The Importance of Communication between Nurses and Interdisciplinary Team Members

By: Jennifer Ward

In specialized healthcare settings, communication and other members of the care team has never been more crucial. The types of patient care problems that care teams encounter are complex and everlasting making teamwork essential. Patients trust that all members of their care team are communicating with each other, each discipline providing input into the treatment regimen and proposing treatment plan. Communication has a huge role on meeting the National Patient Safety Goals introduced by the Joint Commission in 2005. Improvement rests on effective communication between nursing and other disciplines of care. So, how can this 'communication' be improved? The following is a list of proposed strategies: Discharge rounds. This is a chance for the patients assigned nurse to meet with other team members to discuss the patients progress. It is an opportunity to discuss the necessary patient care and needs and to assure that core measures related to in-patient status are addressed. Hospitalists. They are practitioners who are in-house and able to address the patients immediate needs and communicate it with the attending physician. Hospitalists are also readily available to answer questions cutting the hassle of a nurse calling the physician (who has his/her own out-patient practice) then awaiting call back. Objective data. When communicating with other team members, it is helpful if the nurse has objective data in hand to support the claim. For instance, if the patient is complaining of pain, offer a pain score or remedies that the patient uses at home. Similarly, when communicating

with the dietician, state how much the patient ate or her food preferences.

Round with the physician or team members. It is a helpful strategy to have the nurse be present in the patients room during a visit from other care discipline. This is an opportunity for each member to address his concerns or plans related to the nursing care plan and this assures that all players are on the same page. Effective documentation. When documenting, provide objective data. For example, if a nurse is recording a note related to a patients wound, provide measurements.

Core measures. The Joint Commission has implemented a series of core measures related to common diseases and conditions. If the patient is on dialysis, it is a core measure to verify that a daily weight has been entered, and if she has a dialysis shunt, the status of the thrill and bruit should be documented. These core measures are objective data that give each member of the care team an understanding of the patients condition and progress. Effective communication. All members of the care team are busy, especially physicians. Therefore, it is important to contact them only for essential issues that cannot wait until they round. So, if you have several questions for dietary, respiratory or from a particular physician, consolidate them into one email or phone call versus several separate messages. Likewise, if a current nursing intervention is not working, propose a strategy that has worked in the past for the patient.

 Fulfill requested duties. Similarly, if a fellow member of the care team has requested a piece of information from you, follow through with answering the request. This shows your responsibility and dedication, and it builds trust between you both. Demonstrate leadership and a positive attitude. When working with your colleagues, it is important to keep in mind that you all have one common goal: to improve the health of the patient. It is important to show that you enjoy what you are doing, that you enjoy working with others, and that you are a nurse leader on your unit. This positive outlook goes a long way in professional relationships. And, the patients appreciate it. Effective communication is an art, but in todays fast-paced patient care arena, it is essential. Each member of the care team plays an integral role in patient outcomes, and building a comprehensive care plan demands that each discipline communicate her recommendations. No member acts in isolation and the patient trusts that her team is working as a whole to help her to achieve the best outcome.

(Source: http://www.nursetogether.com/Career/CareerArticle/itemId/2180/The-Importance-of-CommunicationBetween-Nurses-and.aspx#.UU3c0RdTCLs)

