Tanya is a 35 year old female who is suffering from severe depression. She has two children, who are boys, aged 14 and 3. Tanya lives in a council house in a poor, rough area. She doesn’t pay her rent, which is £90, as the council help to pay it for her due to the fact that she does not currently work. She is currently going through a divorce with her husband who abused her and her children. On top of all of this Tanya has to care for her mother as she has cancer. There were a variety of professionals involved within this role play. There was a psychiatrist who is a medical doctor who has specialized training in mental illnesses and emotional problems. A psychiatrist may also be trained in psychotherapy as it is quite a common treatment for people who need psychiatrists today. Furthermore, the community psychiatric nurse was someone who would visit clients within their home to give them privacy to talk through the clients problems and offer practical advice and support.
Often they will give out medicines and will specialise in eating disorders and behaviour therapy. Another professional is the social worker who helps to talk people through their problems, giving the client practical advice, emotional support and providing psychological treatments. The occupational therapist helps people with their day to day life as the client may lock themselves away from the outside world. Therefore the occupational therapist will give advice on where their client should live, help to re-build the clients confidence and helps the client to become more independent. Moreover, the clinical psychologist will meet for regular meetings, to talk through the client’s feelings, thoughts and behaviour. As cognitive therapy is a common approach they will use different therapies such as the psychodynamic approach and behavioural psychotherapies.
The pharmacist will give the client expert advice to the GP about the medication the client should take. Finally, the team manager is the senior nurse who organises the team and ensures that they discuss the best treatment for the client. Throughout this meeting we discussed how we could help Tanya by providing her with the correct treatment necessary. To begin with, the senior nurse introduced who Tanya was and her current situation to ensure that the team understood Tanya’s background. The senior nurse then asked each team member what they recommended for Tanya. The social worker then went on to discuss with the team that she could help Tanya by carrying out a risk assessment of Tanya’s house to ensure that there were not any hazards or risks towards Tanya’s children who were living in the house at them time. The social worker then went on to state that she might have the children put in a foster home, however they would be put in the same home so they were not separated, whilst Tanya had her treatment.
This was also because the children’s father was abusive to them and therefore, he should not have the custody of these children. At the end of her discussion the social worker explained that if the father wanted custody of the children he would have to go through the court, nonetheless, the social explained that she wouldn’t let that happen and if the father wanted to see the children he would have to have a supervised visit with them for one hour, and only one day a week. The social worker then referred Tanya to the clinical psychiatrist. The clinical psychiatrist explained that she would have regular discussions with Tanya to find the source of her depression. Furthermore, the clinical psychiatrist will have interviews with Tanya to observe how she behaves. The clinical psychiatrist will also work with a multidisciplinary team including, doctors, nurses, social workers and occupational therapists. In addition to this the clinical psychiatrist will offer Tanya counselling to maintain her depression and let her get things off of her chest.
The clinical psychiatrist will also keep monitoring Tanya’s progress of her treatment to see if she improves or worsens. The clinical psychiatrist then referred Tanya to the psychiatrist. The psychiatrist went on to explain that during mild depression you need to firstly wait and see if you are diagnosed with depression. The psychiatrist then went on to explain that exercise could also help Tanya as there has been proven evidence to show that it helps people with depression. Moreover, there are a variety of self-help groups who Tanya can talk through her feelings with. Additionally, the psychiatrist went on to state that there are also talking therapies which are a type of psychotherapy. As Tanya has severe depression, the psychiatrist stated that she will more than likely be on antidepressants which are tablets which help to treat the symptoms of depression.
The psychiatrist also stated that she can offer Tanya combination therapy which is a course of antidepressants and a talking therapy. There is also cognitive behavioural therapy (CBT) which will help Tanya to understand her thoughts and behaviour and how it affects her life. As well as CBT there is also interpersonal therapy (IPT) which will focus on Tanya’s relationships with the people around her and the problems which may occur within the relationship. There is psychodynamic psychotherapy which involves a therapist allowing Tanya to say whatever is going through her mind. This will help Tanya to be more aware of the hidden meanings which can help contribute to Tanya’s problems. The final treatment the psychiatrist can offer is counselling which will help Tanya to think about the problems she may be experiencing in her life and how to find new ways to deal with them. The psychiatrist then went on to refer Tanya to the pharmacist. The pharmacist will go through Tanya’s medication with her and explain the dosage she needs to take, which is two-four weeks without missing a dosage.
