Clinical Teamwork Issues In Clinical Experience

Description of Clinical Experience

Write Clinical teamwork issues in Clinical Experience.

Teamwork in healthcare can be defined as one two or more people who engage in different interactions interdependently with a common purpose working towards the various measurable goals that help in providing the best care to the patients meeting all their requirements and needs (Cassimiro et al., 2015). This assignment would mainly include an incidence where there was a failure in teamwork and would simultaneously describe the necessary theory that would help to discuss the teamwork issues effectively.

During my clinical placement, I was one of the team member who was caring for a patient who has faced stroke and was currently in the medical ward. I was given the responsibility to be an active member of a team of healthcare professionals who was to treat and provide care to the patient. A team of four nurses and two experts were formed for attending the patient. We were called by phone and assigned our work by care coordinator, who was leading the team. However, the family members of the patient was seen to complain to the compliant department stating that the healthcare team did not care for the patient and there were events of missed medications, wring treatments, clash between experts and nurses and unprofessional behavior in front of the patient. Following such complaint, care coordinator called the team members to enquire about the issues that took place. I was shocked to see that all the members were blaming each other for their faults. Many of the members stated that their team members did not communicate them. This resulted in the medication errors, missed treatments and others. A complete loss of communication was noticed among the team members. Moreover, there was no bonding among the members of the team and as a result, effective feedbacks could not be shared. I got very scared when I saw that there were so much conflicts and power struggles among the team members. So many issues ultimately resulted in very poor outcome when my mentor diagnosed the condition of the patient and stated that her condition had deteriorated mainly due to poor treatment and carelessness. The teamwork entirely failed and I got very upset and lost my confidence.

Theoretical Analysis/Application

Tuckman’s theory of teamwork or group development helped me in analyzing the mistakes that I have conducted while carrying on the teamwork. Tuckman had proposed five important stages of teamwork out of which the first stage is called the forming (Weller et al., 2014). In this stage, the team is mainly seen to acquaint and thereby take part in establishment of different types of ground rules. In this step, formalities are preserved and the members are mainly seen to be acting as strangers. The care coordinator completely neglected the step and did not put any importance in the development of ground rules for the team members. The care coordinator did not set any disciplinary rules as well and therefore all the members were found to be confused. Moreover, the care coordinator did not have any introductory meetings. The team members were not introduced to one another and therefore they faced problems as they did not know with whom they were working (Rosen et al., 2014). The second step is called the storming stage where the members of the team is seen to communicate their feelings but still they visualize themselves as individuals rather than as part of the team. In this step, they are seen to resist the control by group leaders. They are also seen to show hostility. This step was also not conducted successfully. No initiatives were taken, where the members of the team would have got the opportunity for developing rapport with each other or got have the opportunity to communicate with each others. Researchers are of the opinion that better, the individuals communicate, the better will be the bonds between them and this will help in developing mutual trust and respect (Rafalko & Johnson, 2015).

Theoretical Analysis/Application

These aspects are important for working in a collaborative manner to bring out the best care for the patient. The care coordinator held no meetings weekly that would have given the scope of constructive feedback sharing among the members. Such sessions are important for developing bonds as well. The next step is called the norming stage. In this stage, members of the team learn that they can achieve the set of goals if they accept the viewpoints of the other members and start feeling as the part of the team. As the previous step was not conducted successfully, I noticed that the people of the group did not communicate with each other successfully. They were constantly blaming each other and had no emotional as well as professional attachments with each other. As the team members did not communicate with each other, therefore errors, missed and clinical accidents were higher in number for the patients (Amir et al., 2015). They did not have any emotional bonds with each other and could not support each other in times of needs. Therefore, they were found to be suffering from burnouts. They were also blaming each other and were not wanting to work in association with each other. They did not feel to be committed to the team and were easily seen to be working individually rather than as teamwork. Therefore, there was no coordination and hence it resulted in several errors during the treatment. The last step was the performing stage where the team works in the open as well as the trusting environment where flexibility is the key and hierarchy is of little importance (Schumtz, Welp & Kolbe, 2016). As not all the previous steps had been performed successfully, therefore effective bonds and attachments were not formed. Members were not comfortable in each other’s presence and this inculcated to failure of coordination. This resulted in failed teamwork. Flexibility was not observed and in place power struggles was present that affected not only communication but also the members did not share the burden of work with each other. The seniors and the juniors did not communicate with each other and hence the failure in their collaboration had negative outcomes of their patients. Adjourning is the last step where the team is seen to conduct assessment of the year and thereby resulted in implementation of the plan for transitioning the roles and recognizing the contributions of the members. The teamwork did not successfully reach this stage as failure was noted after few days only.

