K101_Tma_O2

Testing the visibility of your tutor’s comments At the end of your marked eTMA 01 your tutor left two messages; the first in a comment box and the second using tracked changes. To confirm to your tutor that you can see comments of both kinds, please type the messages below. Also please type the last 3 words written by your tutor on the TMA Form (PT3e). |Message 1, Comment box: |This is a thoughtful discussion but Iit would have been useful to further | | |explore the interdependence between yourself and Martin. | |Message 2, Tracked changes: |Not sure what to look for here ‘comment d8 it is’ | |TMA form, last three words: |Best wishes, Denise | Part A: Essay Option Number: One Title: Care in the community. Healthcare in the last 50 years has changed dramatically, enough so, that health care in its majority has been moved from the hospitals to the community. In recent years more change has been suggested and put into practice by the publishing of white papers from the Department of Health and other organizations working in collaboration with the government on healthcare. The change in the way diabetes care is delivered in the last half century is a good case to follow as it is a fantastic example to portray the broader changes in healthcare overall. Until recently most healthcare for long term illness has been provided in hospitals under a hierarchical system where the consultants/doctors were in charge of the team and nothing could be done without the direct say so of the doctor. Now however the situation has changed, doctors/consultants are now part of a bigger team. The reality is that if I’m putting people on to insulin, despite the fact that I’m a professor of diabetes, I know that I can’t manage to do that. I liaise carefully with my diabetes specialist nurses, who are the people who are much more capable of transferring you on to insulin treatment than I am. Similarly, I might spot that you are grossly overweight, in which case you had better go and see my dietician. But my dietician knows a great deal more about food and food values and carbohydrate counting and a whole collection of things – that I really would fail an exam if I was sat down and said ‘what do you know about this’. (DVD Audio 2.9) This suggests that there is still a hierarchy system although much more relaxed and not as dictatorial as it was, meaning more of the treatment as well as the care aspect of health care has been passed on to specialist nurses and other healthcare professionals but ultimately the doctor is still in charge. Diabetes care in the community isn’t without its own pitfalls; a specialist diabetes nurse is in essence in charge of the care of the patient. But if the patient is for example like Anwar of the case study in unit two has a lot of self perceived barriers as well as cultural ones. It can lead to problems as portrayed in the unit; it proves badly managed care in the community can have a knock on effect on the overall health and wellbeing of the patient. One problem could be where a patient is given a recipe sheet to follow which is tailored towards someone from a western culture when in fact the patient is from a different culture and does not normally eat or tolerate that kind of food. In reply and as part of good practice the nurse and or dietician should create culturally appropriate recipe cards to prevent problems arising later. Again, exercise could be a problem where diabetes and culture is involved; things could be better explained in the table below. | |Reason for not sticking to regime | How to improve support | |Diet |Not given culturally appropriate diet to |Design/ write a culturally appropriate diet menu. | | |follow. |More information to the patient about how the diet | | |Changes in diet are remedial (i.e. only when |should work. | | |feeling ill) |If the patient is trained properly would know what they | | | |could and couldn’t eat without causing offence. | | |Feels it would be rude to refuse hospitality.|Support to adjust to lifestyle changes for all the | | | |family. | | | | | | |Family eats together. |Discuss cooking methods with the cook(s) of the | | | |household. | | | |Discuss the diet with the whole family. | | |The patient is not responsible for buying or | | | |cooking the food in the household. | | | | | | | |Confusion about diets. | | |Tablets |Poor diabetes knowledge. |Appropriately targeted, culturally sensitive diabetes | | | |services. (e.g. Courses) | | | |Allow extra time for language difficulties, especially | | |Language difficulties make asking questions |when interpreters are involved. | | |difficult. | | |Exercise |Working patterns/ hours. |Realistic, culturally appropriate advice. | | | | | | |Exercise is not part of the patient’s |Negotiate targets with the service user. Start an | | |culture, so it makes them stand out. |exercise class geared towards the patient’s cultural | | | |background, assuming of course that there are enough | | | |people of that cultural background willing to give the | | | |class a try. | (block1, p.79) Another problem arising from diabetes is depression. The patient gets disgruntled by their lack of progress regardless of effort and in turn looses their moral as they have tried and not seen the results expected. Health professionals however suggest that teaching patients that it is just as acceptable to manage and maintain their current condition is better than to set themselves for disappointment, although an improvement could be seen as a very good achievement. Encouraging the ‘expert patient’ is also seen by health professionals as an encouraging factor, these ‘expert patients’ are better able to manage their own conditions. It takes more responsibility away from the healthcare professional and giving it to the patient, helping them to feel more involved in their own care. This in turn gives doctors in the hospital more time to concentrate on acute/emergency patients, the nurses and other health professionals in the community more availability to new and problem patients heading off any potential problems before they get too uncontrollable. And the possibility that one of the healthcare professionals would have enough time on their hands to arrange/teach patients on special courses/group how to manage their conditions by themselves, this would eventually lead to there being no need for the health professionals to teach the ‘expert patient’ anymore as they would be self sufficient in passing on their knowledge to newer members of the course/group therefore bringing care into the community in a very real sense. In conclusion there has, over the last half century or so, been a shift in care from hospitals to the community because the way that health care is delivered has changed dramatically. It is no long delivered in a strict hierarchical manner causing doctors in hospitals to be overstretched with their time in turn missing problems until they are irreversible, now it is shared out amongst a team of professionals trained specifically for their job. I.e., diabetes nurses, opticians, dieticians and not to forget the ‘expert patient’. The health care is improving all the time in twenty years from now we can hopefully be assured that it will have changed all the more for the better for its users. References 1) Open University (2008) K101 An Introduction to Health and Social Care, DVD, Audio 2.9 ‘From Hierarchies to Team Working’ The Open University. 