NR 351 Discussion Collaborative Strategies With Other Professions

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 among different healthcare professions is important in providing quality patient-centered care. The term interprofessional has largely replaced the term interdisciplinary, although you may see both terms used.

NR 351 Discussion Collaborative Strategies With Other Professions

Massachusetts Department of Higher Education Nursing Initiative (2016) stated that understanding “the impact of effective collegial communication on patient outcomes” (p. 39) is essential in professional nursing. While we sometimes collaborate with patients and their families in planning nursing care (Hood, 2018), in this week’s discussion we are considering collaboration between and among different healthcare professions (or disciplines). Since nurses are coordinators of care (Chamberlain College of Nursing, 2016), we need to become experts in the use of communication strategies that enhance and promote interprofessional collaboration.

Class, please return to the original assigned discussion topic above. Clearly and thoroughly address the assigned question. Remember to use your assigned readings or the Week 3 online lesson PLUS a scholarly outside source to support your statements. APA format for citations and references is strongly encouraged.

We look forward to your contributions!

References

Chamberlain College of Nursing. (2016). NR351 Transitions in Professional Nursing: Week 3 lesson. Downers Grove, IL:Online Publication.

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

Massachusetts Department of Higher Education Nursing Initiative. (2010). Massachusetts Nurse of the Future Nursing Core Competencies^© Registered Nurse. 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/

That incidence with the bracelet happens all too often. So many times a patient will come in with a piece of jewelry or something that they just can not part with. It was so kind of you to find a way around all of this so that she would be comfortable proceeding on with the surgery. Its so important to build up that good rapport with patients while you care for them and I bet your patient was truly thankful for your genuineness regarding this situation. I think removing her bracelet would’ve led to increased anxiety. Anxiety has been known to use up vital energy in stressful situations, that the patient could instead be, using to heal (Hood, 2018). I am so glad your patient was able to go through with the surgery. I feel like as nurses, our job is to get on the patients level and try to understand what they are truly going through. All too often nurses get “cold” to situations and we forget that we are taking care of human lives and we need to slow down and remind ourselves that to the patient, this is not just another day at work, this has to do with their health, well being, and future.

Do any of you have sentimental value on something you have that could be detrimental to your recovery?

Nurses need all three skills listed, “interpersonal, Intellectual and Technical skills” to provide a safe environment for all patients. Health care professionals have to create a collaborative relationship so that they can share decision making, improve patient experience, and patients outcomes. Sometimes the patient is more comfortable interacting and speaking to their nurse about critical information; then, the nurse has to convey the information to the physician; therefore, nurses have to be able to communicate effectively.

I enjoyed reading your experience; you were a patient advocate, because of your communication, collaboration, and teamwork with other healthcare professionals, the patient was allowed to have the surgery. What could have turned out as an unpleasant experience for the patient had a good outcome.

Since “quality and safety for patients rely on effective communication among all health team members” (Hood, 2018, p. 108) professional nurses should identify their own strengths and weaknesses, as well as what they, as nurses, can add to the healthcare team (Massachusetts Department Of Higher Education Nursing Core Competencies, Revised 2016) to promote collaboration with other healthcare disciplines and professionals. To achieve this mean, Cummings et al. (2015) encourages all healthcare professionals to “have the confidence and courage” to work in an interdisciplinary fashion to achieve our patients’ best outcomes. Over the years, I have become quite confident in my nursing abilities, allowing me to display the courage necessary to advocate for my patients. Through “clear, concise, and effective written, electronic, and verbal communications,” (Massachusetts Department Of Higher Education Nursing Core Competencies, Revised 2016) I have earned the respect of those with which I collaborate. They too, have earned my respect in a similar fashion. From that, mutual respect fosters excellent communication, collaboration, trust, and teamwork. We all have our jobs… our specialties, and trusting the skills and capacities of each member of the team, in addition to valuing their senses is, in my opinion, the essence of collaboration.

References

Cummings, J., Clarke, J., & Evans, J. (2015). The importance of showing courage in delivering effective health care. British Journal of Healthcare Assistants, 9(6), 295-296.

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

I concur with your comment about being confident and understanding your own strengths and weaknesses. I an era that has been trying to eradicate the bullying (eating our young) aspect of nursing for the betterment of patient care these are important traits.

Safety for patients cannot be maintained in an environment that allows one nurse, physician or any staff person to ride heavy-handed over others. As a younger nurse at a hospital I worked at previously we had a couple of night hospitalists, and specialists that were notorious for being “unfriendly” to nurses on the phone. There was frequently a long delay before phone calls were made on the patients behalf while a nurse bolstered herself for what she knew was coming . While you hope that delays did not occur when it was an urgent matter the fact is there should never be a relationship that causes a nurse to hesitate to collaborate with a physician about a patients condition. As we have all probably seen in our practices, with time nurses become more confident in their roles and knowledge. Hopefully, we all become the nurses that lift up the younger nurse and communicate our knowledge, helping them to flourish and not assume the age-old bully mentality, expecting the new nurse to learn on their own.

NR 351 Discussion Collaborative Strategies With Other Professions