA and TJC-accredited body of the hospital-health department. 5. Established to help accredited organizations address specific areas of concern in regards to patient safety. Identify patients correctly. Improve staff communication. Use medicines safely. Prevent infection. Identify patient safety risks. Prevent mistakes in surgery. 6. Advance directive include living wills, health care proxies, and durable powers of attorney for health care. They are based on values of informed consent, patient autonomy over end-of-life decisions, truth telling, and control over the dying process. 7. Living wills represent written documents that direct treatment in accordance with a patient’s wishes in the event of a terminal illness or condition. The patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a vegetative state. Durable Power of Attorney for health care is a legal document that designates a person or persons of one’s choosing to make health care decisions when the patient is no lo nger able to make decisions on his or her own behalf. 8. 9. 10. Negligence is conduct that falls below a standard of care. Courts define negligence cases as the degree of care that an ordinarily careful and prudent person would use under the same or similar circumstances. 11. Malpractice is a type of negligence and is often referred to as professional negligence. When nursing care falls below a standard of care, nursing malpractice occurs. 12. Assault- any action that places a person in apprehension of a harmful or offensive contact without consent. Battery-any intentional touching without consent. False Imprisonment-unjustified restraint of a person without legal warrant and requires the patient be aware of confinement. Defamation of Character- publication of false statements that result in damage to a persons’ reputation. Invasion of Privacy- the release of a patient’s medical information to an unauthorized person such as a member of the press, the patient’s employer, or the patient’s family. Breach of Confidenti ality-

How Romance Is Celebrated In Literature :: essays research papers

The course of time has opened many doors in terms of romance. The present age not only consists many different forms in which love can be expressed, but exhibits the essence of romance that dates back to the dawn of time. Love has existed in many forms throughout time. There is no better example than in William Shakespeare's Romeo and Juliet. In this tale, when love is most apparent, the most crucial events occur to develop this "tragedy." Firstly, the lustful romance of Mercutio and Benvolio, Romeo’s comrades have never been in true love, their ideas of love is based merely on physical attributes, whereas ‘love is skin deep’.Mercutio, in contrast with Romeo knows not of true love, as "He jests at scars that never felt a wound." (II.ii.1) His idea of love is when he tries to "conjure" Romeo to respond. His childish, immature attitude towards love is expressed when he describes Rosaline’s features:"Her high forehead" and "quivering thigh"(II.ii.18-19). This lustful idea of romance is only emphasised when he describes Rosaline as "An open-arse and thou a poperin pear!"Rosaline, Romeo’s initial unrequited love seemed irrelevant once Romeo had set his eyes upon Juliet. This may portray a side of Romeo, which shows that as easily as he falls ‘in’ love, he can fall ‘out’ of love. However, Romeo and Juliet’s love was pure and ideal, and because of their forbidden love, it leads them to their graves. Upon seeing Juliet all alone, talking in soliloquy, Romeo proclaims, "It is the east, and Juliet is the Sun," this metaphor enhances Juliet’s beauty as it is exaggerated and pronounced as the beauty of the sun. The forbidden love of Romeo and Juliet is spawned from the feud between the two households; Capulet and Montague and throughout Juliet’s ‘supposed’ soliloquy, she ponders over the prospect of the two families’ names: "What’s in a n ame?" (II.ii.43)Upon hearing this, Romeo, who reciprocates the romance, replies belligerently "Had I it written, I would tear the word." (II.ii.57)Convinced that their love was pure, Juliet has been sold, in an unconventional act for a woman in those times, she takes the initiative and plans their future together;"If that thy bent of love be honourable,Thy purpose of marriage" (II.ii.143-144)Leading to the departure of Romeo and Juliet from the balcony scene, Shakespeare has made use of juxtaposition when Juliet sullenly states, "Parting is such sweet sorrow" (II.