2) Open University (2008) K101 An Introduction to Health and Social Care, Unit 2 p, 79. ‘Illness, Health and Care’. The Open University. Part B: Developing care relationships |Principles |Sue’s relationship with Julie |Maria’s relationship with Lyn | |1 Supports in maximising |I do not think that Sue is supporting Julie to |Yes, by accompanying Lyn on her shopping trip Maria is | |potential |maximise her potential in this scene, Sue assumes |supporting Lyn to maximise her potential. Maria accompanying | | |that she will pack Julie’s clothes and borrow her |Lyn enables her to make her own decisions as to what she wants | | |brother’s boots without consulting Julie about it; |and how she wants it done. Also it helps Lyn to socialise | | |what if she wanted to do it herself' |something that I don’t think would happen unless Lyn has | | |This scene doesn’t show if Julie has been asked if |someone available to accompany her to these events. | | |she wants to go in this trip but judging by the | | | |disgruntled look on Julie’s face probably not, so I | | | |do not think that if Julie was given a choice that | | | |she would be going on this trip at all. | | | | | | | | | | |2 Supports in having a |Again Sue doesn’t really support Julie in this |In the supermarket the lady at the checkout asks Maria if she | |voice and being heard |principle either, spending most of the scene talking |wants help with her packing (proving the ignorance of people | | |over Julie and about Julie rather than allowing Julie|outside of the carer/client relationship) and in turn Maria | | |to speak for herself and allowing Julie to lead the |then turns directly to Lyn for her opinion who says ‘yes’. This| | |conversation. |shows that Lyn has been sufficiently trained and also knows | | | |Maria well enough on how to deal with such a situation. | | | | | |3 Respects beliefs and |In private I would expect Sue and Julie’s |Maria lets Lyn choose what she wants from the shelf in the | |preferences |relationship to be a fairly good and happy one. But |supermarket; Maria just retrieves it for Lyn and puts it in the| | |Sue doesn’t really ask Julie her opinion on any of |basket/ trolley for her. Therefore showing a respect for belief| | |the subjects discussed. Suggesting that although |and preferences. | | |meaning well Sue doesn’t respect Julie’s beliefs or | | | |preferences. | | | | | | | | | | |4 Supports rights to |Sue helps to set up the arrangements to enable Julie |Again the situation at the checkout is a brilliant example, as | |appropriate services |to go on the trip. But does Julie want to go on the |Maria looks to Lyn for confirmation of acceptance of the | | |trip at all' (same question keeps coming up) |service offered. | | | | | | | | | |5 Respects privacy and |The final question could have been deflected by Sue |Yes, Maria respects Lyn’s rights to privacy and confidentiality| |rights to confidentiality |and dealt with in a more private setting. A carer |because of the boundaries that they have both put in place it | | |that had the right training would have discussed |is easy to assume that Lyn is confident that her | | |these subjects before hand in private so if Julie was|confidentiality and privacy is respected by Maria. | | |indeed embarrassed by the question Sue could have | | | |given the answer discreetly rather than the awkward | | | |silence. | | | | | | | | | | Self-reflective notes 1 What have you enjoyed most and why' I have enjoyed most of my studies so far, I didn’t realise how narrow minded I was until I started reading into the deeper subjects covered in block 1. 2 What have you liked least and why' At the beginning of March I was a bit down due to personal reasons, so I didn’t study. Then when I began to feel better I came down with a chest infection which delayed my studying even longer so in the end I had just over a week to finish studying just over two units and begin my assignment. So I don’t enjoy cramming to meet a target. Also I don’t like the idea of having to put postings on the forum in order to gain marks towards my assignment, I may be doing a course in health and social care but I was unaware beforehand that I would be marked on actually being social. 3 What have you found most difficult and why' I think the idea of all the information to take in and retain it in some way has been hard. 4 How well do you feel you are getting on with your K101 studies' Although my marks on my first assignment were a little disappointing I hope that you (the person marking my assignment) won’t be as harsh this time around as last time I genuinely missed the second part of the assignment and this time I think I have worked hard to make this assignment my own. 5 Are there things you would like support with' Yes please, after block two I assume there will be more materials posted out to me' As I said in an email to you in February I am pregnant and due to drop on June 10th the submission which is also the submission date for tma04 and would like for you to be very aware in advance that I may not actually succeed in achieving that assignment on time as baby will arrive when baby chooses. Also the online project may not be feasible, I am not saying I don’t want to do it but the first two to three weeks with a newborn are hard enough let alone the added stress of the online project and the stress of tma05. So after that waffle I cannot read ahead unless my next lot of course materials are sent out extra early and possibly an alternative sorted for tma 05/ online project would greatly appreciate your help on this one. | | |Marks | | |Tutor comments |Possible |Actual | |Part B | |8 | | |Self-reflective notes | |4 | | |Participation in online | |3 | | |forums | | | | Sample answer to Part B To be attached here by your tutor on returning your marked eTMA.