NR 351 Week 3 Discussion: Collaborative Strategies With Other Professions (Graded)

Purpose

This week’s graded discussion topic relates to the following Course Outcomes (COs).

• CO2: Demonstrate leadership strategies that promote safety and improve quality in nursing practice and increase collaboration with other disciplines when planning patient-centered care within systems-based practice. (PO2)
• CO4: Integrate critical thinking and judgment in professional decision-making in collaboration with faculty and peers. (PO4)

Due Date

• Answer post due by Wednesday 11:59 p.m. MT in Week 3
• Two replies to classmates and/or instructor due by Sunday 11:59 p.m. MT at the end of Week 3

Discussion

It is essential for professional nurses to be skilled in collaborating with professionals from other healthcare disciplines to plan the best patient care. What collaboration strategies can professional nurses use to specifically promote collaboration with other healthcare disciplines and professionals?

NR 351 Week 3 Discussion: Collaborative Strategies With Other Professions (Graded)

NR 351 Week 3 Discussion: Collaborative Strategies With Other Professions (Graded)

As nurses it is very important for us to collaborate with various disciplines regarding our patients. A patient may deal with upwads of 50 different healthcare professionals throughout a hospital stay (O’Daniel & Rosenstein, 2008). It is very important that when we are collaboarating with different care providers that we deliver the utmost pertinent information to help each and every member of that patients team aware of the situation so that the best decision can be made. Using SBAR has been the commonplace for giving information to different providers and I think that as nurses we need to have strong communication skills. Missing one piece of information could, in the long run, cause a decrease in care or be detrimental to their health. 

As nurses, we need to be willing to address situations that we are uncomfortable with, and be truly empathetic for our patients (O’Daniel & Rosenstein, 2008). “To be truly empathic, nurses as helpers must listen carefully so they can act as intended, perceive and accept the inner feelings and experiences of clients as the clients experience them, and paraphrase feelings, ideas, and intentions accurately” (Hood, 2018). These situations may be a decision made in care, a medication change, or even a placement decision for post discharge. It is very important that we stand up for our patients and advocate correct and just treatment. We are dealing with patients on their worst day, everyday. It is vital to understand that being hospitalized is very scary or traumatic for some and that their thinking process may be slightly clouded. We need to make sure we are willing to address any and all situations that we do not see in the patients best interest. 

As for a personal experience, at my hospital we do care rounding each morning. During the small, informal meeting, we will address diagnosis, any issues in placement, procedures the patient is awaiting, things the patient may need upon discharge, and a variety of other patient centered needs. For example, I had a patient that needed to go on hospice and needed to go back to the long term facility he came from. His wife was unable to properly care for him at home, even with a nurse visit each day. They did not have enough money to pay for room and board at the LTC facility. I was able to contact a different case manager at the hospice company and we were able to get them signed up through a different state funded avenue and he was able to go back to LTC at his facility he was comfortable with. I think its important that this is always done and that as nurses we really take the time to assess the situation so that we can get our patients exactly the care they need so we can optimize healing. 

Hood, L. J. (2018). Leddy & Pepper’s conceptual bases of professional nursing (9th edition). Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins.

O’Daniel, M., & Rosenstein, A. H. (2008). Professional Communication and Team Collaboration. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2637/

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Collaboration is an important factor in any career field. It is especially so for the health care field to provide patients with the best care possible. I thought that collaboration and communication were the same things but, they are different yet codependent. According to Wells (2017), “Collaboration is the action of working with someone to produce or create something. Communication is the imparting or exchanging of information or news.” This is something that nurses and all other members of the health care team do daily to provide the best care for their patients.

While the common goal is to provide the best care possible, there are sometimes barriers. In order to overcome these barriers, nurses can use a variety of collaboration strategies. According to Hood (2018), using SBAR, verifying orders, and using I PASS the BATON are all collaboration strategies for effective communication. SBAR is a template that is used by nurses to communicate with other members of the health care team to explain the situation, background, assessment and recommendations or requests are for the patient. While I communicate this information every shift, I PASS the BATON is a strategy that I haven’t heard of before. Introduction, patient, assessment, situation, safety, background, actions, timing, ownership, and next are all crucial information needed to give in the report to the next shift, (Hood, 2018).

One strategy that I use daily at work is what we call huddle. Around 10 am, Monday-Friday, the nurse, case management, and our manager all meet in the backroom to discuss a plan of care for each patient that we are assigned to. We also discuss what needs to happen to carry out the plan of care for each patient. This includes which doctors need to be contacted, if the case managers need to set up an ambulance ride home or to a facility and making sure they have been approved to go to the facility. This helps make a complex plan more achievable.

