In 2012, the Joint Commission reported that 70% of adverse effects could be contributed to bad communication (Streeton, 2016). It is important to consider what attributes to this culture of miscommunication between staff. While there are many members of the health care team that participate in vital communication regarding patients, a lot of focus is placed on nurse-physician relationships. Fostering a collaborative environment between nurses and physicians would play a crucial role in reducing sentinel events (Streeton, 2016).

In an article cited by Stretton, Johnson and Kring report that 62% of nurses in their study felt that they “were perceived they were subordinate to physicians” (Johnson & Kring, 2012). This supports the notion that positive, respectful relationships need to be formed to help combat these miscommunication errors and allow for effective collaboration between staff.

D’Amour, D., Ferrada-Videla, M., Rodriguez, L., & Beaulieu, M. (2005). The conceptual basis for interprofessional collaboration: core concepts and theoretical frameworks. Journal Of Interprofessional Care, 19116-131.

Johnson, S., & Kring, D. (2012). Nurses’ perceptions of nurse-physician relationships: Medical surgical vs. intensive care. MEDSURG Nursing, 21(6) 343-347

Streeton, A. (2016). Improving Nurse-Physician Teamwork: A Multidisciplinary Collaboration. MEDSURG Nursing, 25(1), 31-66.

The opening text for this blog topic refers to collaboration
that is one among equals. In nursing school, student nurses are taught that we are

equals and to never hesitate question a physician’s pharmacological treatment and to always
advocate for the patient, not hesitating to make recommendations to the physician

as to what the nurse thinks patient needs. We are taught that
we are equal and final gatekeepers for our patients. Legally, the punitive and litigious state of affairs
regards nurses as equals, holding them liable for instance for not picking up
on pharmacy or physician’s medication errors. So while legally we might be regarded as
equals, the question is whether nurses are still regarded as subordinate by
physicians and how much that interferes with effective collaborations.

“There are deeply entrenched superior/subordinate relationships
between medicine and nursing that will have to be moved aside in order for true
collaborative practice to emerge.” (Bankston, 2013) “It is difficult to have a
power-sharing partnership when health professionals view their relationship in
a hierarchical manner.”

I think that a good amount of effective interprofessional
collaboration is taking place in the hospitals. The breakdown and gaps in this
collaboration tend to occur as patients move between different specialists or
different levels of care. Such breakdowns in collaboration can lead to significant
and detrimental fragmentation of patient’s medical records. Therefore, I would
say that fragmentation of healthcare is one of the most significant
contributors to gaps in effective interprofessioinal collaboration.

I think that here the motivation has to come from the
patient to connect all the fragments of his/her scattered medical picture and that
way promote the interprofessional collaboration. One study in fact says that
improving interprofessional collaboration also depends on patient-related
factors. “The patient has to change and
become more proactive as a member of the team.” (van Dongen, 2016)

The study also named the availability of information
and communication technology (ICT) in support of interprofessional collaboration.
“One part of the key to successful interprofessional collaboration can be found
in the implementation of ICT and shared patient files.” (van Dongen, 2016)
Without medical technology and systems that are still stuck in a fragmented and
non-integrative mindset, other attempts at effective and successful
interprofessional collaboration are rendered that much more futile.

Bankston, K., Glazer, G., (2013, November 4)
“Legislative: Interprofessional Collaboration: What’s Taking So
Long?” OJIN: The Online Journal of Issues in Nursing Vol. 19 No.
1. Retrieved September 27, 2016 from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Legislative/Interprofessional-Collaboration.html

van Dongen J. J. J., Lenzen A. S., van Bokhoven A.
M., Daniels R., van der Weijden T., Beurskens A. Interprofessioanl
collaboration regarding patient’s care plans in primary care: a focus group
study into influential factors. (2016, May 28) BioMed Central. Retrieved September 27, 2016 from: https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-016-0456-5

As a student nurse during the clinical experience of nursing school, collaboration between
the nurse and physician is always seen. Research has also proven that
maximizing nurse-physician collaboration has improved patient care and that it
also creates better and efficient work roles (Lindeke 2005). The nurse is
usually with the patient the longest and the care providing the care that will
further better the patient’s diagnoses. This means that any changes that the
patient might experience might be seen by the nurse. The nurse will then report
this to that patient’s physician and something can be done about it as soon as possible.

Collaboration not only fosters better care for the patient, but it also betters the work
place. Working together creates unity and betters each person’s communication
skills. If the patient notices how well everyone works together they will gain trust
and be more open. They sometimes might give you the nurse vital information
that they know you can relay to their physician. When communication is well
between all parties, negotiations are an easy process. Collaboration care
consists of different ideas and interventions for a patient. Collaborative
relationships foster successful patient outcomes (Lindeke 2005). Not all physicians
would agree that collaborative care is of much success but they too are
entitled to their opinions. Everyone who is part of the collaboration should
have knowledge of the field and should be competent enough to contribute to the
plan of care. What strategies do you think can be incorporated in integrating
collaborative care in more healthcare facilities?

Lindeke, L., Sieckert, A. (January 31, 2005). “Nurse-Physician
Workplace Collaboration”. OJIN: The Online Journal of Issues in
Nursing. Vol. 10 No. 1, Manuscript 4.