Reflections Day 3

I think some time devoted to Gwen’s presentation on interprofessional teams is warranted. Just thinking of my own medical school experience, I really didn’t get much in the way of training as to the various members of a healthcare team and how to best leverage the individual skills and training to help patients. I think these knowledge gaps lend themselves to interprofessional tension and frustration as unrealized expectations inevitably occur. And from having supervised other junior physicians and observing their actions and interactions I think my experience was not unique.

Where I’ve seen the most interprofessional tension is between physicians and nurses. Some physicians see pages by nursing as a bother and see the issue reflective of differences in training. I’ve witnessed physicians ridicule nurses for their ‘dumb’ or ‘idiotic’ questions. Sometimes this is an internalized sentiment, sometimes this is a broadcasted feeling to colleagues or the nurse their self. It’s no wonder that nurses label some physicians as ‘a bear’ and are hesitant to call when they have concerns. This behavior can not be tolerated and should be confronted by colleagues.

I’ve had instances where it feels like I am being paged over and over again about the same patient and it gets frustrating. What I’ve learned over time, because it certainly was not taught in my medical school, is that nurses are our frontline troops. They are the very best eyes and ears for patient care. You can validate and encourage them to speak up when concerned and you’ll see avoidable harm go way down and satisfaction rise. Or physicians can undermine that relationship. Those who choose to do so should not be surprised when they are not notified about a potential error on their part or a change in patient status. What the physician will have done is undermine not only that patient’s care, but potentially ‘take the wind out the sails’ of that nurse moving forward. Maybe that nurse loses their idealism for patient care and now it will take a lot of repair work to rehab that person for their love of medicine.

Physicians, as members of an interprofessional team, have the responsibility to cultivate an environment where we honor and recognize everyone in their efforts to promote patient wellbeing. I wish I had been taught these core competencies earlier in my training. It certainly would have allowed me to avoid some major missteps in interprofessional team collaboration earlier in my career.

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