In this assignment I am going to discuss my Work based project how I came to design it and the outcomes. The individuals mentioned are described using pseudonyms and I have also applied asterisks against these names. My workplace (Willows) is a 14 bedded psychiatric unit with currently twelve service users who are seven females and 6 males respectively. It is a secure psychiatric care unit for patients who have been sectioned under the Mental Health Act, 1983. The patients range from the age of 21 – 40.
The ward offers assessment, treatment and an intensive level of nursing care to patients who: – Present a risk to themselves due to suicidal ideation or actions – Present a risk to others due to actual or threatening violent behaviour – Present with behaviour which is too disturbed or too disruptive to manage on an open ward – Present a risk to self or others due to absconding behaviour Each referral to the ward is assessed on an individual basis according to antecedents and environmental factors leading to referral.
Admissions to the service are normally by the following routes: – Transfer from other wards within the Trust. – Directly from the community via the Emergency Clinic. Occasionally patients may be transferred from prison under a hospital order for assessment and treatment, after a medical and nursing assessment. The service users suffer from various illnesses including bipolar disorder, depression and schizophrenia. Many of them are long term patients and may continue to be in the future. I have been working at the unit for about 4 months but only as a bank shift worker.
The service users are encouraged to undertake several activities for recreational purposes such as crafts, cooking, grooming, music, watching television and so on. However I noticed that very few of them took part in any of these activities and seemed less than enthusiastic or were totally disinterested in them. Moreover when the patients undertook the activities they did not do them as a group activity and social interaction was low. Therefore I realised that there was a need for the activities to be examined and find out why the service users did not enjoy taking part in activities.
Proposal I approached the Senior RMN on the ward and proposed that I would like to devise an activity that the service users would thoroughly enjoy because it would be chosen by themselves rather than the current way of presenting them with a list of set options of activities and asking them to chose one to do, in most cases when I had asked the patients to choose they did not chose any at all or very reluctantly chose an activity to do. The collaboration with the RMN was very important in aiding the design of my project and would be instrumental in producing a successful result.
Firstly, because she has in depth knowledge and understanding of the mental illnesses that the patients have and also she could explain the best way of approaching the patients individually and finding out what their interests are. Secondly it was important to make sure that I was adhering to the ward’s policies and make certain that the project did not compromise the service users wellbeing and reserve that I would be ethically aware at all times. My main aim was to make sure that the service users had a say in the development of the activity that was going to be chosen.
I then decided to devise a pilot study and researched on the different methods of research design that I could use. I decided on a questionnaire(see appendix 1), which consisted of open ended questions and this would aid me in having an idea as to what the service users thoughts were about the activities that were offered at the unit. After lunch on one of my long day shifts I announced to all the service users that I would be giving out a questionnaire and explained the details as to why I was doing it and asked for four volunteers to take part, preferably two of each sex.
Five service users seemed enthusiastic and said they’d like to take part. I decided to give the questionnaires to them and asked them to fill them in whilst they were in their rooms and that I would collect them the next day. It was important for me to take into consideration the timing of giving out the questionnaire as ‘there may be particular times of the day when someone feels more able to focus on a discussion because of their medication’ (White and McCollam, 1999). My aim was to explore themes that arose from the questionnaires by conducting interviews with the patients.