Professional Nursing: Dealing with Difficult Patients

By: Lanette Anderson

In professional nursing, we dont always like the patients that we take care of. It sounds harsh, but lets be honest. The caveat to that statement is that we dont have to like them. We do, however, have to provide the best possible patient care that we can, while maintaining an appropriate level of professionalism and compassion. People in general can be difficult to deal with, and with sick people who are frightened, this quality can intensify. In addition, medications and conditions such as confusion can also make our patients behave in a way that we dont understand. Some of our patients are just demanding and never seem to be satisfied with anything that we do for them. Sometimes we may want to curse the person who invented the call light. Instead, we need to focus on mechanisms that we can use to help effectively handle a difficult patient. From a patient care and satisfaction perspective, we should consider the following: Remember what position the patient is in. Hes sick. Hes uncomfortable. Hes frustrated. Hes frightened. He may feel that he isnt getting enough attention from caregivers or that people arent listening to his concerns. Its not his choice to be a patient. It is our choice to be a nurse. Dont just hear what the patient says, listen to him. Let him know that you are listening by maintaining eye contact. Its been said that approximately 80% of our communication is nonverbal. Dont stand with arms crossed, dont look at your watch as if you have someplace else more important to be, etc. Also, watch for the patients nonverbal cues. Taking these steps will help to establish a level of trust and enhance the effectiveness of our nurse and patient communication.

Be nice. Be caring. Keep your promises. Remember that our role as nurses is not only to provide safe care, but also to provide information, support, and reassurance to our patients. We made a commitment to do these things when we chose nursing.

From a risk management perspective, some other steps are also important: Adequately document any relevant events. If an adverse event occurs, document it in the appropriate part of the patient record or on an incident report per facility policy. In the event of litigation involving the patient, good objective documentation can increase the chances of a positive outcome for the nurse. Pay attention if a patient threatens to sue you, the facility, the physician, etc. While in many cases these are only threats, you never know for certain. Inform your nursing supervisor and risk manager that the patient has made this statement, so that steps can be taken to resolve any issues that the patient may have, thereby potentially avoiding litigation. If a patient tells you that they have previously sued a health care provider,pay even closer attention. Seek the assistance of your supervisor or other appropriate person if you are caring for a patient who makes you feel uncomfortable, either physically or emotionally. There are times when a change in patient assignment is a reasonable step to take.

(Source: http://www.nursetogether.com/Career/CareerArticle)

All About Nurses: What Am I Good At?

By: Debra Kirkley, PhD, RN

Nurses are always quick to tell what they're not good at, what they didnt manage to get done that day, or the myriad of ways they let their peers or patients down. Rarely does a nurse say, You know what? Today I realized Im a really good at something. But as you look across a nursing unit, there are no clones. Sure, all nurses on a unit have similar baseline skills- the skills needed to deliver safe patient care in their setting. But beyond that, there are always some who motivate patients with ease, and others who make great charge nurses persuading their peers to take time for lunch. Are you the sensitive nurse-teacher? Did you convince and help a shy student or orientee to try a new procedure? This is all about those nurses who often forget the value of what they do everyday. What are your unique nursing strengths? Clinical/Technical savvy. You go to nursing conferences and participate in journal clubs. Colleagues seek you out when they cant make sense of lab values, or clinical findings. Similarly, youre probably the first to figure out how to program the new IV pumps or upload a document to your hospital intranet.

Service ethic. Youre the first to volunteer and always willing to do more to help staff and patients. You may already chair the unit social committee. You make banners for new nursing gradswhen they pass NCLEX and you organize the staff to send a sympathy card when a colleague suffers a loss.

Psychomotor savvy. Youre one of those nurses with a steady hand, a keen eye, a good eye-hand coordination, or a combination of those. You are the one others seek out when they cannot get an IV started. You draw up meds quickly in a code, and who, despite the adrenaline rush, keep her hands steady and keeps thinking

ahead.

Interpersonal savvy. You get along easily with others, often sensing what they need. You excel at supporting patients and families. You clue in quickly to the exhausted wife sitting at her husbands bedside needing someone to talk to. Your ability to connect with others probably makes you a good teacher as well, coaxing students and patients to learn by tuning into their strengths. Give some thought to the question, What am I good at? Are you tapping into your strengths to improve patient care on your unit? Could you use your skills to make your unit a better place to work? Could you team up with others, with like or complementary strengths, to complete a project that needs to get done? Ive got a secret to share about job satisfaction: Celebrate what youre good at, then figure out how to use that skill more often on the job. This is, after all, about great nurses like you!

(Source: http://www.nursetogether.com/Career/CareerArticle)