Implications for Professional Practice and Management

One of the most important aspects of teamwork is communication. When team members are seen to communicate with each other efficiently, there will be fewer occurrences of medication errors. Moreover waiting time of the patients will be less as the experts would communicate and attend the patients accordingly without missing any treatments and services. Better the communication among the members, there will be chance of better development of bonds among the members. This will result in effective coordination and collaboration among the members and would result in effective teamwork and efficient patient care. Better the teamwork; there would be mutual respect and trust among the members (Lundgren & Molander, 2017). This would result in reduction of stress and work burden among the members. This prevents workers from suffering from burnouts and thereby increases the efficiency and the productivity of the team. Better, the teamwork, it becomes easier for the members to not only meet their individual objectives but also to meet the team goal as a whole. Moreover, the team members should be free from any sort of power struggles. Power struggles not only disrupt the smooth workflow but also creates negative feeling among the members against each other. This prevents the formation of emotional attachments among the team members that is also one of the most important aspects necessary for teamwork. When teamwork becomes efficient, it results in the prevention of medical errors and increases efficiency of care. When teams sit together and exchanges feedback on the conditions of the patient and proposed different ideas, chances of effective care from meetings increases and this ensures that the best evidence based care is provided to patients (Mijakoski et al., 2018). Moreover, effective teamwork helps in planning different intervention with the professionals in a coordinated manner and chances of miss-outs decreases. It helps in the improvement of the patient responsiveness and helps in development of overall satisfaction of the patients. Principle 10 needs to be followed by every health professionals as instructed by SINGAPORE NURSING BOARD where professionals need to work collaboratively with all members of the healthcare team to ensure best outcomes on the health of the patient (Singapore Nursing Board, Code For Nurses And Midwives, 2018).

Conclusion

From the above discussion, it becomes clear that the teamwork is an important aspect that is directly and indirectly associated with the success of patient care increasing patient satisfaction. For effective teamwork, communication, mutual trust, respect and effective feedback sharing are extremely important. Moreover, it is also important for the team leaders to follow the process of Tuckman’s group development to ensure best work output. Better the teamwork, the higher is patient satisfaction and the organization reaches the zenith of success.

References:

Amir, O., Grosz, B. J., Gajos, K. Z., Swenson, S. M., & Sanders, L. M. (2015, April). From care plans to care coordination: Opportunities for computer support of teamwork in complex healthcare. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (pp. 1419-1428). ACM.

Casimiro, L. M., Hall, P., Kuziemsky, C., O’Connor, M., & Varpio, L. (2015). Enhancing patient-engaged teamwork in healthcare: An observational case study. Journal of interprofessional care, 29(1), 55-61.

Lundgren, C., & Molander, C. (2017). Teamwork in medical rehabilitation. Routledge.

Mijakoski, D., Karadzhinska-Bislimovska, J., Stoleski, S., Minov, J., Atanasovska, A., & Bihorac, E. (2018). Job Demands, Burnout, and Teamwork in Healthcare Professionals Working in a General Hospital that Was Analysed At Two Points in Time. Open Access Maced J Med Sci. 2018 Apr 15; 6 (4): 723-729.

Rafalko, J. W., & Johnson, M. (2015). Human patient simulation: Student leadership achieved through mentoring and modeling in health care education by teamwork.

Rosen, M. A., Dietz, A. S., Yang, T., Priebe, C. E., & Pronovost, P. J. (2014). An integrative framework for sensor-based measurement of teamwork in healthcare. Journal of the American Medical Informatics Association, 22(1), 11-18.

Schmutz, J., Welp, A., & Kolbe, M. (2016). Teamwork in healthcare organizations. In Management Innovations for Health Care Organizations: Adopt, Abandon or Adapt? (Vol. 18, pp. 359-377). Routledge.

Singapore Nursing Board, Code For Nurses And Midwives (2018) retrieved from : https://www.healthprofessionals.gov.sg/content/dam/hprof/snb/docs/publications/Code%20for%20Nurses%20and%20Midwives%20April%202018.pdf

Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate medical journal, 90(1061), 149-154.