The Healthcare Professional Assignment Sample

Introduction Of The Healthcare Professional

Health and social care roles are fulfilled with proper caregiving which improves the condition of patients and ensures sustainable well-being. Existing practices in addition to innovative and scientific approaches to individualised care can facilitate that. The population of the UK has the need for mental health related care to function better and suffer less. People from all walks of life may require different types of inpatient and outpatient care. From autism spectrum disorders to anorexia nervosa and many other issues may require intensive inpatient care. Facilities designed to provide inpatient care have to nurture a positive environment with outcome-driven features. All stakeholders including the administrators, nurses, support workers, and families of the patients are to be proactive in developing and maintaining the essential qualities of such facilities. Reflective accounts of incidents involving such facilities and systems provide the opportunity to find actionable insights and reinforce the ideas essential for proper learning.

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Present conditions and ways to improve can be obtained through the observation and critical assessment of such incidents. Usage of “Gibb’s Reflective Cycle (1988)” to carry out the reflection is a scientific and effective approach to developing a vivid understanding of an incident at such facilities involving healthcare professionals and the recipients of the care. The description of such an evidence-backed and well-reported incident remains the source of identifiable issues including the lack of necessary resources, malpractices, and deviations from standard procedures. Expressing the feeling based on the mostly negative incident enables us to prioritise and focus on the alarming issues. Careful evaluation and subsequent analysis of the facts further enable us to develop an action plan that can be executed to mitigate the existing issues. It also provides the scope to grow to be an ideal healthcare professional capable of contributing to preventing similar incidents in future.

Gibbs reflective cycle

Description

The medium security facility in Greater Manchester is one of the UK’s biggest ones designed to provide care focused on improving the mental health of the patients. Run by the “Greater Manchester Mental Health NHS Foundation Trust” and rated by the “Care Quality Commission” to be “GOOD”, this facility has been exposed to be engaged in activities that raise multiple questions. The facility has the capacity to host above 150 patients under the “Mental Health Act '' who are at high risk of harming others or themselves including patients from the “criminal justice system”. As per my observations, the staff are caught physically and mentally abusing the patients. These include mocking their sufferings, forcefully restraining them, unnecessarily secluding the patients, and being careless about medication overdosing. They act as bullies making the most of vulnerabilities to demean, and dehumanise. Few female staff also exhibited sexualised interactions with male patients. Many patients were isolated in “seclusion rooms” for days, weeks, and months for reasons like “getting a break from them”.

Patient observation records to monitor the proper functioning of the facility are regularly falsified. New workers are encouraged to take part in such activities from the very first days. This way they avoid their crucial duties like periodic cold checkups of the patients. The 15-minute interval between the “obs” is extended beyond 75 minutes. I have seen that patients in discomfort are making noises that are left unchecked and joked about by them. I also witnessed that patients complain of being treated like animals, being stuck, and being in a worse state due to the intervention. Mental health nursing and psychiatry experts opine that the “toxic staff” “acts like gangs” “against all policies” in an extremely “unjustifiable” way. The foundation, NHS, and the government recognise these promptly and suspend the staff, initiate an investigation, withdraw the “GOOD” rating and a criminal investigation initiated by the GM police follows.

Feelings

The Edenfield mental health facility is designed to care for the patients by facilitating the recovery process. The duties of the caregivers including the registered nurses support workers and other workers include interacting with the patients to the best of their professional skills and abilities (Staniszewska et al., 2019). Here they are exposed to routinely conducting activities which torment the patients and add to their sufferings. I think that they are doing things that they are never expected to do. The physical tortures inflicted to make them comply with instructions, and threats are preferred by the staff over respectful ways. “Use of force when it is utmost necessary” has been replaced with “Use of force all the time”. Their unethical actions are directed against the roles they have been assigned. In my opinion, if it was not exposed, family members would have remained oblivious, and the higher authorities responsible for monitoring would still be tricked with falsified records.

I think that it is apparent that the punitive seclusions are highly damaging to the patients. In addition to the existing mental health issues, deprivation of liberty, and dehumanisation is causing further damage. The “toxic, hostile, and unsafe” environment is pushing them into a state which it is even harder for them to recover from. This is both heartbreaking and frustrating for me, a student wishing to build a career in social care. The people with “great internal disturbances” living miserably in such a “horrible” and hellish environment in Edenfield can not be expected to show signs of improvement. The culture has become highly toxic and full of corruption. They knowingly do many of the “bad things”. How they have disregarded the caregiving professional and patient boundaries is highly concerning.