The pharmacist will also explain that the medication will help to reduce Tanya’s stress levels and will help her to control her feelings. The pharmacist then referred Tanya to the community psychiatric nurse (CPN). The CPN will help Tanya to get back on track and will offer Tanya support for her Mum who has cancer. Furthermore, the CPN will monitor Tanya’s mood swings and medication, the CPN will ensure that Tanya understands the medication she is taking and why she needs to take it, to ensure that she is taking the correct amount and doesn’t worsen her condition. Moreover, the CPN will offer help for the children to understand that their mum has a severe case of depression and that she needs their help in order to make a full recovery. Additionally, the CPN will give Tanya some support and advice to help her get through her divorce. The CPN will also ensure that the family are well looked after and that they stick together. The community psychiatric nurse then referred Tanya to the occupational therapist.
The occupational therapist offers four different types of treatment for Tanya regarding four different aspects of Tanya’s life. The first type of treatment is for depressive thinking. This is due to the fact that Tanya may think in negative patterns and become preoccupied with problems and will feel as if she deserves to be punished. Therefore, Tanya may think she is stupid. The occupational therapist can help with this by getting Tanya to change the way she is thinking these negative thoughts, the occupational therapist will do this by asking Tanya to challenge her negative thoughts. Another treatment the occupational therapist can offer Tanya is treatment for her depressive feelings. This is where Tanya may feel as if she is hopeless, overwhelmed and irritable. Normally, with these feelings Tanya will result in crying or hiding away from others.
The occupational therapist can help by helping Tanya to regain her hope and confidence by teaching Tanya different ways she can cope using strategies to deal with these depressive feelings. These strategies can include relaxation, mind techniques and accepting difficult feelings. Moreover, Tanya’s behaviour may change during her depressive state. This means that she will do fewer activities every week. She may find it hard to get out of bed, go to work and coping with working pressures. As a result of this Tanya may not take care of herself hygienically, pay her bills, and doing everyday activities such as gardening. The occupational therapist can help by using behavioural activation and activity scheduling to increase Tanya’s participation. This can be done by the occupational therapist breaking down the activity into manageable tasks, setting goals and solving problems. The final treatment the occupational therapist will help Tanya with is her physical changes.
This means that Tanya may have a disturbed sleep, gain or lose weight, lose interest in sex, experience tiredness and feel aches and pains. The occupational therapist can help Tanya by reviewing Tanya’s diet patterns, alcohol and caffeine consumption, exercise and bedtime routines. The occupational therapist will also go through techniques to help reduce Tanya’s anxiety levels as fatigue, aches and pains can often lead to someone becoming anxious. The second meeting for the multidisciplinary team was conducted to figure out how to treat Gerry. Gerry is a 65 year old man who is experiencing symptoms of Type 2 diabetes. Gerry is happily married and has three children with several grandchildren. Gerry found that he was urinating more frequently than he should have been, he was itching around the genital area which was causing him pain when he was urinating, he suffered from fatigue, his vision was becoming very blurry and when he injured or cut himself his wounds healed very slowly.
There were a variety of professionals involved within this role play. There was a GP who is Gerry’s first point of contact and who will update Gerry of any changes and is responsible for prescribing the medication Gerry will take. The diabetes specialist nurse specialises in diabetes and helps to support clients who have diabetes and help them to manage their condition. The practice nurse is trained to deal with a variety of tasks and will treat injuries and perform blood tests and vaccinations. The pharmacist will give the client expert advice to the GP about the medication the client should take. The optometrist is an eye specialist who will help the client with retinopathy screening and various eye conditions such as glaucoma and cataracts. The podiatrist is someone who will check over your feet to ensure they are not infected and that they do not have swelling.
Furthermore, the dietician specialises in food and nutrition and will advise the client on what they can and cannot eat. Finally, the psychologist is someone who has the ability to give the client support regarding their emotional and psychological issues. As the first point of contact Gerry went to see his GP first. The GP then explained Gerry’s case to the multidisciplinary team. The GP would then give Gerry an overview of the symptoms he is experiencing and will give him a diagnosis and prescribe him with medication to help control his diabetes. The GP will then refer Gerry to the diabetes specialist nurse (DSN). The DSN will go through what diabetes is for Gerry, the symptoms, the factors which can affect the risk of getting Type 2 Diabetes and various treatments. Diabetes is a physiological disorder of the metabolism which causes excessive thirst and production of large amounts of urine and is a life-long condition. The DSN will visit Gerry on a regular basis to ensure he is taking his medication and checking his progress just in case it deteriorates.
The diabetes specialist nurse will then refer Gerry to the practice nurse (PN). The PN will help Gerry with the three major areas which affect diabetes more, which are Gerry’s diet, his weight and his level of physical activity. The PN will have regular meetings with Gerry and will allow Gerry to raise any concerns he has. Moreover, the PN will encourage Gerry to eat healthily but ensure him that he can still have all the food he loves just in smaller amounts. Furthermore, the PN will ensure Gerry does regular exercise to ensure he loses the weight to prevent his diabetes from developing any further. She will also encourage Gerry to not smoke as it will increase the risk of Gerry developing a cardiovascular disease, for example a heart attack or a stroke. This will also increase Gerry’s risk of lung cancer. The practice nurse will then refer Gerry to the podiatrist.
