There are interventions in the teamwork process. The Teamwork Process The case study is a nurse at a particular hospital who is reactive in a real life situation that is faced with the lack of teamwork in operational procedures. Nurse B has a self-oriented attitude. According to Johnson (2009, p. 133) Nurse B: “There is a painful process of finding out what didn’t work and saying “We won’t do that again. ” We are reactive. The nurses have to run for stuff unexpectedly…. If you observe something that might be a problem you are obligated to speak up, but you choose your time. I work around [the surgeon].
I will go to his PA [physician’s assistant] if there is a problem… If I see a [surgical] case on the list [for tomorrow] I think, “Oh! Do we really have to do it! Just get me a fresh blade so I can slash my wrist now. ” The intervention is to address what is really going on in this case study, and is Nurse B creating a conflict among team members. Concurring with Johnson (2009, p. 128) inter-professional teams (rather than groups or individuals) are equipped to deliver the highest quality of care. The major problem with Nurse B is the performance in a negative attitude reflected onto the team members.
The healthcare delivery system demands extensive teamwork. Nurse B lacks guidelines to foster good communication and the process in the outcomes of effective teams to achieve group consensus on issues and problems in the operating room setting. According to Johnson (2009, p. 128) this means hierarchical relationships can be modified when knowledge is re-distributed at a lower-level. Therefore the surgeon intervention needs to be clear in positive communication and improved team interactions while in the operating room to increase trust (Angermeier, Dunford, Boss, & Boss, 2009).
This would increase Nurse B’s job satisfaction in access to informed information, and not reactive clinical errors that Nurse B expresses the concerns to the physician’s assistant. According to Angermeier, Dunford, Boss, & Boss (2009) the healthcare delivery system should facilitate open and honest discussions between physicians and nurses teams in clinical relationships. The focus is to be patient centered and used as a management tool in quality services (Mickan, 2010). In addition Nurse B can be seen as a bully in the health care environment among the team members.
Nurse B subjects the team member’s process where emotions are communicated negatively with a life threating scenario of “slashing my own wrist now” or threatening “I will go to his PA [physician’s assistant] if there is a problem” Johnson (2009, p. 133). According to Mickan (2010) the benefits of effective teams include the coordination of care, efficient use of health services, increased job satisfaction among team members and a higher increase in patient satisfaction. Nurse B projects an intimidating environment among the team members.
Workplace bullying impacts the organization through decreased productivity, increased sick time and nurse attrition (Johnson, & Rea, 2009). According to Johnson (2009, p. 126) table 7-5 is an example in the team process to select members that have diverse expertise, and cross-train members on each other’s tasks in rotating assignments. This means Nurse B would experience greater improvements in sharing different knowledge in the operating room setting. In a true clinical sense dissemination of this information throughout all surgical training programs would increase staff participation and better patient outcomes (Stefl, 2009).
The collaboration in the team process is to work together to achieve a common goal, and those team members are complementary and committed to each member skills. The distinguishing characteristics of a healthcare environment are that professional staff needs to work closely and collaboratively to meet patient’s needs, because they are depend upon the skills and work of others. Therefore the leadership needs to place all clinical teams and Nurse B in clinical cross functional teams to foster communication and improve patient outcomes in quality care.
Nurse B is in a painful clinical process, where services and distribution impacts the team decision making in continuous quality improvement, and quality in the operations of this hospital environment. According to Johnson (2009, p. 118) highly tactical groups where safety, morale and customer satisfaction is utmost importance team members must have a clear definition of roles, engage in clear communication and allow each team member to be an equal contributor. According to Johnson (2009, p.115) Nurse B is in two types of role conflicts the intrarole and intrasender in the way of doing things and unrealistic expectations. Therefore Nurse B would be with a cross functional team, in creative solutions, innovation, quality decision making that would increase the operating room effectiveness in surgical procedures. Nurse B feels the challenge of teamwork and communicates a self-oriented approach that is the interest of Nurse B’s welfare, and not structured in a team-oriented process.
According to Stefl (2009) the surgeon as the leader of the surgical team, is the capability to perform the duties of one’s profession, the team process of particular task and skills that are acceptable qualities in the delivery of services and patients outcomes. Nurse B needs to envision the team process and embrace teamwork among the team and the surgeon. Therefore, the surgeon needs to develop and manage the surgical team to align in shared goals, communication, reducing medical errors and delegate task that are effective in quality patient care Mickan, (2010).
This would increase the level of trust, set realistic expectations in the decision making process and give a clear sense of a strategic direction. According to Johnson (2009, p. 127) transforming healthcare groups can be better coordinated through collaboration rather than through chain of communication. Therefore, Nurse B needs to be a selected employee who prefers to work as a team and not alone. In addition this would include the implementation of new technology that demonstrates a need for substantial change in team member’s routines, and re-formulation of group member’s role and decision making power Johnson (2009, p.127). Conclusion The above case study scenario in this operating room really is about Nurse B, and the nurse’s attitude being self-oriented and not involved in the wellbeing of the team process. The examples above illustrate the team process and group dynamics is the delivery of services and quality care in patient’s outcomes. The case study scenario is transforming teams in a clinical environment in a relevant and practical way. The objective of this paper proposed solutions to the described situation, quality services in patient centered outcomes and an effective teamwork process in delivery of clinical services.