I feel horribly outraged at the thought that a facility that was invested into recovering from damages has inflicted further damages and some of these are irreversible. It is highly shocking for me to discover the level of absence of compassion among people who are expected to be compassionate and professional. The tendency to punish them for being in trouble is appalling. Being “part of the crowd” and not being able to “lead them” as ideal professionals have led to the loss of integrity and the risk of losing the trust of the commoners in existing healthcare systems.

Evaluation

The experience of observing the incident for the most part is being shocked by the negativity. The people trusted to be doing their jobs compassionately at the mental health facility are engaged in activities that torment the patients. The patients are already suffering from different mental health conditions. On top of that, the unprofessional behaviours of the caregivers are worsening their problems. A medium security facility that can host more than 150 patients needs proper checks and balances to function. The existing record-keeping practices are being failed by the corrupt practices of falsifying the records. All of the staff are in on this. They have created a nexus of corrupt bullies that cheat the system. The development of such a facility, designing and implementation of caregiving systems, and investment in mental health issue-related caregiving under the act are essential and the purposes are noble (Masuku, 2022). Registered nurses being employed, and support workers being involved are necessary. To deal with complicated and extreme case scenarios, the availability of seclusion facilities is also crucial (Abu-Rumman et al., 2022).

Restraint too needs to be used to control the patients who are otherwise impossible to control for giving proper care. It is supposed to be the last resort when all other methods fail to make a patient comply to do something or prevent from causing harm to others or self (Jasper, 2013). Seclusion chambers are designed to protect the patients and the caregivers. These are not meant for imprisonment of the patients as punitive measures for any reason. But all of these resources are being improperly used over here for unethical activities. The abuses, severity and frequency of these are alarming. In my opinion, exposing the incident has been a great phenomenon. This has illuminated the malpractices that have been conducted in the darkness away from public knowledge. I think the extent of these malpractices could exist in other similar places as well. A facility designed to support the public has failed and caused damages that are mostly irreversible. The families of the patients who are previously oblivious to these are tormented to learn these. I think unless the whole system is reformed to make it capable of resisting such corruption and malpractices, patients are bound to continue to suffer.

Analysis

The malpractices exposed here are completely unjustified as these directly and clearly violate all the policies existing. The mental abuse includes jokes about the suffering of the patients to mock them, dehumanising them with verbal insults, disrespectful phrases and a tone of belittling them is completely unprofessional. The way the patients are being compelled to comply with the instructions is unethical. They are not being encouraged to take part in activities by helping them understand the importance of it. Rather they are being threatened to comply. In addition to that they are being physically forced to move. Pinching hard on the shoulder to inflict pain, and twisting hands are physical abuses observed. The forceful constraint is the primary reason identified to be the cause of injury among mental health patients in the UK (Hargreaves and Page, 2013). It is also a major reason for injuries to the caregiving professionals who engage in it. The NHS recommends doing it in extreme cases but the frequent use here is unproductive and damaging. It disrespects the dignity of the patients and worsens the problems in most cases including here (Burrows et al.,2022).

The patients legitimately complain of feeling like “being treated as animals”, “being stuck”, and “becoming worse” (Askew et al., 2020). The “use of force” is recommended by the government to be applied in an extreme situation and a proportionate number of cases. But the doubling of seclusion in the country in the last 5 years indicates the failure to maintain that (Conlan-Trant et al., 2021). This place is a part of that problem which needs to be solved urgently (Jackson et al., 2019). I think failing as a nurse, and as a reputed caregiving system to protect patients from overdosing on prescribed medication is a serious threat to the country’s healthcare system (Tchanturia et al., 2019). In this case, a patient alerting and insisting on already ingesting a particular medication turns out to be the reason for being able to prevent an overdose accident. I can say that the absence of responsible medication distribution practices in place is apparent. The wide range of activities to monitor patient conditions and progress are not conducted and even the simple 15-minute interval “obs” is ignored.

Pulling in the new members and making them falsify the records is observed. This is generalising the corrupt malpractices of cheating the system and causing irreversible damage (Alqahtani et al., 2019). Over 4000 additional doctors and 10000 more nurses included in the NHS in a year is not enough and still almost one out of five nursing posts in the mental healthcare system is vacant (Shalaby and Rahman, 2021). The workforce shortage puts additional stress on the currently working mental health professionals in the system (Mandell et al., 2019). Even then the levels of these atrocities are not “justified”. After the revelation, the suspension of the workers involved and the initiation of an investigation by the “Greater Manchester Mental Health NHS Foundation Trust” has been prompt.