References:

Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer.

Wells, K. (2017, November 29). Collaboration vs. Communication: Why the Difference Matters. Retrieved March 10, 2020, from Field Service Digital website: https://fsd.servicemax.com/2017/11/29/collaboration-vs-communication-the-difference-matters/

There have been many efforts to promote collaboration and communication in health care teams and disciplines. Off the top of my head, communication tools such as an SBAR (a ,technique of delivering information of: situation, background, assessment, recommendation to develop a multidisciplinary decision and treatment), contribute significantly to collaboration. When used in a consistent matter with all members of the health care team, it can help to ensure everyone is on the same page with addressing concerns and safety of the patient.

“Collaboration in health care is defined as health care professionals assuming complementary roles and cooperatively working together, sharing responsibility for problem-solving and making decisions to formulate and carry out plans for patient care” (O’Daniel, Rosenstein, 2008). Collaboration and communication must co-exist in the health care setting in order to deliver and provide best patient outcomes.  I strongly feel that collaboration with other health care disciplines and professionals needs to have a strong foundation of communication to be able to build upon that. Developing a strong skill for communication is something that is practiced daily and improved over time.

One of the strategies that I appreciated, besides communication, that would help promote collaboration with our health care team and professionals was to be able to identify and be accountable for your limitations, strengths and weaknesses as a member of a team (Massachusetts Nurse of the Future Nursing Core Competencies, 2016 ). I feel that our discussions thus far have helped us all in this strategy already and it makes it very relatable. This strategy of recognizing within one’s self can help nurses recognize their responsibilities, contributions and role in the team and be able to collaborate with other professionals with respect, honesty and integrity (Massachusetts Nurse of the Future Nursing Core Competencies, 2016). All of which are key components to promote healthy, strong collaboration in a team setting.

In the article “Professional Communication and Team Collaboration” by Michelle O’Daniel and Alan Rosenstein, it is noted that poor communication or a lack of communication have a higher incidence of causing medical errors (p 271). According to the Joint Commission, if medical errors were considered a cause of death in national health statistics, it would rank as number 5 in the United States (O’Daniel, Rosenstein, 2008).  Health care teams can consist of multiple members in different modalities of care and because this creates a level of diversity, respect and thorough communication are key. With good and frequent communication between individuals, understanding others’ knowledge and skill set in their practice helps to establish familiarity, trust and respect for the individuals (O’Daniel, Rosenstein, 2008). These components help contribute to improve collaboration in health care teams, improve patient safety and outcomes, and decrease the incidence of medical errors.

O’Daniel, M., Rosenstein, A., (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses, 2^nd Edition. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2637/Links to an external site..

Massachusetts Nurse of the Future Nursing Core Competencies: Registered Nurse. (Revised March 2016). Retrieved from http://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016.pdf

Nursing as a health care science focuses on serving the needs of humans as a biophychosocial and spiritual being.  Its practice requires not only scientific knowledge, but also interpersonal, intellectual and technical abilities and skills.  This means a composition of knowledge, clinical work and interpersonal communication.  Communication is a vital element in nursing in all areas of activity and in all its interventions such as prevention, treatment, therapy, rehabilitation, education and health promotion.  Good Communication also improves the quality of care provided  to patients, which is observed in the results.  Additionally, it is considered an inalienable right and a prerequisite for building a genuine and meaningful relationship between patients and nurses and other health professionals.  Kourkouta (2014). Effective communication between nurses and physicians is extremely important to patient safety.  The Joint Commission reports that communication errors contribute to the majority of sentinel events reported.  Thomas (2009)

I would like to share an experience I had recently involving poor communication, teamwork and collaboration.  It involved a scheduled procedure on a patient’s left hand.  This patient was evaluated and diagnosed by her surgeon, seen by him the morning of the procedure, completed all the pre-operative assessments and was ready to be transported to the operating room.

While performing my assessment and interview, I noticed a bangle bracelet on her left wrist, the operative limb.  I kindly asked her to remove the bracelet.  Patient stated that the bracelet has been on for the past 20 years and she was physically unable to remove it.  She became emotional and tears begin to flow.  She shared with me how special the bracelet was to her and if it must be removed she would not proceed with her surgery.  By taking the time to listen and sympathize with my patient, I recommended that she reconsider her decision.  I pointed out that she had mentally and physically prepared for the procedure.  She would still have the pain and problems that she had previously. Upon further dialogue, it was discovered that the bracelet was actually made of glass and therefore, could not be removed safely in the hospital setting. I explained that we would try to figure out a solution together.

