Scenario Involving Interprofessional Practice
Student nurses are placed in different professional practice settings to experience and witness different care processes to give them an actual experience of working with real patients. Some of these experiences, whether negative or positive, have various implications for the student nurse’s current and future practice.
My professional practice setting is the surgical floor, where I am paired with another nurse or supervisor to provide pre-and post-operative care. I have the opportunity to witness all manners of positive interprofessional practice situations because of being around the majority of the time. One of these significant events involved a middle-aged male with a history of heart disease and diabetes being admitted for a surgical procedure to remove a cancerous tumour. That meant that a team of professionals, i.e., the surgeon, oncology specialist, anaesthesiologist, surgical nurses, and scrub technicians, was supposed to work with each other to ensure the patient received the services as required. The most impressive part of this scenario was how duties flowed from one professional to another, the collaboration aspects and the communication between them. I joined the nurse I was paired with to provide pre-operative care prior to surgery. The Nurse Practitioner ordered an IV, which the nurse RN was to insert and monitor for adverse reactions. I stayed and listened as the nurse interacted with the patient, who was a little anxious but was confident he would go through with the surgery. I also helped the nurse ensure the patient was free of any foreign objects and didn’t take any fluids or eat anything. I learned from the nurse that we would be there again to provide post-operative care.
Analysis using the CIHC National Interprofessional Competency Framework
The CIHC National Interprofessional Competency Framework aids the description of the competencies required for effective interprofessional collaboration (Orchard et al., 2010). This framework helps student nurses and practitioners in learning and applying the competencies regardless of their skill level and practice setting. As it is, the competencies build upon each other gradually, i.e., learners and practitioners showing their abilities in collaborating with others are developmental since each competency develops on the mastery of the individual professional lifespan.
The scenario on the surgical floor reflects several competencies, from interprofessional communication to team functioning. From the start of the situation, the healthcare team displayed multiple competency domains that can be analyzed individually and then ultimately linked to conclude the quality of care based on interprofessional collaboration. Below is an analysis of the situation based on the CIHC National Interprofessional Competency Framework’s interprofessional communication, patient/client-centred care, role clarification, team functioning, collaborative leadership and interprofessional conflict resolution competencies.
Interprofessional Communication
Communication is the most significant competency in the scenario described above. Considering how many professionals were involved in the patient’s care, ensuring communication flows seamlessly is necessary. As Bok et al. (2020) explain, effective interprofessional communication (IPC) between professionals promotes teamwork to improve patient care and ultimately boost cost efficiency. Besides, collaboration in healthcare is the capability of every professional to embrace complementary roles within the practice setting’s team, share responsibilities, cooperate, and communicate properly (Busari, Moll, and Duits, 2017).
In the scenario, all professionals needed to communicate the various aspects of the patient that needed to be considered before surgery could begin. At the same time, the team needed to figure out all pre-operative and post-operative care processes before the surgery so as to ensure every step of the patient’s handling was done safely and efficiently. Worth noting is that the patient and their family had been informed about the surgery and were aware of the potential risks and benefits. However, this type of communication should reflect interprofessional collaboration by focusing on how the surgeon, oncology specialist, anaesthesiologist, surgical nurses, and scrub technicians communicated between themselves in a collaborative, responsive and responsible manner. Each one was aware of the role they were going to play and ensured respectful language while consulting whenever possible. For instance, during the pre-operative briefing done shortly before the patient was taken into the operation room, the patient’s medical history was reviewed while consulting on the implications. The oncology specialist was present to contribute to the session as the surgeon led. Therefore, considering other professionals’ roles and accessing each other’s skills and knowledge through consultation promotes interprofessional communication.
Client-Centred Care
Ensuring efficient communication and all collaborative practices ensures that care revolves around the patient, otherwise described as client-centred care. The patient was briefed on the procedure and consented to it. At the same time, they were allowed to decide whether they would like to proceed despite the necessitated surgery. This means that, although the professionals view the surgery as important to the patient’s well-being, it is up to the patient to decide whether they would proceed with the surgery. As Orchard et al. (2010) state, patient-centred care is about seeking out, integrating and valuing the engagement of the patient and their families in designing and implementing care. Therefore, for care to be completed, the patient is involved, as in Jean Watson’s theory emphasizing the carative factors based on the human being (patient), health, and environment (Pajnkihar, Štiglic, and Vrbnjak, 2017).