A criminal investigation into this matter which is being conducted by the local police is also appropriate. Revoking the “GOOD” rating by the “Care Quality Commission” has followed and both the NHS and the government have reaffirmed their commitments to “give high priority to high-quality care" and ensure that “the patients are looked after with dignity and respect.” These immediate and small-scale responses to identify the people responsible, the loopholes in the system etc. These actions must be supported by further elaborate actions that aim to focus on developing ways to prevent such incidents.

Conclusion

The action of exposing this nexus and the malpractices conducted that are irreversibly damaging to society has been highly impactful. If this weren’t exposed in this manner this could have been continued for a longer period. Out of all the atrocities caught on camera, the most concerning ones are identifiable. The mental and physical abuses are of varying severity but all of these are frequent. Damages to physical health due to the unnecessary “use of force” to make the patients comply with the instructions and also to seclude them against their will and violating standard policies are unacceptable. Mental health issues intensified and more issues developed due to the verbal abuses, insults regarding their sufferings, threats to make them comply, and mockery of their helplessness are shocking. The corrupt malpractices prevalent are successful in cheating the system. They generalise these malpractices by involving the new employees from the very first days. No corrective or punitive measures were before the revelation, and the “GOOD” rating by the “Care Quality Commission” indicates that. Not maintaining the standard boundary between the professionals and the patients has led to the development of an environment that further promotes malpractices.

I might conclude that this indicates the failure to “lead the group” by the professionals and being a dysfunctional and negatively influencing “part of the group.” The desired activities guided and led by the professionals are extremely lacking and unnecessary activities that are damaging are prevalent. The striking lack of compassion has made the place toxic. This toxicity has consumed the entire system and damaged it to a great extent with irreversible consequences. Low staffing can not be an excuse for such atrocities committed indicating highly unprofessional behaviour. Most of the sobbing and wailings of the patients are the result of the malevolent and negligent actions of the workers in the facility.

Action Plan

Considering all of the alarming and unethical activities prevalent at the mental health care facility exposed by the undercover journalist, the proactive and effective participation of all relevant parts of the society is required. The government, NHS, the trusts running such facilities, healthcare professionals throughout the country, and even the families of the patients must be more vigilant. Any individual like me who is working to become a trustworthy and capable healthcare professional needs to learn many things from this. The key takeaways include the fact that a healthcare professional must not give in to the pressure and take part in falsifying the records to avoid duties. I also expect possible additional use of sensor based data collection methods which are harder to falsify. Involving independent standardisation assessors and families of the patients can enable tracking progress and identify untoward deviations. Encouraging young people to become healthcare professionals, raising the concern of the understaffed system to appropriate authorities are essential. Periodic professional training, transfer and assessment of the caregivers are necessary.

Interacting with the patients receiving care to discover any malpractice experienced by them can be useful (Gosek et al., 2021). The undercover operation conducted by Panorama based on whistleblower inputs has been instrumental in uncovering the rot. Such operations well-coordinated at multiple facilities can be useful in discovering more of such incidents across the UK. The reasons behind the doubling of recorded cases of seclusion in the UK in just four years can be identified this way. Punitive actions against the individuals responsible for these atrocities need to be exemplary. Media coverage, public observation, discussions in public forums, and landmark judgements can create a positive environment. The momentum to facilitate the necessary changes can only be gained by the participation of all cognizant parts of the society.

