Collaborative competencies refer to the knowledge, skills, and attitudes needed when working in a team. Healthcare teams are usually composed of various health professionals. For example, an inter-professional team may be made of physicians, nurses, pharmacists, physiotherapists, dentists, and nutritionists. In the current scenario, the only members of the healthcare team who are mentioned are two nurses and an anesthesiologist.
Key competencies required of an inter-professional team include communication, responsibility, ethics/values, patient-centeredness, and teamwork processes. Communication is an important aspect of healthcare delivery. When communication is lacking, the quality of care given goes down. In the present scenario, communication between the members of the team is not effective. Ineffective communication has been cited as one of the factors contributing to patient dissatisfaction. For example, in this case, the admitting nurse failed to inform the receiving nurse about the patient’s condition and what to pay attention to. That is, the admitting nurse did not mention anything about sufentanil. Communication between members of the healthcare team, patients, and patients’ families is not evident in this scenario. Poor communication contributed to the undesirable outcome. The patient could not have gone into a respiratory arrest if all the information had been communicated appropriately and effectively. Therefore, both intra-professional and inter-professional collaboration was affected by ineffective communication. In general, health professionals should communicate in a responsive and responsible manner that promotes the maintenance of good health.
Roles and responsibilities were not clear in the scenario. Health workers should know individual responsibilities and those of other members of the healthcare team. The knowledge of one’s roles and those of other professionals helps the healthcare worker to assess the patient and formulate appropriate interventions. Awareness of individual roles enables one to understand the scope of his practice. Knowledge of the roles of other professionals involved in the delivery of healthcare enables one to appreciate other team members. In the scenario, it appears that some team members did not adequately understand their roles. For example, the admitting nurse had the responsibility of informing the receiving nurse about the patient’s condition. On the other hand, the anesthesiologist left PACU before ensuring that the patient was safe. The anesthesiologist should have made sure that the patient was not in any imminent danger. In addition, the admitting nurse left the patient unattended. This constitutes a serious ignorance of one’s responsibility.
Ethics and values were also not adhered to in this scenario. The caregivers did not make an attempt to safeguard patient privacy and dignity. For example, the privacy curtains were not closed. Other patients in transient awakening states were visible and could be seen by other patients and their caretakers. Moreover, the healthcare providers discussed patient information in the presence of third parties. The nurses and the anesthesiologist should have ensured that patient confidentiality was guaranteed. Professional ethics dictate that patient information should be kept confidential at all times to safeguard their privacy. This includes situations like the one presented in the scenario. When exchanging information, the patient’s express consent and implied consent must be considered. The scenario permitted general ignorance of the patient’s need for privacy. Besides respecting each other, healthcare workers should ensure that the patients are respected as well. This creates a good working environment for everyone who is involved in the maintenance and restoration of health.
Another violation that is evident in this scenario is deviation from patient centered care. Healthcare workers should do things that are in the interest of both individual patients and populations. Healthcare should be patient centered at all times. In this scenario, the care givers appear to have detached themselves from the patient. For instance, they discussed her information in the presence of others who should not access the information. It has been noted that in the absence of patient centeredness, healthcare loses its rationale.
The barriers to collaboration that existed in this circumstance include lack of knowledge of the roles of other health professionals, small team and role ambiguity, lack of an appropriate mechanism to exchange information, lack of commitment, and lack of a clear shared purpose. The team members did not appear to know the roles of other members. For example, the anesthesiologist handed over the patient to the admitting nurse in the absence of the receiving nurse. However, the most evident barrier is lack of an appropriate mechanism to exchange information. In this circumstance the health professionals discussed the patient’s information in the open. Had there been an appropriate way to share information, the patient’s dignity would not have been violated. The team does not appear to have a shared purpose. Each member of the team works independently. The anesthesiologist and the admitting nurse handed over the patient before leaving. They then returned after a while and found the patient going into respiratory arrest.
Various nursing roles were ignored in this scenario. First, the admitting nurse did not communicate appropriately with the receiving nurse. Vital information like patient’s drug regimen and current condition were ignored. A professional nurse is a good communicator. Secondly, patient safety was ignored. Failure to report all the information to the next caregiver compromises patient safety. In this case, the patient almost died from respiratory arrest due to negligence. This is not acceptable in a professional setup. Other violations include negligence of patient privacy and dignity, and ignorance of roles and responsibilities. The health professionals in this scenario did not safeguard patient privacy and dignity. Patient’s privileged information was discussed openly. In addition, the patients were cared for in an open environment. The privacy curtains were not drawn. The receiving nurse left the patient alone and went to document some information. Patients recovering from the effects of anesthesia must not be left alone. They should be monitored closely and their vital signs taken every fifteen minutes until they are fully awake or conscious. The fact that the nurse left the patient alone in a semi-awake state is a misconduct that should be reported to authorities. While documentation is an important aspect of caregiving, it should not be done at the expense of patient safety. In this circumstance, patient safety and dignity were either knowingly or unknowingly ignored.
The lapses should be reported for further action. It is important that appropriate action be taken. However, in the present scenario all the members of the team are to blame for the mishap. This makes reporting difficult. The caregivers can easily decide together not to report. The individual who is supposed to report may also fail to report. However, the incident should be reported in order to take corrective measures. This should be done in spite of the apparent conflict of interest. Hierarchy can also make reporting difficult.