DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

Individual authors from different professional disciplines have published opinions
regarding ward round practice. One article in the form of a letter written by a consultant
psychiatrist expressed very negative views about the way ward rounds are conducted
highlighting the lack of a pharmacist in many mental health ward rounds and the
emotional effects on the patients, (Palin, 2005). In another study the nursing team in a
paediatric hospital expressed dissatisfaction with many aspects of the ward round,
(Birtwistle, 2003). Birtwistle’s article highlighted that the perceived inequality of roles in
ward rounds is not confined to psychiatry, reporting that nurses expressed dissatisfaction
with many aspects of the surgical ward round. There were numerous additional articles
that highlighted the experience of nurses not feeling able to participate in decisionmaking
activities in ward rounds due to the dominance of doctors e.g. Manias (2001).
Another suggestion about how ward rounds can best be conducted was to have a
communal ward round in which all available staff and all the team inpatients (usually
between six and ten) attend, (Price, 2005). This had been piloted and the advantages
included saving time as welcoming/introductions and explanations of drug actions, side
effects and other matters, which often affect more than one patient, only had to be done
once. Moreover, patients did not feel as anxious because no-one had to go in and
confront the team alone and no-one had to wonder whether they would be summoned at
all. It was also found that the individual could hear the view of their fellow patients and
that this was often more powerful than the advice of the staff. The disadvantages included
problems with confidentiality e.g. the fact that it was not judged appropriate for family
members to attend, meaning they were seen separately. The author found that most
patients preferred the communal meetings, however this may have been because the unit
was run on group lines and that if this were not the case the patients may not have been as
receptive.
Certain professionals have been found to be under-represented in ward round attendance
e.g. psychology and pharmacy services, (Hodgson, 2005). Therefore the views of these
professionals may not be as recognised and it remains unknown whether they differ from
other professionals.
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