I contact the surgeon and he said he would not perform the procedure if the bracelet was not removed.  At this point, I communicated the situation to my supervisor.  My supervisor consulted the surgeon and explained the predicament.  At this point, he decided to perform the procedure with the bracelet left in place but secured and kept out of the sterile field.  

Again, I returned to the patient and explained what the plan was moving forward. She was to immediately seek treatment in the emergency department should swelling occur because the bracelet could cause harm and increase the risk for potential loss of hand/limb.  She understood and agreed to use ice and elevation to minimize the swelling.  I also spoke to the husband and explained the events, the delay and the importance of monitoring for swelling. 

My patient was relieved, the procedure safely performed and her bracelet remained in place.  The roles assumed by nurses require that they have a repertoire of clinical, cognitive and communication skills.  Adaptation to situations is necessary as nurses often encounter complicated patient situations.  Hood ( 2018). This event included communication, teamwork and collaboration, safety, patient centered care, quality improvement, leadership and professionalism on my part as a nurse.  These core competencies came together to allow me to provide excellent patient care.

References

Hood, L. J. Leddy and Pepper’s Professional Nursing (9th ed.).  Philadelphia, PA Wolters Kluwer 

Kourkouta, L. Communication in Nursing Practice (February 2014).  https://www.ncbi.nlm/nih.gov/pmc/articles/PMC3990376/

Collaboration is an important factor in any career field. It is especially so for the health care field to provide patients with the best care possible. I thought that collaboration and communication were the same things but, they are different yet codependent. According to Wells (2017), “Collaboration is the action of working with someone to produce or create something. Communication is the imparting or exchanging of information or news.” This is something that nurses and all other members of the health care team do daily to provide the best care for their patients.

While the common goal is to provide the best care possible, there are sometimes barriers. In order to overcome these barriers, nurses can use a variety of collaboration strategies. According to Hood (2018), using SBAR, verifying orders, and using I PASS the BATON are all collaboration strategies for effective communication. SBAR is a template that is used by nurses to communicate with other members of the health care team to explain the situation, background, assessment and recommendations or requests are for the patient. While I communicate this information every shift, I PASS the BATON is a strategy that I haven’t heard of before. Introduction, patient, assessment, situation, safety, background, actions, timing, ownership, and next are all crucial information needed to give in the report to the next shift, (Hood, 2018).

One strategy that I use daily at work is what we call huddle. Around 10 am, Monday-Friday, the nurse, case management, and our manager all meet in the backroom to discuss a plan of care for each patient that we are assigned to. We also discuss what needs to happen to carry out the plan of care for each patient. This includes which doctors need to be contacted, if the case managers need to set up an ambulance ride home or to a facility and making sure they have been approved to go to the facility. This helps make a complex plan more achievable.

References:

Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer.

Wells, K. (2017, November 29). Collaboration vs. Communication: Why the Difference Matters. Retrieved March 10, 2020, from Field Service Digital website: https://fsd.servicemax.com/2017/11/29/collaboration-vs-communication-the-difference-matters/

Collaboration strategies that can be used by professional nurses to specifically promote collaboration with other healthcare disciplines and professionals are clear and concise communication, whether it is verbally or written. In order to have successful collaboration one most know the principles of communication, which according to Hood (2018) is presence, empathy, respect, and genuineness. When we communicate effectively, we should be present and engaging, show we care, listen attentively to others and be genuine in order to work well with others as part of a team. One way we collaborate in PACU is bedside report, it is started in pre-op and ends when the patient is taken to the floor. This helps the team provide optimal care to the patient by letting the team know if there are any health problems that need to be monitored, likes/dislikes or cultural/language barriers. When there is a breakdown in one of the principles of communication valuable information is lost which can lead to a poor outcome.

  The purpose of collaboration is to create a shared vision, address concerns, exchange information, alter activities and share resources to achieve a common purpose.  According to experts, collaboration requires two basic competencies: technical, which refers to the knowledge and skills needed; and personal, which is the ability to work in a team with others, in order to move forward as collaboration becomes progressively more important ( Berman, 2006).  Therefore, I believe we can’t collaborate unless we have effective communication.

References:

Berman, J. (2006). Working Toward the Future: Why and How to Collaborate Effectively (5th ed.,       Vol. 68, pp. 44-48). N.p.: Corrections Today.

Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters   Kluwer Health | Lippincott Williams & Wilkins, p. 92.