Role Clarification
Each professional understood their own role and other professionals’ roles to meet the patient’s goals. For instance, I understood that I had to work together with the nurse in pre-operative care, like IV insertion and monitoring. I also understood that the surgical nurse I was working with was not cleared to order an IV because the NP or available physician is responsible for that. The same case applies to the knowledge about the cancerous tumour that was to be surgically removed, hence the involvement of the oncology specialist. Ultimately, every professional in the team recognized that the surgeon had the central role in the patient’s procedure because he had the knowledge and skills to perform such a surgery, unlike other professionals. According to Hudson et al. (2017), interprofessional collaboration has been associated with positive client-care outcomes, with role clarification as one of the significant facets of this consistent effectiveness. Otherwise, poor role definition can lead to conflicts in practice and affect the quality of care a patient receives.
Team Functioning
From the competency domains of communication to clarification, teamwork is the ultimate achievement when the competencies are performed effectively. In the described scenario, professionals came together to contribute with their knowledge and specialization to ensure care flows seamlessly. All professionals understood the team dynamics and group processes, which enabled effective team collaboration. The nurse prepared the patient for surgery, the surgeon took over the intraoperative care, and the surgical nurses prepared to hand over post-operative care. Besides, there was effective facilitation of discussions and interactions among team members, which were majorly respective and built on the already existing healthy working relationships. Therefore, for long-lasting team functioning, professionals learn to respect team ethics like resource allocation and professionalism to contribute towards collaboration (Varkey, 2021).
Interprofessional Conflict Resolution
Although there are no matters involving conflicts, they could have arisen from problems like when role clarification, interprofessional communication, and team functioning are not ensured when the professionals work together. Conflicts can arise from the interaction between the professional and the patient, the client, or their families. In case, the team would have ensured that they recognized the potential for conflict and taken constructive steps to address it (Orchard et al., 2010). Again, there would be strategies to deal with conflict and establish a safe environment for free expression.
Collaborative Leadership
The team on the surgical floor worked together to enable effective patient outcomes. With the existing interdependent working relationship, the team processes were efficient, as did decision-making. As Orchard et al. (2010) note, co-creating a climate for collaborative practice will ensure the ultimate interprofessional collaboration. The example shown by the team has the potential to integrate continuous quality improvement principles into the care processes and outcomes. For instance, leadership is important in different levels of healthcare practice, like in how the surgeon worked together with the anesthesiologist to provide clear guidance and set expectations while promoting a positive team culture.
Evidence-Informed Strategies to Promote Effective Collaboration
For effective interprofessional collaboration, the application of evidence-informed strategies has to be sought. These strategies include interprofessional team huddles and structured interprofessional education and training, which can be applied accordingly to ensure effective collaboration.
Gardner et al. (2018) describe huddles as the hub of inter-professional and team-based care because they facilitate a venue where trainees learn and improve their communication skills, systems issues and resources, team member roles, and overall clinical knowledge as expected. Huddles can provide opportunities for the team involved in this scenario to learn about aspects of care coordination, develop a camaraderie sense, and build work relationships that support team-based functioning. Otherwise, when interprofessional team huddles are sought and embedded in faculty, the team will learn and apply the skills gained.
Structured interprofessional education and training is another strategy that focuses on enhancing understanding and appreciating each team member’s role and expertise in the team. Having a qualified and competent healthcare professional team working in a team environment serves as a prerequisite for quality care (Zechariah et al., 2019). This scenario could utilize Interprofessional Education (IPE) to equip the healthcare professionals involved to ensure the delivery of safe and high-quality patient care. IPE involves engaging two or more professionals from different professions in an integrated learning environment to further collaboration and improve health. In the same way, if the surgical team can be picked, i.e., the surgeon and the surgical nurses to be exposed to IPE, their team approach can be nurtured to lead to improved patient-care quality and fewer conflicts.
Potential Evidence-Informed Outcomes from the Strategies
The preliminary conclusion is that the strategies will further enhance collaboration in this paper’s scenario. While such is an objective that needs to be approached with clearly set goals, the strategies can directly translate to effective collaboration. However, the outcomes should be evidence-informed as in, the interprofessional team huddles and structured interprofessional education and training should lead to improved information sharing and coordination and enhanced collaboration and mutual respect, respectively, backed by evidence. According to Zechariah et al. (2019), structured interprofessional education and training help in developing interprofessional competencies of ethics, teamwork, communication, and roles and responsibilities significant to workplace collaboration. Again, matters of biases are addressed in training to ensure that professionals embrace mutual respect. On the other hand, interprofessional team huddles support shared decision-making, which involves information sharing and coordination. In summary, the huddles reinforce collaborative practices while professionals seek to learn from each other (Gardner et al., 2018).