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A single tube of cerebration's fluid is received In the laboratory and the following tests requested: total protein, albumin, Gig quantization, microbial culture, Gram stain, leukocyte count and differential cell count. The specimen should be sent to the various laboratories in which order? A. Chemistry lab, homology lab, microbiology lab b. Homology lab, chemistry lab, microbiology lab c. Microbiology lab, homology lab, chemistry lab d. Homology lab, microbiology lab, chemistry lab 3. You need to prepare a 1 TTT (1 :4 or h) dilution off serum specimen using saline before analysis.Which of the following petting steps would result in this dilution? A. Pipette 0. 5 ml serum, then add 1. 0 ml saline b. Pipette 1. 0 ml serum, then add 2. 0 ml saline c. Pipette 1. 5 ml serum, then add 4. 5 ml saline d. Pipette 2. 0 ml serum, then add 5. 0 ml saline 4. The major components of a spectrophotometer are represented in the following diagram. Which component determines the factor â€Å"b† in Beer's law, A=BBC? A. Component A b. Component B c. Component C d. Component D At pH of 7. 4, which of the enzymes listed catalysts the following reaction? 5. Private + NADIA a. Lactate oxides b. Lactate dehydrogenate .Private kinas lactate * AND pH 8. 6 is used for serum protein electrophoresis so that 6. A. All serum proteins will have a net negative charge b. All serum proteins will have a net positive charge c. Electromagnetisms is avoided d. Heat production is minimized Seasonality measurements determine the 7. A. Activity of ions per kilogram of solvent b. Grams of dissolved solutes per kilogram of solvent c. Moles of dissolved solutes per kilogram of solvent d. Equivalents of dissolved solutes per kilogram of solvent Which of the following formulas can be used to calculate serum seasonality? 8. A. 2. 5 x An+ .An+ +K+ +CIA- +CO content c. (1. 86 x An+) + (1/18 x glucose) + (112. 8 x BUN) +9 (An+ + K+) -? (CLC- + HCI) 11. A serum sample is diluted 1 to 3 (1:3) before analys is and the following results obtained: Total protein – 4. 1 g/del Albumin- 1. 5 g/del Which total protein concentration should be reported? A. 4. 1 g/del b. 8. 2 g/del c. 12. 3 g/del d. 16. 4 g/del 16. Review the following serum test results: Creating 2. 5 MGM/del (0. 75- 1. 5 MGM/del) Cholesterol 220 MGM/del 126 MGM/del b. A serum glucose 200 MGM/del at anytime 38. If OLD receptors are non-functional due to disease, the plasma level of which lipid loud increase the most? . Fatty acids b. Cholesterol c. Cholesterol esters d. Triglycerides 39. Which of the following serum protein electrophoresis patterns is most typical of the nephritic syndrome? Albumin alpha alphas b. Normal d. Normal beta gamma 40. Which analyze is most likely to be elevated in a specimen drawn 2 hours after an uncomplicated myocardial infarction? A. KC- MBA (KC-2) b. Mycologist c. Titration I d. Titration T 41. Which of the following serum results correlates best with the rapid cell turnover associated wit h chemotherapy treatment regimens? A. Creating of 2. 5 MGM/del b. Potassium of 5. Mol/L c.Urea nitrogen of 30 MGM/del d. Uric acid of 10. 0 MGM/del 42. Which set of serum electrolyte results (in Mol/L) is most likely obtain from serum with an elevated lactate level? An+ a. 125 4. 5 b. 135 3. 5 c. 1454. 0 HCI 10 95 28 90 15 43. The following arterial blood gas results are obtained: PH 7. 28 APPC 53 meg POP 75 meg 26 Mol/L HCI- These results correlate best with patient experiencing a. Metabolic acidosis b. Metabolic alkaloids c. Respiratory acidosis d. Respiratory alkaloids 44. The patient with intermittent hypertension has an elevated value for urinary catecholamine metabolites (e. G. Malignancies acid [VIM]). This result may indicate a. Hyperventilation's b. Hyperthyroidism c. Idiopathic hypertension d. Phosphorescently 45. Blood from newborn has low thyroxin (TO) and elevated thyroid – stimulating – hormone (TTS) compared to reference ranges for that age. These result s are most consistent with a. Congenital hypothermia's b. Congenital primary hypothyroidism c. Congenital secondary hypothyroidism d. A normal response to pregnancy – induced changes in maternal thyroid function 47. The following results are obtained from a patient whose admission diagnosis is billiard obstruction TestResult Conjugated blurring increased Serum: Total blurring Blurring Urine: increased positive Which of the results obtained is inconsistent with the admission diagnosis? A. Serum conjugated blurring b. Serum total blurring c. Urinary blurring d. Urinary rebilling 49. Which of the following enzymes provides the best indication of obstructive liver disease, I. E. , schoolmates? A. Amylase b. Alkaline phosphate c. Separate nontransferable d. Lactate dehydrogenate 50. In a cerebration's fluid (SF) sample, which of the following proteins is quantitative to assess the permeability of the blood/brain barrier .Albumin b. Gig c. Transferring d. Preferable 51. The followi ng urinalysis are obtained: Glucose by reagent strip: negative Stones by reagent strip: positive These results are most consistent with a. Starvation b. Polynesia c. Diabetes mellitus d. Diabetes insipid 52. A patient with Type l, IDEM has the following results VBG Patient 1 50 MGM/del Ref Range 70- 110 MGM/del FSP 2. 