Empathy

For centuries, the differences between men and women were socially defined through a lens of sexism, in which men assumed to be superior over women. The vision of equality between the sexes has narrowed the possibilities for discovery of what truly exists within a man and women. The world would be less interesting when everything is the same. Today none of us would argue that men and women are physically different, but they differ emotionally, and mentally. The physical differences are rather obvious and most of these can be seen and easily measured such as Weight, shape, and size.

There are many physical differences that are not noticeable. Men are 3o percent stronger especially in upper body strength. On the other hand, women have greater body fat percentages because women have children. No matter how strong men are they will never be able to handle child birth. Men build muscle easily, they have thicker oilier skin, they bruise less easily, and have a lower ability of injuries to their extremities. Men and women have different hormone levels such as testosterone, while women have a higher concentration of estrogens.

Testosterone is a male sex hormone that is important for sexual and reproductive development. Estrogen is a hormone in women that shapes the characteristic of the body. I can go on and on with many physical differences but lastly men have larger hearts, brains, and lungs. Since their hearts are bigger that means that they are filled with love, care and affection. Their brains are 11-12 percent bigger than women’s so this should mean that they are the smartest creatures ever. Even though they have big hearts and a bigger brain sadly it has nothing to do with intelligence or their emotions.

It is for producing more red blood cells because of their muscle mass. Emotionally men and women have a significant difference. I am not a man so I cannot speak for men when I say that men need trust. A man feels trusted when a woman’s attitude is open, to trust a man is to believe in his abilities and intentions. Women needs caring, when a man shows interest in a woman’s feelings she feels loved and cared for and becomes more open. Men needs acceptance, men are not very comfortable of being changed. If a woman lovingly receives a man without trying to change him he feels accepted.

Women need understanding, when a man listens without judgment, but with empathy she feels heard and understood. When a woman’s need to be heard and understood is fulfilled it is easier for her to accept his needs. A man needs appreciation, when a woman acknowledges the little things her man has done for her he feels appreciated. When he feels appreciated he is encouraged to do more. Now I understand that some guys here are not going to agree with me nor the girls, and I respect that because I can only speak for myself.

Mentally men and women differ drastically. Women are better at communicating because of the frontal lobe which is responsible for problem solving. The limbic cortex of the female brain is larger than the male counterparts, this provides women with an advantage in problem solving and emotionally. Remember earlier I said that men have bigger brains? Well, the male brain contains more grey matter whereas a female brain contains more white matter. White matter basically increases thoughts more rapidly than males.

Females speak from a more emotional perspective. It is due to chemistry and social learning. There is a stereotypical idea that females within the general public that has made it easier for women to openly cry, sympathize, laugh etc without feeling judged or vulnerable like male counterpart might feel in a similar situation. For instance, a man and a woman go on a movie date and there is a sad movie playing; and the woman starts to cry. The man might want to cry to but instead he hides it due to embarrassment. (I don’t know why)

Everyone understands that there are plenty of differences between men and women but we all have to realize that God created all of us for a reason. Men and women are totally different but it is more exciting to have varieties rather than everything being the same. As it is written in the Bible men cannot live without women. We need to all face the facts that men and women are different but we should all be treated equally. Guys have you ever had this said to you? You do this like a girl or you do that like a girl.

It is not only offensive to guys, but it is offensive to girls as well. Now, girls do handle situations differently. I admit we can get a little feisty. For instance someone throws something at Jessie, Jessie would throw the object back and then proceeds in offensive word play. The same situation applies to Sammie he throws the object back and then laughs it off then it becomes a fun game rather than an unnecessary fight. Men and women do things differently but we still need to respect each other because we are all God’s children.

The conduct and process of psychoanalysis are sometimes defined by selfobject transferences that ‘mirror’ the true mind and feeling of the person concerned. In the first example, it is revealed that patients sometimes express ‘cross-sectional snapshot’ when they crave for recognition or admiration, as an effect of not feeling proud with their accomplishments. This ‘opening move’ would progress towards a convergence and then would progress resolutely, while the psychoanalyst deals with the pathognomonic selfobject transference that is reflected in the analytic atmosphere, to come up with the development of ‘trust’ and a ‘feeling of safety’.

