Teamwork and Collaboration in Nursing

A crucial part of nursing is being able to cooperate and work with others to provide the best quality of care possible for the people we care for. For us to achieve this we must work as a team and collaborate with others involved in the care process. Working together to achieve a common goal by having the ability to function effectively within nursing and interdisciplinary teams, while fostering open communication, respect for others, and shared decision-making to accomplish quality patient care is teamwork and collaboration (Hood, 2014).

Teamwork and collaboration does not happen only between physicians and nurses, it includes the patient as well as the interdisciplinary members involved in their care whether directly or indirectly, throughout their entire hospital stay. It is critical for nurses to work as a team and collaborate with others involved in the care of their patients because it is essential to providing superior patient care as well as reduce the risk for medical errors (Fewster-Thuente, 2015). The most crucial factors of teamwork and collaboration are our number priority as nurses, the patient and the need to build a relation between co-workers.

Patients, our Priority

As nurses our obvious priority are the patients, as the priority we must be able to work with the patients as a team as well as have them collaborate in their care. The ability to communicate with patients respectfully, honestly, as well as being able to empathize with their situation, allows the patient to share in the responsibility for their care, which will facilitate a successful nurse and patient team and collaboration. Nurses develop what is known as a collaborative relationship with their patients, during the process of assessment and medication administration by communicating with the patient this type of relationship “”allows the patient to feel more open to sharing key information that can be helpful during their plan of care”” (Hood, 2014, p.85).

When nurses effectively collaborate and work with their patients as a team they can decrease the occurrence of miscommunication and errors. By including as well as making the patient aware of what their plan of care entails, care plans effectively implement the plan of care established for the patient, to do so they need to s hare what the plan for care is patients as if they are a member of the team and not just someone who has to do what we say, when we say, build for better team.

Allowing the patient to participate in their care, provide them the ability to speak up earlier rather than later when a treatment is not being effective. Nurses must speak with their patients before administering any form of medication or treatment not only because the patient has the right to know what they are taking or what is being done to them but because effective communication decrease the risks for any potential errors. i.e. the physician could have discontinued a medication, the patient is aware of this however , the physician or the previous nurse forgot to discontinue the medication, it is still showing on the patient chart to be administered , if the nurse just went into the patient’s room and said here are your medications instead of going over the medications to be given, they have now caused a medication e1rnr. If they were working with the patient as a team member the error could have been prevented by the patient letting them know the medication was discontinued which they could have then called and verified the information with the physician.

Impact on Nursing

Effective teamwork and communication are critical to functioning safely in any situation you may be presented with. A nurse who is able to work in an empowering environment who is comfortable communicating with peers will have greater success if they are ever in an overwhelming situation. This nurse knows that she has a team of nurses who are able to step in to assist at a moment’s notice. This type of teamwork in the health care system can result in an increase in effectiveness, time efficiency, staff moral e and patient satisfaction, as well as lower stress for nurses on the unit (Kilner & Sheppard , 2010).

Impact on Patient Care and Patient Outcomes

The main goal of any patient situation is to improve patient care and improve patient outcomes. When people work together, this can be accomplished. Teamwork and communication are essential priorities because it provides a base for quality patient care. When a nurse is working in a unit that practices effective teamwork and communication, she is not just using these skills to collaborate with other nurses, but to also make sure the patient is involved in the process as well. When the nurse involves the patient in the plan of care, they will not only get the autonomy they deserve but will also feel trust and confidence in the members organizing care.

Interventions to Improve Teamwork and Communication

Team Strategies and Tools to Enhance Performance and Patient Safety, or TeamSTEPPS, is an evidence-based framework that has been designed to improve health care professionals’ teamwork and communication skills ask they work towards improving patient safety (Agency for Healthcare Research and Quality [AHRQ], 2017).

Developed by the Department of Defense’s

Patient Safety Program in collaboration with the AHRQ, TeamSTEPPS is a source for materials and a training curriculum to effectively incorporate teamwork principles into all aspects of a nursing unit. TeamSTEPPS not only offers methods towards providing higher quality and safer patient care, but they also have a three-phase delivery system aimed at creating and sustaining a culture of safety. These phases determine the readiness of the unit, implementing all TeamSTEPPS strategies and tools throughout the unit and ensures continual reinforcement of the TeamSTEPPS principles from all nurse lea der s within the unit (AHRQ, 2017).

Although this might present itself as a complicated system, there are many different ways a nurse leader can implement the TeamSTEPPS tools and strategies to develop effective teamwork and communication on the unit while ultimately improving patient safety. This can include, speaking up about your concerns, communicating professionally to resolve conflicts and learning how to be an active team member.

Another intervention that nurse leaders could use towards improving teamwork and communication within the unit is following the framework of the Interpersonal Relations Theory by Hildegard Peplau. This theory shed light on the value of the nurse -patient relationship while providing a framework for the building and maintaining of that relationship (“”H. Peplau Theory,”” 2016). Peplau’ s theory not only provides great resources for the nurse-patient relationship, but it can also provide a framework for nurse leaders looking to improve communication in a nurse leader-nurse relationship.