6 Mol/L 2 – 2. 9 Mol/L 53. The patient has the following thyroid profile TTT: decreased OFT: decreased Thyroid peroxides anybody: positive TTS: decreased This patient most probably has a. Hyperthyroidism b. Hypothyroidism .A normal thyroid d. Grave's disease 53. Choose the diagnosis most consistent with the following: Serum total bill: elevated Serum direct bill: O MGM/del Serum indirect bill: elevated Urine blurring: negative Rebilling: decreased a. UDP – GET deficiency b. Posthypnotic bile obstruction c. Dublin Johnson syndrome d. Intramuscular hemolytic 5. When is a blood sample for determination of the trough level off drug proportionately drawn? A. D uring the absorption phase of the drug b. During the distribution phase of the drug c. Shortly before the drug administration d. Two hours after the administrationWhich of the following is used in the treatment of manic depression b. Lithium c. Calcium d. Chloride Which of the following is a commonly encountered xanthium that could potentially interfere with the determination of Diophantine? A. Nicotine b. Caffeine c. Amphetamine d. Proclaimed Which of the following drugs is used as an instrumentation in organ transplantation, especially in liver transplants? A. Metamorphose b. Emendation c. Cloistering d. Parenting Free drug levels can generally be determined by analyzing what body fluid? 9. A. Whole blood b. Illiterate of the plasma c. Urine .OFF of plasma 10. For what colorimetric reaction is the Trainer's reaction widely used? A. Acetaminophen b. Proponent c. Silicates d. Barbiturates 11. Anticoagulants whole blood is the preferred specimen in determining the exposure to what co mpound? A. Methanol b. Mercury d. Carbon monoxide 12. Free erythrocyte proprietorship (FEE) levels are useful as a screening method to which of the following metals? A. Zinc b. Lead c. Iron d. Mercury 13. Of the following specimens, which would be appropriate for determining the exposure to lead? A. DEED plasma b. Serum c. Whole blood d. SF 14.Identification of the urinary metabolite bioengineering would be useful in determining exposure to which of the following drugs? A. Codeine b. Cocaine c. Amphetamines d. Proponent 15. TECH is the principal active component of what drug? A. Benedictine b. Marijuana c. Morphine d. Codeine 17. When screening urine for toxic substances, which of the following will not be identified be Irenics Test? A. Bismuth b. Arsenic d. Cyanide 18. Which of the following tests would be particularly useful in determining sopranos exposure? A. Serum seasonality and urine acetone b. Urine seasonality and serum seasonality .Urine acetone and urine seasonality d. Se rum sodium and serum acetone 19. Which of the following methods would yield reliable quantification of ethanol in the presence of sopranos a. Reaction with permanganate and chronometric acid b. Conway diffusion followed by dichloride c. Alcohol dehydrogenate reaction d. Gas – liquid chromatography 20. Levels of 8 – 9% chronologically saturation of whole blood are commonly found in which of the following situations? A. Fatal carbon monoxide poisoning b. Acute carbon monoxide poisoning c. Non – smoking residents of rural areas d. Cigarette smokers

Why Is Interprofessional Working Important To Nursing Practice - Free Essay Example

Sample details Pages: 8 Words: 2543 Downloads: 6 Date added: 2017/06/26 Category Medicine Essay Type Analytical essay Level High school Did you like this example? Inter-professional working is constantly promoted to professionals within the health and social care sector. Various terms such as interdisciplinary, multidisciplinary and interagency collaboration working have been used to promote professionals to work together with the patient, carers, relations, services and other professionals (SCIE, 2009). This Paper will explore the importance of inter-professional working in nursing practice, due to nurses supporting and treating a variety of patients. Don’t waste time! Our writers will create an original "Why Is Interprofessional Working Important To Nursing Practice" essay for you Create order This paper will discuss the general importance of inter-professionalism as part of good nursing practice, it will use examples of adult stroke patients and children who have cerebral palsy. These two conditions have been chosen because they allow the paper to explore two different age groups and the needs of patients who tend to have complex social and healthcare needs. There is also a wealth of literature available on these conditions which helps highlight the need for nurses to work effectively with other health and social care professionals, service providers and carers. Patients initially tend to see nurses either alone on arrival at accident and emergency departments, or in conjunction with a medical practitioner. Therefore, the duration of time that a nurse spends with a patient tends to be longer than most other health/medical professionals (Godfrey, 2012). Ward nurses who work on hospital wards, provide care and support to admitted patients throughout their whole stay. Thi s length of time spent with the patients allow them to be familiar with