The Role of Teamwork and Collaboration Processes in Patient Care

As the trained nursing staff are often deployed in administrative, teaching and supervisory roles, student nurses are, in effect, the nursing staff of the hospital, the team at the operational level with patients and carry out most of the relevant tasks says Menzies. This essay on teamwork and collaboration will explore the role and contribution of the student, their colleagues and different professions make to the provision of effective teamwork and collaboration within the work place and organization. Knowledge and understanding will be demonstrated of the roles and different contributions each profession makes within the work place and organization. An awareness of inter-professional and inter-agency issues with regard to effective communication, teamwork and collaboration will be demonstrated. A brief description of effective communication, teamwork and collaboration will be provided and theories of communication and teamwork will be brought in, focusing into my role, in relation to my team and how this effects my contribution both positively and negatively. My personal role will be identified in detail and linked to what I do in practice relating to taught theories and my specific team. I will pick several professionals I routinely work with and discuss how we work together effectively within the team including any barriers.

The Importance of Effective Communication in Patient Care and Teamwork

In order for delivery of patient care to ran smoothly and effectively, teamwork and collaboration are important and good, clear communication is the element that binds them together. Communication is a two way effective process in which two or more people send and receive messages. In their Circular transactional framework of communication, Bach and Grant say that between the sender and receiver, communication can be influenced by context, channels of communication, distracting stimuli and interpersonal space. Good communication adds Hargie, promotes, among many positive aspects, Person Centred care, more accurate and sharing of information and fewer mistakes. Sadly, according to Boudreau et al; Browning and Waite, not feeling listened to is a major complaint from patients. Poor communication, therefore, can result in avoidable situations where patients needs are unmet causing deterioration in their conditions.

In communication there is much more to consider than mere words. Hargie reminds us that 'listening is at the heart of communication. It is a fundamental skill and a basis of all communication'. Mehrabian talks of the three basic elements of communication of feelings attitudes being broken down as 55% body language; 38% tone of voice and only 7% on content. In the listening process, the listener receives the message, selects what matters to them, interprets the meaning before integrating the message into their frame of reference, hence understanding it. With that they evaluate the merits of any action before deciding what to do with the information, hence resolving it. Verbal communication, the speech, depends on tone, volume, intonation, pitch and pace. Body language, non-verbal communication, says a lot without words by way of facial expressions, gestures, eye contact appearance, touch and posture among others. With patients, we use both verbal and non-verbal communication all the time.

About a month ago, a colleague and I had to visit an elderly, amputee patient who we had not seen before. The patient was wheel chair bound and when we got to him he was eating his dinner. Unfortunately he was not a very friendly patient and ordered us about as soon as we got through the door. The room the patient was in had a strong smell of faeces and we were to discover his bed was smeared with it. We assisted him with a full body wash and changed his beddings. I thought we did a good job but just before we left, my colleague was doing an entry in the folder in another room and the Patient accused me of pulling a face. I certainly was not aware I had done this and I apologised. Whether this was true or not, it reminded me how much we need to be aware of non-verbal signals as these can easily be misconstrued.

Some considerations to bear in mind as barriers to good communication include time, language, gender, cognitive ability and personal agenda among others. While working in a team, active listening is very important. As Arnold and Boggs say, it combines verbal and non verbal components of a message into an integrated, meaningful whole, With good communication in an organization's success, is effective teamwork and collaboration.

Effective Teamwork and Collaboration in Patient Care

A team is a group of different individuals having clear shared objectives, working interdependently to achieve these objectives and regularly reviewing the way in which the team is working to achieve those objectives. Teamwork is a result of what this group of people produces; 'Working through collective endeavour towards a common goal' as described by NHS Leadership Academy. As patients conditions normally have different causes requiring multiple treatments and inputs, a range of social care and health professions with differing skills and expertise, work together in inter-professional and inter-agency teams to deliver good quality care as just one team cannot meet all the patient's needs. Within such a large group of people, the team, different strengths are needed from different ones for building success and understanding failure according to Team Roles at Work. These roles: shaper, implementer, completer, co-ordinator, team worker, resource investigator, plant, monitor evaluator and specialist; each one plays an important role complementing each other, there are no stars and no extras. I believe I fit best in the role of plant, the source of ideas, suggestions and proposals that are usually original and radical. I am also a good team worker as I operate against division and disruption in the team, I believe in a win/win policy; if my input helps the team to excel then I am a winner and so is the team. All these roles will be present in a balanced team.