Analytic relationship needs contribution from each of the individuals, which is why, in the process, accepting, understanding and explaining past experiences are detrimental for a successful psychoanalysis. Understanding the fantasies, needs and demands leads to empathy. In the second example, it was described how patients’ responsiveness stems from accepting ‘their’ reality (Ornstein, 1998, par. 22) as well as accepting ‘their’ meanings and functions of reality (Ornstein, 1998, par. 24). The process of empathy is the best way to conduct clinical psychoanalysis.

Centrality of the concept of the selfobject transferences was emphasized by means of defining the nature of the process, by focusing on the experiences of the patients, and by coming up with some general statements made out of the details. FINDINGS: Empathy and selfobject transferences are the basis of self psychology. This is reasonably true, since psychological treatment can only be successful with both ends (or individuals) meeting at a common point.

The essence of the soul rests on ‘self-motion’, while its reversal rests on passivity (Riker, 2003, par. 13). As disintegrating forces would lead to passivity, then ethical breaks the repression made by passivity, so that there is self-motion and life in the soul. As reason and virtues control desires and emotions, then it leads to growth, development and actualization. However, in the modern concept of the soul’s life, “[l]ife is that which must disrupt itself in order to live” (Raiker, 2003, par. 18).

It must be a free spirit that lives with the will-to-power soul of a child, which exceedingly values life itself… the willingness to live, as life is the motion of the soul. This defines chaos as the proper breeding of a soul’s life, meaning that the most alive soul in the modern era is the ‘alienated individual’ that experiences struggle and isolation. There are different versions on how a soul may be able to achieve its life to the fullest, some of which are under self-motion, passivity and chaos. Findings come from the classical and modern conceptions of the soul’s life, as well as some ecological resolutions.

Classical theories are very much opposite to the modern theories of today. What deeply nourishes the life of the soul now appears to be under the event of chaos and disruption. But as this means developing a self or ‘I’ that is capable of living in reality without repression or submission, the soul should choose its own way of living, which may be a multitude of various ways and paths. I agree that diversity should be valued by all means. This implies that there is no single way in which a soul may live to the fullest. It depends on state of reality.

Introduction

This aim of this assignment is to analyse the unique role and contribution of nursing practices within inter-professional jobs and consider how inter-professional practices influence the way we manage the people in our care, using evidence based commentary. Mental illnesses are complex conditions and therefore cannot be managed by one professional. Holistic treatment of mental health patients requires a cohort of clinical professionals (Barker, 2008).

For this assignment I chose Gibbs Reflective framework (1988) to enable my personal reflection and to improve my future nursing practice. In accordance with the NMC Code of Practice (2008) names have been changed to comply with confidentiality regulations; Grace will be my client’s name.

Inter-Professional Team Working

Pollard (2005), defined inter-professional working, as the process whereby members of different professions and/or agencies work together to provide integrated health and social care. Leathard (2003) states inter-professional working implies a group of professionals from different professions engaging in interdependent collaborations with mutual respect to provide integrated health and social care for the client’s benefit., Housley (2003) argues the multidisciplinary team is a group of people of different professions who meet regularly to discuss individual clients. Successful teamwork can have direct consequences for patient care and the inter-collaboration model of healthcare delivery is one of the most important modernisations of the healthcare system in recent years (Humphris and Hean, 2004). Effective team-working produces positive patient outcomes, while ineffectual team-working contributes to negative incidents in patient care (Grumbach and Bodenheimer, 2004).

Client background

Grace, a 21 year old female, was formally admitted via community mental health nurse due to non-concordance of medication. Grace suffers severe mental illness and personality disorder with a high level of self-harming, poor personal hygiene and inability to perform activities of daily living ADL’s. The Roper, Logan and Tierney model (Bellman 1996) states that 12 ADL’s produce a picture of the person’s lifestyle and these can be used to highlight problems which require nursing intervention.

Inter-disciplinary team working and my role in Grace’s care

The multidisciplinary review meeting for Grace’s care comprised a consultant psychiatrist,; a psychologist who assessed Grace’s behaviours and gave counselling sessions; social workers who assessed social wellbeing; an occupational therapist who assessed ADL; a dietician and the care-coordinator who was the key-worker involved in Grace’s care when she was in the community. The registered mental health nurse assigned to Grace was my mentor, and I was given the task of shadowing my mentor to assess Grace’s mental state on the ward and monitor any physical changes. The inter-professional team at the review placed Grace on level 3 observation due to her self-harming.