As a nurse leader, one could move through Peplau’s four phases while working towards building a stronger connection amongst staff. First, we have the orientation phase, this begins with two strangers who are essentially different, with their own ideas, values, and goals. As nurses, it is common to find yourself in the role of the strange r when stai1ing a new job, moving to a different unit or even when switching from night shifts to day shifts.

Building trust and establishing a therapeutic and dynamic environment where the nurses can identify their need s is important in this phase. Here, the nurse leader is able to build a relationship with other nurses and can begin communication necessary for progression into the identification phase. In the identification phase, the nurses should feel more at ease as they are able to identify their problems and issues they find within their group. In this phase, nurses are able to explain their need for better teamwork and communication and the nurse ‘ s feelings can be explored.

The discovery of these feelings might lead to a feeling of helpless ness and dependence by some nurses, so it is important for the nurse leader to ensure enough space and time to express these feelings while maintaining a non-judgmental relationship (Beeber, Anderson, & Sills, n.d). Next is the exploitation phase, where the nurses are able to embrace the thriving environment that now uses effective teamwork and communication strategies. Here, the nurses will feel like an integral part of the process and will have to balance between dependence and independence.

In this period of change, the nurse leader must be able to recognize when other nurses need guidance as they shift between dependence and independence. As the nurses begin to use their new teamwork and communication strategies consistently during their daily practice, the resolution phase begins. In Peplau’s theory, this is where the nurse-patient relationship is terminated. However, if we are applying this theory to a nurse leader-nurse relationship, termination cannot be an option as it is essential to always keep communication lines open between all members of a team.

The evolution of health care has become more interconnected by coordinating the ca re of patient s between the ones involved in planning the care to help improve patient outcomes. Teamwork and collaboration between nurses, pharmacists, physicians, social workers, therapists, and other disciplines have become increasingly crucial to a positive patient outcome. “”For patients to achieve their goals an exchange of information and ideas between interdisciplinary members to develop the plan of care includes discussing, sharing information , asking questions, offering suggestions and opinions, and working out differences, and must occur in an environment of respect, open-mindedness, and listening for collaboration to occur and harmony to be created”” (Fewster-Thuente, 2015, p. 360). The ability to work together not only promote for a better outcome for patients but also builds a better more successful relationship between team members.

Direct patient care is not the sole responsibility of the professional nurse. There are a multitude of health care team members that provide direct patient care such as, nursing assistants, lab technicians, radiology technician, dietary aids and many others. To provide the best quality care each of those team members need to be able to collaborate wand work together, there cannot be any animosity or feelings of superiority amongst each other because patients are able to detect when there is conflict amongst co-workers.

They can see it on our faces and hear it in our tone of voice or even in our body language or attitude. We can work on our teamwork and collaboration skills by building a relationship that is built on mutual respect, taking the time to listen to each other’s views, asking questions if unsure of a situation instead of assuming, resolving any conflict that may arise as soon as possible with the assistance of a third party if unable to resolve it amongst each other (Hood, 2014). We all have the same common goal, providing quality care.

In conclusion, the patient is our number one priority and providing them with the most efficient, effective quality care is a common goal we all share whether we care for them directly or indirectly. So, for us to provide them with the most optimal care we as nurses need to remember that we are not the only ones that provide care for them but that there are a multitude of people who are involved in the care planning and implementing process.

We must be able to work as a team and collaborate with each other to provide such care. We need to also realize that even though the care team plan and implement care, the patients are also a member of the team and must be included in their plan of care. The care we provide will not be effective if the patient is not willing to accept it. For the most effective, efficient, and quality care to be provided we must work together to achieve it.

References

1. Fewster-Thuente, L. (2015). Working together toward a common goal: A grounded theory of nurse- physician collaboration. MEDSURG Nursing, 24(5), 35 6- 362.
2. Hood, L. J. (2014). Establishing helping and healing relationships. In Leddy & Pepper’s conceptual bases of professional nursing (8th ed., pp. 85, 101-102, & 104). Philadelphia, PA: Wolters Kluwer Health /Lippincott Williams & Wilkins.
3. Hood, L. J. (2014). Health care delivery systems. In Leddy & Pepper’s conceptual bases of professional nursing (8th ed., pp. 227-230). Philadelphia, PA: Wolters Kluwer Health
4. /Lippincott Williams & Wilkins.
5. Institute for Healthcare Improvement. (2017). PS 104: Teamwork and communication in a culture of safety. Retrieved from http://app.ihi.org
6. Kilner, E., & Sheppard, L. A. (2010, May 27). The role of teamwork and communication in the emergency department: A systematic review. International Emergency Nursing, 18, 127- 137. http://dx.doi.org/10.1016

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