The podiatrist will explain to Gerry that Type 2 Diabetes can help to reduce the blood supply to his feet and may cause a loss of feeling which is known as neuropathy. This can mean that Gerry’s foot injuries may not heal well. The podiatrist will then go on to treat Gerry’s abnormalities of his lower limbs. Furthermore, the podiatrist will need to continue to check if there are any infections in Gerry’s feet as 1 in 10 people get a foot ulcer which causes a serious infection. Finally, the podiatrist will check to see if Gerry has a sores and cuts on his feet which don’t heal, and for puffiness or swelling in his feet. The podiatrist will then refer Gerry to the optometrist. Diabetic retinopathy is a common complication of diabetes.
This occurs when high blood sugar levels damage the cells at the back of the eye, the retina. If this is not treated it can lead to the person with diabetes becoming blind. The retina is the light-sensitive layer of cells which is at the back of the eye. This converts light into electrical signals. These signals are then sent to the brain through the optic nerve and the brain will interpret them to produce the images Gerry will see. To work effectively, the retina will need a constant supply of blood which it receives through a network of tiny blood vessels. Throughout time, a continuously high blood sugar level will cause the blood vessels to narrow, bleed or leak. Consequently, the retina will stop working. This is known as diabetic maculopathy. The optometrist will offer Gerry treatment depending on how far the retina has been damaged so far. The optometrist will advise Gerry to go to annual screening appointments to ensure that he can be informed of any change to Gerry’s eyesight.
He will also advise Gerry that if his vision changes he will need to inform his GP immediately so that he can receive treatment as soon as possible. The optometrist will also advise Gerry to take his medication, which is prescribed by the pharmacist, to ensure that his condition does not worsen. In addition to this the optometrist will also ask Gerry to eat a balanced diet and to lose some weight if he is overweight, Gerry can do this by exercising regularly. Finally, the optometrist will ask Gerry to try and control his blood pressure and cholesterol levels to ensure that his retina is working perfectly. The optometrist will then refer Gerry to the dietician. The dietician will go through the foods that Gerry can eat and provide him with a diet plan to ensure that he doesn’t gain any more weight. The dietician will then refer Gerry to the psychologist. The psychologist will talk to Gerry about how he is in denial about having diabetes, this means he may begin to suffer from depression.
This means that the psychologist will need to help Gerry come to terms with the fact that he has diabetes and support him throughout this period. The psychologist will then refer Gerry to have treatment for his condition. The pharmacist is responsible for providing Gerry with treatment for his condition. Therefore, the pharmacist will advise the GP that Gerry should have insulin treatment to help control his blood sugar levels. However, the GP will warn Gerry that some of these will take a whole day to work (long-acting), some will take eight hours to work (short-acting) and others will not last long but will work (rapid-acting). She will also advise that Gerry has an insulin pen to inject the insulin himself. Furthermore, if Gerry’s blood glucose levels become low he will have hypoglycaemia. If he has mild hypoglycaemia (hypo) he will feel shaky, weak and hungry, nonetheless these can be controlled by eating or drinking something sugary. However, if Gerry has severe hypoglycaemia he may become drowsy, confused and may even lose consciousness.
If Gerry has severe hypoglycaemia he will need to have an injection of glucagon, which is a hormone which increases blood glucose levels, into a muscle or a vein. Workforce development is a multidisciplinary team who work together to develop their services for service users and will provide volunteers and staff with the skills and knowledge they need to effectively deliver and improve their service for children, young people, families, elderly people etc… By working in a team it can help workforce development as the team will focus on what they want to accomplish together. For example, if a patient requires specialist treatment the hospital will provide someone who can help the patient. The team will also need to consider their strengths and weaknesses and try to improve on these to provide a better workforce. This is due to the fact that it means they will be able to improve their workforce and will effectively develop their workforce. Furthermore, the team will need to organise the workforce to show that they work successfully as a team.
For example, company policies and procedures that have been in use for a long period of time may need to be updated to ensure that people understand what they are doing. In addition to this, the team could provide additional training to improve their knowledge. This means that the workforce will develop further and ensures that members of staff can provide their service users with knowledge. Moreover, the team will need to assess their methods to ensure that they are doing everything they possibly can to help their service users. This ensures that their policies, procedures and methods are up to date. Finally, the team should encourage positive reinforcement which ensures that the members of staff work together to provide their service users with a competent workforce that are developing.