Feelings

I felt challenged and nervous about shadowing and handling the nursing report during the multidisciplinary team review. However, I realised this is a key role of the nursing professional in an inter-professional team, Davies & Priestly (2006) views nursing handover as vital information about clients under the care of nurses, allowing nurses to improve both the handover process and improve patient care delivery.

I felt empathy for Grace, especially her anxiety over the (in her eyes) large number of people (the care team) caring for and deciding her ‘fate’. She shared in her one-to-one sessions that she was nervous of not doing the right things in front of the team and I remember thinking ‘we are both nervous for similar reasons’,, as I was also nervous about what the team thought about me and my practice. I reassured Grace that we were here to help her, using my communication skills to listen and ally her fears. Hamilton et al. (2010) stated listening is an essential skill for a mental health nurse.

I felt frustrated within the team, feeling that some members worked toward their own goals rather than collectively aiming to ensure the best holistic care for Grace, which made working within the team challenging. An example of this was the doctor’s decision to exclude Grace from participating in ward activities without assessment from the occupational therapist. This is at odds with the traditional nursing role, which seeks to include the patient both physically and psychologically. I felt that this decision was not in Grace’s best interest, and could prolong her discharge.

Evaluation

In evaluating my empathy with Grace and her anxiety, I felt there was an understandable connection as we were both in new situations, while too much empathy can lead to difficulties in nursing (Mercer and Reynolds 2002), empathy is an important aspect in nursing. Whitehead (2000) states that one angle of team work that is often neglected is the ‘relationship’ between client and nurse, which she argues is important to ensure positive care outcomes and therefore should not be disregarded within a collaborative framework.

After talking to my peers I found that we all felt some anxiety about working within a multi-disciplinary team. In evaluating my time as an inter-disciplinary team member and my anxiety, I realised this eased when roles were defined and responsibilities shared. Ovretveit et al. (1997) asserted that understanding and clarification of roles from the onset is necessary for good team-working and failure to define roles correctly can lead to confusion.

My frustrations within the team were in part due to my anxiety of performing poorly in front of my mentor, and my inexperience of working within an interdisciplinary-team. I had little understanding of how the different roles and philosophies of other professionals would need to be compromised to ensure both safety of and good care for Grace and perhaps I placed too much importance on the nursing role without understanding what other professionals brought to the team.

Analysis

While my empathy can be a positive aspect to my nursing, on reflection, it may have clouded my judgement and my ability to follow the right course of action, given that Grace was known to self-harm. The decisions made by the doctor complied with Local Trust Policy (2010) on self-harming. Furthermore, NICE guidelines (2004) states that staff develop preventative strategies to ensure patient safety in cases of self-harming, by reducing opportunities to self-harm. The inter-disciplinary team decided Grace should not be allowed to participate in ward activities due to risk of self-harm.

Through analysis of the team-work shown within this case, I believe that the team showed effective communication, as each professional had a good knowledge of the role they were expected to play in supporting Grace’s care and effective communication is vital in team-working (Ovretveit et al. 1997). My frustrations within the team can be explained by Whitehead (2001) who identified that collaboration work, while beneficial, did have a variety of barriers that could hinder development of close collaborative relationships within the different service provider’s professions, one being that the different professions may have different ideas on patient treatments that are at odds with other professionals within the multi-disciplinary team.

While at first I did not understand the challenges that inter-professional working brings and thus did not feel that every member had Grace’s care foremost, after analysing my time within the team, I feel that every member was supportive of each other’s efforts to facilitate Grace’s recovery. Many opportunities were available to discuss concerns over the care-plan such as debriefing, one to one interactions, and supervision, highlighted by Freeth (2007) as vital to ensure good inter-professional development. Barriers to good inter-professional collaborations include poor communication, lack of understanding of other team members’ roles, work priorities and professional hierarchy (Whitehead, 2000), where such issues are apparent, it can be helpful to identify shared goals and voice concerns. Inter-professionals should use clinical judgment that encompasses the best of all team members’ professions in care provision to improve client wellbeing, aid them to cope with health problems and achieve the best quality of life with their illness (RCN 2003; DoH, 2008).