the patient, hence allowing them to recognise changes in a patients health and also to identify any new needs. Often, patients need to see more than one health/medical professional in their stay at the hospital, due to their health needs. Despite these professionals possessing specialist skills to support or treat specific health concerns that the patient may have, often the health recommendations that are given to the patient need to be performed routinely even when the patient is not in the presence of this specialist. Therefore, allied health professionals tend to advise, seek the support of, or hand specific recommendations over to nurses. This is often seen between nurses and physiotherapists in mobility recommendations, this is because nurses often have to mobilise a patient out of hours as recommended by the physiotherapist (Godfrey, 2012). This avoids the patient having to wait for a physiotherapist on w eekends, or to become frustrated due to being in one position for long periods of time and it also supports the overall hospital service aim of better patient outcomes. Similarly patients with complex physical issues, minimal mobility or neurological complications, such as stroke patients, need to be regularly moved to avoid pressure ulcers developing. In addition to this, regaining mobility gradually is often part of a patients stroke rehabilitation programme. Clear guidelines and training are given, as recommended by NICE, to nurses to perform safe moving and handling techniques on patients. These guidelines advise 2-3 trained professionals to move a patient who is bed bound, depending on the patients movement ability and weight (Jacob et al, 2007). If this is a stroke patient this needs to be done on recommendation of a physiotherapist (RCP, 2012). Therefore, it is important for nurses to communicate effectively with other health and social care professionals when moving and h andling a patient who may have complex needs, as nurses may need specialist recommendations by the physiotherapist, or the patient may have medical equipment attached to them which needs to be handled carefully or removed temporarily. Safe moving and handling techniques as part of a team effort not only promotes good health and social care practice, it also decreases the risk of injury to a nurse. This is particularly important as moving and handling injuries have been the most common causes of staff absence for a period of 3 days and longer between the years of 2007 and 2013 (Anderson, 2014). A key feature of hospital care is information sharing through ward rounds done by doctors and other health professionals. The aim of this is to provide patient care which can be delivered in a timely manner, but it also allows the multidisciplinary team involved with the patient to plan their future care and treatments. Nurses input via reporting to colleagues their judgement and observatio ns on the patients current health state is not only vital for better care planning in the future, but it is also important because nurses can often voice the preferences that patients have expressed to them, hence promoting the principle of patient centred care (RCP and RCN, 2012). Furthermore, due to the direct care ward nurses give on their shift throughout the day to allocated patients, they often recognise the general deterioration of a patients health and wellbeing before other health professionals and doctors. Therefore, it is extremely important for the safety and well-being of patients for nurses to liaise with doctors regularly to manage the change of symptoms as soon as possible. Even though patient care planning is revisited and documented regularly by health and medical professionals when changes are needed for the patient, formal multidisciplinary meetings allow improved outcomes for the patient, an example of an improved outcome is when Stroke Early Discharge Suppor t Teams can discharge patients earlier, allowing them to more likely be independent sooner in their daily tasks (Clarke, 2013). The multi-disciplinary team who has contributed to this evidence has consisted of specialist medical practitioners, various speciality therapists, dietitian, a care manager, nurses and sometimes a social worker. Nurses, due to possessing past history medical notes and the knowledge of relations who visit the patient, can usually provide the occupational therapist and the allocated social worker with information on key relations of the patient that maybe useful to contact prior to discharge. Also, nurses through conversation can gather information on the patients living situation at home. This is paramount in discharge planning for stroke patients as sometimes they are unable to communicate fully and clearly their living environment at home, as stroke can impact an individuals ability to communicate verbally and physically. Also, if patients have few or no r elations living with them, they may need home care via nursing staff or telecare equipment which can support risks of injury or allow individuals to alert emergency care services via sensory equipment when they have a fall or another stroke which results them to fall. Even though occupational therapists will do assessments of the environment