Introduction
The emergency room setting is notoriously a high-stress environment where interprofessional teams must collaborate to ensure quick and efficient delivery of care to patients, particularly those who are in crisis. The emergency room consists of various teams such as physicians, front-end nurses, advanced trainees, paramedics, and medical students that must communicate and collaborate for integrated care coordination.
Some elements of interprofessional collaboration include patient handoffs, diagnostic procedures, and treatment. Research shows that interprofessional teams working effectively perform better on common objectives, demonstrate increased diagnostic accuracy, and exhibit better patient management (Karam, Tricas-Sauras, Darras, & Macq, 2017). One aspect of team function that requires improvement at the emergency department of employment is the patient handoff.
In high-pressure environments, the interdisciplinary teams do not always effectively communicate during the transfer of care, resulting in critical loss of time and redundancies of some actions being repeated. Overall, interprofessional collaboration is complex and requires the alignment of numerous factors to achieve efficiency. This report will investigate how a nurse can use the iCARE model to contribute to this improvement.
Compassion
Many nurses experience compassion fatigue from day-to-day demands in clinical settings. However, it remains a fundamental aspect of the nursing profession and contributes to the delivery of care as well as the relationship with patients and co-workers alike. The success of interprofessional teams partially depends on interpersonal relationships, which consist of hierarchy, belonging, familiarity, and mutual respect (Bekkink, Farrell, & Takayesu, 2018).
Unfortunately, interprofessional hierarchies may hamper compassion due to conflicts or low levels of autonomy. A nurse can introduce compassion by building compassion literacy and demonstrating it through leadership and example. A nurse should focus on one’s own compassion and engage others with it, thus transforming the system (Burridge, Winch, Kay, & Henderson, 2017). Compassion is a vital component of collaborative practice as it helps to engage others, develop coalitions, and achieve results affecting the unit culture in a positive way.
Advocacy
Advocacy is an important part of the nursing profession and something that nurses prepare for in their jobs and education. In a complex healthcare environment, nurses should be able to collaboratively advocate for health policies that will benefit patients and communities. A considerable aspect of health advocacy is understanding policy and other factors which may affect patients and co-workers (Eaton et al., 2017).
Using interprofessional collaboration can be a powerful advocacy tool as an integral approach to resolving key issues. An interdisciplinary team can provide significant contributions to key advocacy issues through organizational influence, professional experience, and interpersonal relationships with patients and other medical professionals (van Dongen et al., 2016). Eventually, tools and interventions can be developed to target a plan for development through interprofessional collaboration, improving cohesiveness in the unit as well.
Resilience
Resilience is a multi-dimensional concept that is often overlooked in the nursing profession and collaborative teamwork. It provides the ability to persist and thrive in high-pressure situations, which is relevant in the context of the emergency room department. Building resilience in inter-professional teams is difficult due to the number of people and personalities involved. A nurse can build team resilience by conducting a small intervention that focuses on reflection.
An exploratory group discussion on the topic allows members of the interprofessional teams to voice their personal perception of resilience, which helps others to understand the stress triggers and qualities of this characteristic. In turn, members build crucial relationships and could better understand the team strengths and each individual’s weaknesses. From an organizational standpoint, the multi-disciplinary team becomes more effective, building resilience by maintaining professional boundaries, demonstrating mindfulness, and reflecting on the nursing practice (McCray, Palmer, & Chmiel, 2016).
Evidence-Based Practice
One barrier that significantly challenges the full scope of practice for a registered nurse is insufficient interprofessional collaboration for evidence-based research and practice. Evidence-based practice (EBP) implies the transition of knowledge and theory to practice in order to provide high-quality clinical health delivery and patient outcomes. EBP is inherently complex to facilitate and requires the support of nursing leaders and fellow co-workers across different nursing units (Moss, Seifert, & O’Sullivan, 2016).
A nurse can apply evidence-based practice in a collaborative environment by suggesting to introduce certain changes that would make healthcare delivery more efficient. For example, in regard to patient handoffs from paramedics, a better system could be put in place, such as a checklist with key information and procedures on the patient clearly outlined. It is important to ensure everyone is aware of the changes and provide research to justify that this is necessary, thus setting a common objective for the interprofessional team to reach. As a result, the organization will become more streamlined, optimizing healthcare delivery, both in speed and quality.
Summary
Interprofessional teams are the key to an effectively functioning emergency department. However, high pressure and inefficient processes such as patient handoffs lead to some issues in healthcare delivery. Using the iCARE model, a nurse can address various aspects of interdisciplinary practice which require improvement, greatly enhancing teamwork and clinical practice. This is done through both focusing on interpersonal relationships, personal self-development, and evidence-based organizational change. Since interprofessional collaboration is vital to the full role of a registered nurse, it is important to work with nursing leaders and advocate for more opportunities for such cooperation and abilities to modify certain aspects of the health delivery process.
References
Bekkink, M. O., Farrell, S. E., & Takayesu, J. K. (2018). Interprofessional communication in the emergency department: Residents’ perceptions and implications for medical education. International Journal of Medical Education, 9, 262-270. Web.
Burridge, L. H., Winch, S., Kay, M., & Henderson, A. (2017). Building compassion literacy: Enabling care in primary health care nursing. Collegian, 24(1), 85–91. Web.
Eaton, M., deValpine, M., Sanford, J., Lee, J., Trull, L., & Smith, K. (2017). Be the change. Nurse Educator, 42(5), 226–230. Web.
Karam, M., Tricas-Sauras, S., Darras, E., & Macq, J. (2017). Interprofessional collaboration between general physicians and emergency department teams in Belgium: A Qualitative Study. International Journal of Integrated Care, 17(4), 1-16. Web.
McCray, J., Palmer, A., & Chmiel, N. (2016). Building resilience in health and social care teams. Personnel Review, 45(6), 1132–1155. Web.
Moss, E., Seifert, C.P., O’Sullivan, A. (2016). Registered nurses as interprofessional collaborative partners: Creating value-based outcomes. OJIN, 21(3), Manuscript 4.
van Dongen, J. J., Lenzen, S. A., van Bokhoven, M. A., Daniëls, R., van der Weijden, T., & Beurskens, A. (2016). Interprofessional collaboration regarding patients’ care plans in primary care: A focus group study into influential factors. BMC Family Practice, 17(58), 1-10. Web.