Conclusion

In retrospect, I feel the strength of the team was its ability to develop and manage excellent patient-focussed care, resulting from the variety of disciplines, personalities and expertises. I have gained an in-depth insight into the roles and responsibilities nurses have in the development of client-centred care and a better understanding for the other team members professions, which I feel now that I was lacking. This reflective process has helped me gain an understanding of the importance of inter-professional team collaboration in managing clients with self-harm issues using positive practice guidance as stated in the NHS guidelines.

Action plan

This experience has taught me that inter-professional practices involve effective communication between team members and respect for other professional’s knowledge of client needs. I will seek to gain greater understanding of other clinical roles and what they represent and bring to the inter-disciplinary team. I will undertake personal development and learning by keeping up-to-date with changes in practice, embracing and promoting interpersonal working.

This reflective commentary has enhanced my knowledge of inter-professional working, the challenges involved and the importance of communication and compromise, which will contribute to my personal development as a mental health nurse. In respect to my patient centred empathy, I believe this is an important trait in nursing; however, in the future I will temper my empathy with professionalism that focuses on patient safety first.

I plan to improve my knowledge and expertise of the roles of other professionals. I will begin by focussing on the respect and value I have of other professionals’ expertise. With respect to my lack of confidence, I shall endeavour to develop confidence in sharing my knowledge in group forums. The placement amplified the importance of identifying and understanding patients’ needs and sharing this understanding with the inter-professional team members in order to facilitate effective healthcare interventions.

References

Barker. P., (2009). Psychiatric and Mental Health Nursing: The Craft of Caring. 2nd ed. London. Hodder Arnold.

Bellman, LM. (1996) Changing nursing practice through reflection on the Roper, Logan and Tierney model: the enhancement approach to action research. Journal of Advanced Nursing, 24(1): 129–138.

Davies S., Priestley MJ., (2006). A reflective evaluation of patient handover practices. Nurs Stand. 20(21):49-52.

Day, J., (2006). Interprofessional working an essential guide for health and social care professionals. Cheltenham: Nelson Thornes.

Freeth, D., (2007). International learning Association for the Study of Medical Education: Edinburgh.

Gibbs, G., (1998). Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Further Education Unit, Oxford Brookes University.

Grumbach K, Bodenheimer T. (2004) Can health care teams improve primary care practiceJAMA. Mar 10;291(10):1246-51.

Hamilton S., (2010). Rethink, Research and Innovation Teams Report for Nursing and Midwifery Council on nursing skills for working with people with a mental health diagnosis, London

Housley, W., (2003). Interaction in Multidisciplinary Teams. Ashgate Publishing Limited: England.

Humphris D, Hean S. (2004) Educating the future workforce: building the evidence about interprofessional learning. J Health Serv Res Policy. Jan;9 Suppl 1:24-7.

Kozier, B., Erb G., Berman A., Snyder S., Lake R., Harvey S. (2008). Fundamentals of nursing: concept, process and practice. Harlow: Pearson Education Limited.

Leathard, A., (2003). Inter-professional Collaboration: from policy to practice in health and social care. Philadelphia: Brunner – Routledge.

Local Trust Policy (2010b). Assessment and Management of Service Users Who Self-Harm Policy, Local Trust

Mercer, SW and Reynolds, WJ (2002) Empathy and quality of care. Br J Gen Pract. 52(Suppl): S9–12.

NHS Choice (2011)

NICE (2004), Self-Harm, Clinical Guidelines 16, cited from:http://www.nice.org.uk/nicemedia/pdf/CG16FullGuideline.pdf (Accessed 11/11 2012)

NMC (2008), Code of Conduct, Nursing and Midwifery Council, London

Ovretveit, J., Mathias, F., Thomoson, T. eds., (1997). Interprofessional working for health and social care. Hampshire: Macmillan Press Limited.

Pollard, K., (2005). Interprofessional Working: an Essential Guide for Health and Social-Care Professionals; England, Nelson Thrones Limited.

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Whithead (2000) Education, behavioural change and social psychology: Nursing’s contribution to health promotion. Journal of Advanced Nursing, 34(6), 822-832

Whitehead D, (2001) Applying collaborative practice to health promotion. Nursing Standards. 15(20):33-7.

Bibliography

General Social Care Council, (2006). Code of Practice For Social Workers and Employers. London: GSCC.

Golightley, M., (2008). Social Work and Mental Health People. Learning Matters.