which the patient resides in (EKUHFT, 2015), nurses can often give the therapist insight on any issue the patient has had in their stay at the hospital, an example of this may be that the patient has difficulty lowering themselves to sit on the toilet, the occupational therapist would usually request for a grab/hand rail to be fitted in the patients home to support them to do this action. Patient care planning via inter-professional working is also fundamental to children who have been born with Cerebral Palsy. Nurses with specialist roles such as Health visitors, provide a community based service to cerebral palsy patients and their families . This differs to the role of nurses on the ward as Health visitors review the health of the patient in reference to their living environment and public health needs, hence allowing them to identify the wider health needs of the family too (Alexander, 2014).. Due to cerebral palsy being a non-curable condition the child and the family/carers of the child will regularly receive treatments and support from an extended network of health and social care professionals and also educational specialists and support staff (NHS, 2014). Therefore, health visitors need to be able to create successful inter-professional relations with professionals who are external to the health and social care industry such as educational psychologists, by understanding the role and service that the professional is providing to the patient. It is also vital to understand roles due to the referral systems we have in the United Kingdom, both within hospital and community care. Furthermore, policies can differ bet ween the local authority, the NHS and private healthcare providers and the child and his/her family may have chosen to have a specific care package which the health visitor may not be aware of (Know your rights, 2015; NHS, 2013). Also, Health visitors often need to liaise with professionals who are not employed by the NHS or another private healthcare provider but by a local authority instead. This can mean the caseload is allocated differently, waiting times may differ and methods of referral may differ too. Therefore, to ensure that the patients transition is efficient and positive from immediate hospital care to accessing community based services, nurses need to be aware of the basic structure and logistics of other services. This awareness needs to be raised more specifically in the working environment for younger student nurses or graduate nurses who may not know the difference between certain professional roles, as despite accredited nursing programmes having modules or les sons in multidisciplinary practice covering the importance of knowing the roles of other health and social care professionals, sometimes there is confusion between specialists who support patients or service users with the same condition(s). A classic misunderstanding is a student nurse struggling to understand the difference between a mental health social worker and a mental health nurse, who can both work for community based teams and may be employed by the local authority (The Masked AMHP, 2012). The administration of medication is another role that nurses carry out in health and social care settings. The administration or preparation of medication is usually done by using the skills learnt from their training, instructions from the pharmacist or manufacturer guidelines. However, human error in the administration or preparation or omission of the medication can put the patient at risk of poor health or even death (NICE, 2014). Hospital pharmacists and dispensing staff function in a fast paced environment, hence processing prescriptions for medications that are needed for patients on the ward who vary in conditions. Some medications are needed urgently and human error can occur on the behalf of pharmacist or dispensing staff. Despite pharmacy staff recording clinical errors as part of their good clinical practise, nurses also need to be aware of these errors for the patients safety and awareness also needs to be raised to other nursing colleagues of the issue because the patients health may need to be checked regularly. . Furthermore, as doctors complete prescriptions for the request of medications, nursing staff only follow the patients drug chart in administrating the medication, hence it is vital for the nurse to understand what the doctor is prescribing the medication for (UHS, 2015). This is important to know as the nurse may observe patient changes after the patient has had the medication, which need to be recorded. To avoid error and to justify the ir clinical actions in medical administration of drugs, nurses need to be able to follow the advice and instructions of both the doctor and pharmacist, therefore effective and open communication allows questions to be asked and concerns to be raised, hence creating a strong working relationship. This protects not only the patient but it also improves working relationships between medical and nursing staff. Also, nursing staff and doctors caring and treating patients with cerebral palsy have to work using a comprehensive rehabilitation approach, which includes working alongside physiatrists who manage