Implications of Effective Interprofessional Collaboration to Student’s Professional Growth
A student in a professional practice setting is bent on engaging in interprofessional collaboration as part of their education to equip themselves with essential competencies to thrive in a collaborative healthcare environment while positively impacting patient care outcomes. Based on the scenario and the subsequent analysis, the information obtained has implications for enhancing communication skills, expanding the knowledge base, strengthening critical thinking and problem-solving abilities, improving teamwork and leadership skills, and fostering professional networking and career development (Orchard et al., 2010). For instance, the scenario involved pre-operative and post-operative care, which was enriching in information about the nursing actions and recommendations from the team with varied skills. Therefore, the effective collaboration will ensure that a student’s learning reflects the future by instilling knowledge on team leadership and functioning, communication skills, and role definition (Green and Johnson, 2015). With such aspects, the student is well-equipped to be an informal leader at the point of care. Besides, professional collaboration instils the values of respect, trust, and professional intimacy, that a nurse can exert their power over the patient while recognizing how the authority observes collaborative practice with the patient (CNO, 2019).
Conclusion
Interprofessional collaboration is a significant aspect of patient care due to the efficiency achieved from the strategies employed. Using interprofessional team huddles and structured interprofessional education and training, as discussed herein, should be able to lead to improved information sharing and coordination and enhanced collaboration and mutual respect, respectively. Otherwise, interprofessional collaboration has various implications on the student’s professional development, such as enhancing communication skills, strengthening critical thinking and problem-solving abilities, and improving teamwork and leadership skills, ultimately fostering professional networking and career development.
Critical Appraisal of Articles
Bok et al. (2020) is a relevant source because the title and abstract indicate that it focuses on interprofessional communication, which was part of the competency domains included herein. The article’s validity is established through the study design, methodology, and data analysis, followed by valid research materials. Again, the results of the study are valid. On the other hand, the article’s reliability is established through the information supported by authors from a medical background who understand interprofessional communication. Lastly, the article is peer reviewed and obtained from PubMed-a reliable database.
(Orchard et al., 2010): this is the professional document for the CIHC-National Interprofessional competency framework. It is a credible resource provided by the Public Health Association of British Columbia. The information provided is reliable and simple to understand for professionals and students.
References
Bok, C., Ng, C. H., Koh, J. W. H., Ong, Z. H., Ghazali, H. Z. B., Tan, L. H. E., … & Krishna, L. K. R. (2020). Interprofessional communication (IPC) for medical students: a scoping review. BMC medical education, 20(1), 1-17. https://doi.org/10.1186/s12909-020-02296-x
Busari, J. O., Moll, F. M., & Duits, A. J. (2017). Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource limited health care environment. Journal of multidisciplinary healthcare, 10, 227–234. https://doi.org/10.2147/JMDH.S140042
CNO. (2019). Therapeutic Nurse-Client Relationship, Revised 2006. College of Nurses of Ontario Practice Standard. https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf
Gardner, A. L., Shunk, R., Dulay, M., Strewler, A., & O’Brien, B. (2018). Huddling for High-Performing Teams. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 35(9), 16–22.
Green, B. N., & Johnson, C. D. (2015). Interprofessional collaboration in research, education, and clinical practice: working together for a better future. The Journal of chiropractic education, 29(1), 1–10. https://doi.org/10.7899/JCE-14-36
Hudson, C. C., Gauvin, S., Tabanfar, R., Poffenroth, A. M., Lee, J. S., & O’Riordan, A. L. (2017). Promotion of role clarification in the Health Care Team Challenge. Journal of interprofessional care, 31(3), 401–403. https://doi.org/10.1080/13561820.2016.1258393
Orchard, C., Bainbridge, L., Bassendowski, S., Stevenson, K., Wagner, S. J., Weinberg, L., … & Sawatsky-Girling, B. (2010). Canadian Interprofessional Health Collaborative: A National Interprofessional Competency Framework. https://phabc.org/wp-content/uploads/2015/07/CIHC-National-Interprofessional-Competency-Framework.pdf
Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940. https://doi.org/10.7717/peerj.2940
Varkey B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice: international journal of the Kuwait University, Health Science Centre, 30(1), 17–28. https://doi.org/10.1159/000509119
Zechariah, S., Ansa, B. E., Johnson, S. W., Gates, A. M., & Leo, G. (2019). Interprofessional Education and Collaboration in Healthcare: An Exploratory Study of the Perspectives of Medical Students in the United States. Healthcare (Basel, Switzerland), 7(4), 117. https://doi.org/10.3390/healthcare7040117
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