Smart Goals table

Goals	Specific	Measurable	Achievable	Relevant	Time Bound
Goal 1: To Develop Accountability.	This goal is specific because it is a practice which can be reflected in the actions successfully performed in a healthcare setting.	Improvement can be tracked in the performance assessment processes and qualitative studies on patient experience.	To achieve this goal, simply not skipping assigned duties and refraining from falsifying records can be done.	This goal is relevant because as per the observations, lack of it turns a healthcare setting into a breeding-ground of malpractices and cheats the system.	6 weeks
Goal 2: To Create A Mental Abuse-Free Environment for The Patients.	The specificity of this goal lies in stopping this malpractice of mental abuse entirely.	The measurement regarding this goal can be done by looking at the number of complaints and eye-witness accounts.	This goal can be achieved by creating a list of simple “Not-to-Do”s and enforcing it with a strict directive and compassion-inducing activities.	This is necessary to prevent further damages to the mental health of the already suffering individuals.	3 days
Goal 3: To Create A Physical Abuse-Free Environment for The Patients	The specificity of this goal lies in stopping this malpractice of physical abuse entirely.	The measurement regarding this goal can be done by looking at the number of complaints and eye-witness accounts.	This goal can be achieved by creating a list of simple “Not-to-Do”s and enforcing it with a strict directive and compassion-inducing activities..	This is necessary to prevent additional damages to the health of the already suffering individuals.	3 days
Goal 4: To Stop Unnecessary “Use of Force”	This goal is specific because it translates into replacing disrespectful interventions with suggestions , assistance and other forms of encouragement.	The measurement regarding this goal can also be done by looking at the number of complaints and eye-witness accounts.	This requires patience but is achievable because the training is designed to build capabilities to do this.	This reduces the risks of injury, respects the dignity of the humans, promotes a healthy patient-caregiver bond.	9 days
Goal 5: To Stop Punitive Confinement	The specificity of this goal lies in the stopping of this practice that is totally against all policies and a misuse of the resources.	The measurement can be full of numerical observations including frequency, number of patients, and duration in the seclusion chambers.	This requires proper staffing, proper training and keeping actual records.	Success in achieving this goal promotes recovery, prevents human-right violations regarding the right to freedom.	5 months

References

Provided

• Hargreaves, J and Page, L 2013. Reflective Practice. Hoboken: Wiley
• Jasper, M., 2013 Beginning Reflective Practice, 2nd edn. Andover: Cengage
• Learning
• Masuku, S. (ed). 2022 The Healthcare Professional MOD005910. Custom eBook. ARU London: John Wiley & Sons Publishers

Others

• Abu-Rumman, A., Al Shraah, A., Al-Madi, F. and Alfalah, T., 2022. The impact of quality framework application on patients’ satisfaction. International Journal of Human Rights in Healthcare, 15(2), pp.151-165.
• Alqahtani, S., Nehme, Z., Williams, B., Bernard, S. and Smith, K., 2019. Long-term trends in the epidemiology of out-of-hospital cardiac arrest precipitated by suspected drug overdose. Resuscitation, 144, pp.17-24.
• Askew, L., Fisher, P. and Beazley, P., 2020. Being in a seclusion room: The forensic psychiatric inpatients’ perspective. Journal of psychiatric and mental health nursing, 27(3), pp.272-280.
• Burrows, L., Page, G., Plugaru, E., Kent, B., Odiyoor, M., Jaydeokar, S., Williams, J., Elliot, K., Laugharne, R. and Shankar, R., 2022. Ideal models of good inpatient care for adults with intellectual disability: Lessons from England. International Journal of Social Psychiatry, p.00207640221140290.
• Conlan-Trant, R., Corrigan, K. and Whitty, P., 2021. Completed audit of the use of seclusion in the Approved Centre in Tallaght University Hospital following the introduction of an Integrated Care Pathway. BJPsych Open, 7(S1), pp.S16-S16.
• Gosek, P., Kotowska, J., Rowi?ska?Garbie?, E., Bartczak, D., Tomlin, J. and Heitzman, J., 2021. Longer than prison? A comparison of length of stay in a medium security hospital and prison for perpetrators of violent crimes other than homicide or attempted homicide. Criminal behaviour and mental health, 31(3), pp.162-170.
• Jackson, H., Baker, J. and Berzins, K., 2019. Factors influencing decisions of mental health professionals to release service users from seclusion: A qualitative study. Journal of advanced nursing, 75(10), pp.2178-2188.
• Mandell, D.S., Candon, M.K., Xie, M., Marcus, S.C., Kennedy-Hendricks, A., Epstein, A.J. and Barry, C.L., 2019. Effect of outpatient service utilization on hospitalizations and emergency visits among youths with autism spectrum disorder. Psychiatric Services, 70(10), pp.888-893.
• Shalaby, M. and Rahman, M., 2021. Improving the confidence and competence of junior doctors in conducting seclusion reviews. BJPsych Open, 7(S1), pp.S156-S157.
• Staniszewska, S., Mockford, C., Chadburn, G., Fenton, S.J., Bhui, K., Larkin, M., Newton, E., Crepaz-Keay, D., Griffiths, F. and Weich, S., 2019. Experiences of in-patient mental health services: systematic review. The British Journal of Psychiatry, 214(6), pp.329-338.
• Tchanturia, K., Adamson, J., Leppanen, J. and Westwood, H., 2019. Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme. Autism, 23(1), pp.123-130.