Collaboration

I am a community Generic Worker in a local trust working within a Multi Disciplinary Team of professionals. My personal role from day to day is to support patients in the their own homes with Activities of Daily Living (ADLS). While assisting patients with personal care, meals and drinks preparation, and any other activity they might be struggling with, I also support them with any exercises prescribed, deliver equipment and sometimes need to monitor their observations. I feed back any concerns or progress to the clinicians from the patients, their care givers or families. Other professionals include nurses, these do observations and take bloods from the patient to establish if their medical status needs action; physiotherapists assess a patient for any exercise regime needs; occupational therapists and assistant practitioners assess a patient for any equipment needs; all these professionals can make an initial assessment on the patient to establish their needs at a time of crisis. In addition there are voluntary services on the team like red cross who assist patients in non-medical needs like shopping, cleaning and moving furniture and Suffolk family carers who give advice and support to carers and their families. Social workers organise on going care if a patient needs assistance longer term after our five days crisis period is over. For delivery of successful patient care, effective teamwork and collaboration on my team is tantamount.

About two months ago, we had a patient who had had two strokes and was struggling to weight bear especially on her left side, her husband had been managing by physically transferring her to and from different positions around the house. One morning the husband told us to transfer her onto the commode and give her a wash there. As soon as he left the room, the patient said she did not want to use the commode and preferred to have a wash in bed; we granted her wish. A couple of days later the husband rang to say the patient had fallen and he needed our help to get her off the floor. As we had the right equipment, a riser, we did that no problem. On the next visit however, the patient confided in one of us that her husband was getting very rough with her and she was quite upset and tearful. That raised some concerns and was reported back to the clinicians who, before escalating it to a safeguarding issue, as we have a duty of care to our patients and something needed to be done. They did their research and it was decided rather than escalating, the husband needed help and support as he was clearly tired and frustrated hence appearing tense, edgy and snappy. The Social Worker organised for our visits a day (QDS) to alleviate the onus of all care from the husband and Red Cross arranged some visits to help with domestic chores. Suffolk Family carers also paid him a visit to offer support and advice. This is a good example of effective teamwork and collaboration.

If communication is poor, this can be a barrier to teamwork and collaboration as different roles within the team would not be clear on what they were to support a patient with on a visit. To avoid such breakdowns, a green folder is left in a patient's house and anyone who visits from the team documents what they have done for or with the patient so that there is a continuous flow of information that can easily be read back if need be. This same information is also entered into System1 which is a centralized computer system that all on the team can access as long as they have an assigned username and password. Another barrier would be the use of jargon.

Conclusion

In conclusion, this essay has explored the role and contribution of the student, their colleagues and different professions, make to the provision of effective teamwork and collaboration within the work place and organization. It has identified my personal role in relation to my team, and roles within different professionals I routinely work with in practice, and how this effects my contribution to the team both positively and negatively. It has linked back to things I was taught on the modules on communication and teamwork theories relevant to the work area considering any barriers. It has shown that the student has an important part to play in any organization as their desire is often to deliver the best service possible to the service users through teamwork and collaboration with fellow colleagues.

References

• Boudreau, J.D., Jagosh, J., Slee, R., Macdonald, M.E. and Steinert, Y., (2008). Patients’ perspectives on physicians’ roles: implications for curricular reform. Academic Medicine, 83(8), pp.744-753.
• Grant, A. and Bach, S., 2009. Communication and interpersonal skills for nurses. SAGE.
• Menzies, I.E., 1960. A case-study in the functioning of social systems as a defence against anxiety: A report on a study of the nursing service of a general hospital. Human relations, 13(2), pp.95-121.