Barker. P., (2009). Psychiatric and Mental Health Nursing: The Craft of Caring. 2nd ed. London. Hodder Arnold.

Taylor. C., Lillis. C., Lemone. P., (2001). Fundamentals of Nursing: The art and Science of Nursing Care, 4th edn, Lippincott, Philadelphia.

Thompson I., Melia K., & Boyd K., (2000). Nursing Ethics, London, Churchill Livingstone

After the delayed initial response BP’s official Press releases and relationship with the media continued to be strained and inconsistent. The Company was consistently under media focus but it failed to use the limelight to its advantage. Instead of being unco-operative and avoiding media interest in the crises the Company could have used the presence of media to take command and reverse a bad situation quickly. In the past media savvy companies have used their ability to understand how the media works to turn the crises around to their advantage in a timely manner.

BP could have done the same by being more honest with the media in describing the huge challenges that it faced in stopping the leak and implementing a successful cleanup operation. It could have described in detail how it was working together with the Government to deal with the crises. Instead the lack of media consistency made it appear that the company could not handle the crises on their own and had to ask for government help in the clean up operation.

This perception again reduced the faith and trust that the public had in he Corporation for government help made it seem like the company couldn’t handle the situation on its own. One message that BP and its CEO did not convey to the public was empathy with their situation and that is what really helped the tide turned against the company. If the Company had utilized its massive PR infrastructure to communicate that they genuinely cared for the impact of the disaster and that they empathized with the plight of the fishermen and others affected by it perhaps its perception would have been different now.

Instead the ex CEO Hayward’s comment that all he wanted was his life back sent a very insensitive message to the public and the victims of the crises indicating that as the CEO of BP he personally did not care for the damage inflicted on the community and the environment . (Hoggan 2010) However uncommunicative it was with conventional media BP did have a good strategy in using the social media and the web to its advantage. Though traditional methods of PR like official statements, press releases, interviews have all not worked in favour of BP it does appear to be having relative success with social media and networking.

Though its initial response was delayed in the social media sphere as it was in conventional media it has been utilizing social media much more than conventional sources to convey its responses and progress in containing the oil spill. In the age of the internet when a large proportion of the population rely on the web for its news and analysis this was a wise move. BP have created a section of its Web site dedicated to the spill, and have updated it with the latest progress on the cleanup related photos, video, and maps .

This web site gives a more direct perspective of the efforts being put in by the company to contain and correct the oil spill another website which the company supports is Deepwaterhorizonresponse. com, which has been created to provide a current and updated account of the disaster. Over the course of the crises the company has also been very regular in posting constant tweets about the latest successes in cleaning up and plugging the leak.

The crises and BP’s use of social network site such as twitter and Face book has created a whole new trend of using social networking sites for company propaganda Though the techniques for advancing propaganda have changed it has also made it easier to for BP to receive feedback and also respond more quickly to new developments on the crises But it does help a company respond faster and more precisely to new developments. BP has been using twitter to clarify its actions and also address rumours on some of its compensatory settlements with fishermen and other victims of the disaster.

It is also being used to inform people about the hotline setup to contact the company if they see any forms of oiled wildlife that can be saved by intervention from the company’s experts. BP has embraced new media with a greater success than conventional media. Even if it can do the damage to its reputation caused by its earlier mishandling of the public relation function it can still salvage some of it by providing regular updates to all those impacted and interested in how the crises develops and is eventually solved.

As is evident from the above analysis BP has committed several transgressions when it comes to its crises public relation function and these transgressions account for what has now evolved into an extreme example of a epic Public relations failure in Crises Management Today the company has lost all credibility in the eyes of both the public media and the Government. It stands at the verge of hundreds of lawsuits launched by people who consider themselves victims of the disaster and the company responsible for putting them in such a predicament.

Could the Company have avoided this massive breach of trust and managed to retain some of its credibility if it had simply released a statement and followed the basic rules of crises public relations at the onset of the disaster? Could BP have controlled the situation better if instead of apportioning blame it had opted for full disclosure and been honest about the causes and the impact of his disaster right from the very beginning?

Looking at these questions in the aftermath of the disaster the answer is a definitive yes. Even if the impacts of the disaster had remained the same an effective crises public relations campaign would have resulted in establishing a more positive , responsible and empathetic public image of the Corporation instead of the current image of a Rich Oil Mogul who must be punished for its negligent practices.