The intensive care unit (ICU) is a highly complex dynamic work environment that requires highly sophisticated and engaged interprofessional team functioning. Interprofessional contributions and expertise are necessary for effective treatment and patient safety in ICU. There are a variety of teams, including nurses, technical support, clinicians, and specialists which collaborate on all levels of the interprofessional framework. However, there are also significant challenges present in regard to power dynamics and communication that can impact morale, the effectiveness of treatment, and patient outcomes (Donovan et al., 2018). This report will examine nurse actions and contributions which can be implemented to improve interprofessional care and team support in the ICU.
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Communication and interpersonal conflict are key issues to interprofessional collaboration. Compassion can be practiced in action through basic dialogue and understanding. By demonstrating compassion, one can facilitate clear and calm communication, which highlights any potential points of conflict or stressors that the medical team can work toward resolving together. Serving as a neutral party between others who are conflicting may be helpful as well to resolve any conflict through compassionate means. As a result, communication will become clear, leading to fewer errors, better collaboration, improved support among team members, and a healthy rapport among the involved professionals in the complex work environment of the ICU (Donovan et al., 2018).
As a nurse, one is expected to advocate for various improvements to procedures in medical care. In interprofessional care in ICU, power dynamics create consistent barriers to healthy collaboration. Therefore, as a nurse, one can advocate for healthcare policy changes which would establish more leadership and responsibilities for nurses as well as provide oversight for physicians and specialists interacting with lower-ranked members on the interprofessional team. This type of health policy advocacy may contribute to changing the culture on the team to one that is more equitable and respectful. Nurses and other supporting staff would gain recognition and ensure equal treatment.
Interprofessional teams in ICUs face extreme stress and a high risk of burnout. Resilience, the concept of being able to withstand moral difficulty and distress. Nurses who are directly faced with situations with the need to demonstrate resilience often can share that experience and implement group interventions that are based on mindfulness and resilience training. Such training provides the benefits of self-care and techniques to deal with stress (Nissim, Malfitano, Coleman, Rodin, & Elliot, 2018). With nurses serving as leaders, the culture of the team can change to become more comprehensively resilient to high stress and challenges, making it more effective and improving attitudes, satisfaction, and professional longevity.
Nurses, particularly unit leaders, have a significant influence on making improvements to guidelines. Using integrated strategies and activities, nurse leaders can introduce practice guidelines among staff based on evidence-based parameters, including those that promote sustainability and accountability in teamwork environments through the exchange of knowledge and information (Fleiszer, Semenic, Ritchie, Richer, and Denis, 2015).
For example, to improve communication and exchange of information, a new guideline regarding handoffs can be introduced to limit misunderstanding and promoting greater cooperation between various team members on the interprofessional team. It will greatly benefit patient outcomes while improving the culture towards a common understanding of the team.
Interprofessional teams serve critical importance in providing high-quality and effective treatment in the ICU. However, the complexity and high-stress environment pose various challenges. Through the iCare model, a nurse can lead to improvements in communication, attitudes, and process improvements by demonstrating compassion in dialogue, advocating for equality among staff, leading initiatives on resilience, and implementing evidence-based methods into patient handoffs.
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The model can create significant change within the culture of an interprofessional unit. The author of this paper hopes to implement these changes in their place of work by demonstrating engagement and advocacy and working with other team members and nurse leaders to affect any challenges to interprofessional collaboration.
Donovan, A. L., Aldrich, J. M., Gross, A. K., Barchas, D. M., Thornton, K. C., Schell-Chaple, H. M., … Lipshutz, A. K. M. (2018). Interprofessional care and teamwork in the ICU. Critical Care Medicine, 46(6), 980-990. Web.
Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M.-C., & Denis, J.-L. (2015). Nursing unit leaders’ influence on the long-term sustainability of evidence-based practice improvements. Journal of Nursing Management, 24(3), 309-318. Web.
Nissim, R., Malfitano, C., Coleman, M., Rodin, G., & Elliott, M. (2018). A qualitative study of compassion, presence, and resilience training for oncology interprofessional teams. Journal of Holistic Nursing, 37(1), 30-44. Web.