anti-spasticity medication and review medical complications associated with cerebral palsy. Hence, nursing staff need to have a broad understanding of the specialisms of the medical practitioners that they are liaising with, as often nursing staff liaise with several different specialists. To conclude, inter-professional working is clearly important for all health and social care sta ff, however it is extremely important for nursing staff because their varied role requires them to liaise with different professionals, settings and patients. Also, as nurses can now undertake CPD to specialise in areas such as such as stroke, diabetes, palliative care and disability, their role has changed from providing traditional nursing through practical care to now being able to provide specialist advice to the patient and relations on the management of the condition. (Niece McEwen, 2015). For nurses to be successful in their specialist roles they need to create positive working relationships with other health/medical staff, non-clinical professionals, carers/families and most importantly the patient. Furthermore, due to the demand of nurses in non-clinical settings such as homes and schools, for nurses to practice effectively they need to be able to understand the roles of professionals practicing in community settings as often these professionals can provide the nurse with how the patient functions in their daily life. Due to ward nurses providing care throughout their shift, usually to the same patients, the greater length of time with the patient allows them to have a better insight to the patient and their health whilst in care of that ward. This allows them to feed back to fellow nurses and other health/medical professionals any changes that need to be made to the patients care plans. It seems not only is patient care improved by inter-professional working but also the skills and knowledge of nursing staff is also developed by learning from other professionals, it is likely that in the future, guidelines will further advise nurses to work more inter-professionally with other professionals. Bibliography Alexander, C. (2014) Growing into the role. Nursing Standard. 28 (20). p. 63. Anderson, M.P, Carlisle, S, Thomson, C, Ross, C, Reid, H.J, Hart, N.D, Clarkle, A. (2014) Safe moving and handling of patients: an interprofessional approach. Nursing Standard. 28 (46). p. 37-41. Clarke, D.J. (2013) The role of multidisciplinary team care in stroke rehabilitation. Progress in Neurology and Psychiatry. 17 (4). p. 5-8. East Kent Hospitals University. (2015) The Stroke multidisciplinary team. [Online] Available from: https://www.ekhuft.nhs.uk/patients-and-visitors/services/elderly-services/stroke-services/stroke-care/the-stroke-multidisciplinary-team Godfrey, K. (2012) Is interhttps://www.ekhuft.nhs.uk/patients-and-visitors/services/elderly-services/stroke-services/stroke-care/the-stroke-multidisciplinary-teamdisciplinary the new multidisciplinary? [Online] Available from: https://www.nursingtimes.net/opinion/nt-blog/is-interdisciplinary-the-new-multidisciplinary/5052155.blog Jacob, A, Rekha, R, Tarachand, J.S. (2007) Clinical Nursing Procedures: The Art of Nursing Practice. Jaypee Brothers Medical Publishers Limited: New Delhi. Know your rights. (2015) 02. Your right to Health and Social Care. [Online] Available from: https://www.know-your-rights.org.uk/02.html National Health Service. (2013) Who Pays? Determining responsibility for payments to providers. [Online] Available from: https://www.england.nhs.uk/wp-content/uploads/2014/05/who-pays.pdf National Health Service. (2014) Cerebral palsy à ¢Ã¢â€š ¬Ã¢â‚¬Å" treatment. [Online] Available from:  https://www.nhs.uk/conditions/cerebral-palsy/treatment/ National Institute for Health and Care Excellence. (2014) Safe staffing for nursing in adult inpatient wards in acute hospitals. [Online] Available from: https://www.nice.org.uk/guidance/sg1/chapter/9-safe-nursing-indicators#safe-nursing-indicator-medication-administration-errors Nies, M.A, McEwen, M. (2015) Community/Public Health nursing : Promoting the Health of Populations. Elsevier Saunders: Missouri. Royal College of Physicians and Royal College of Nursing. (2012) Ward Rounds in medicine: principles for best practice. [Online] Available from: https://www.rcn.org.uk/__data/assets/pdf_file/0007/479329/004342.pdf Royal College of Physicians. (2012) National Clinical guideline for stroke. [Online] Available from: https://www.rcplondon.ac.uk/sites/default/files/national-clinical-guidelines-for-stroke-fourth-edition.pdf/ Social Care Institute for Excellence. (2009) Interprofessional and inter-agency collobration. [Online] Available from: https://www.communitycare.co.uk/2009/08/03/interprofessional-and-inter-agency-collaboration/ The Masked, AMHP. (2012) Maintaining identity as a social worker in a multidisciplinary team. [Online] Available from: https://www.theguardian.com/social-care-network/social-life-blog/2012/jul/20/social-work-in-multidisciplinary-teams University Hospital Southampton. (2015) Sect ion 1 à ¢Ã¢â€š ¬Ã¢â‚¬Å" Prescription Writing. [Online] Available from: https://www.uhs.nhs.uk/Media/suhtideal/Doctors/SaferPrescribingWorkbook/Section1-Prescriptionwriting.pdf