Nurs-FPX4010:Interprofessional Collaboration

Good afternoon everyone! Welcome to my Collaboration and Leadership Reflection Video for NURS4010. My name is……

Interprofessional collaboration is a critical aspect of a nurse’s work. Through interprofessional collaboration, practitioners and patients share information and consider each other’s perspectives to better understand and address the many factors that contribute to health and well-being. Essentially, by collaborating, health care practitioners and patients can have better health outcomes. Nurses, who are often at the frontlines of interacting with various groups and records, are full partners in this approach to health care.

During this video I plan to:

• Identify how poor collaboration can result in inefficient management of human and financial resources supported by evidence from the literature.
• Reflect on an interdisciplinary collaboration experience noting ways in which it was successful and unsuccessful in achieving desired outcomes.
• Identify best-practice interdisciplinary collaboration strategies to help a team to achieve its goals and work more effectively together.
• Identify best-practice leadership strategies from the literature, which would improve an interdisciplinary team’s ability to achieve its goals.
• Provide full reference list from relevant and evidence-based (published within 5 years) sources.

My Experience

Growing up in northern New Jersey you will find that the community is mostly Spanish speaking residents. Throughout my seven-year CNA work experience and during my clinical rotations as a student nurse, it was not uncommon that I would be asked to interpret for another healthcare provider who did not speak the same language as the patient. Having a variety of interpreting resources can be of great asset and facilitate the experience between a patient and another healthcare worker. There are many different types of interpreting services such as, professional in-house interpreters, on-call interpreters, bilingual staff, telephone and video-based interpreting services. It is essential when the doctor is trying to retrieve important information from the patient to provide a better and more effective goal outcome. 

During my clinical experience, I was caring for a Spanish speaking patient and had the opportunity to witness a telephone interpreting interaction. The telephone equipment, that was initially very hard to find, has two handsets where the doctor used in his ear and the patient used for her ear. He began to speak, providing the interpreter information regarding the patient. When it was the patients turn to speak, she shook her head and said she did not feel comfortable using the telephone. The doctor was made aware by the interpreter and discontinued the service. He ran outside and looked for the charge nurse and asked to look for a qualified in person interpreter. Several staff members were available but none of them were qualified. It was a very frustrating moment for the doctor who simply was just trying to explain a consent form to the patient.  I volunteered since I had been trained at a different facility and showed them my certification proof. The charge nurse and doctor both agreed that I was the right candidate for this role. After the interaction, the patient seemed much more at ease and was thankful that I was there to help through the experience. This type of collaboration enabled the patient to be attended to as required.  However, if there was poor collaboration it would have meant that the patient diagnosis would not have been realized in time, also there would have been a lot of patient errors since the doctor would have failed to inform the right medical professional, we would not have understood the type of care needed for the patient and we would have failed to recognize other underlying conditions.

A qualified interpreter is trained in medical terminology, follow uniform codes, respect patient confidentiality, repeat everything provider and patient say. They do not summarize, paraphrase, add to, omit or change the meaning of words, and say what they “think” the patient or doctor means. When getting trained to interpret, they teach us the advantages and disadvantages of all the different types of interpreting services. I felt with great responsibility to gather a list for the charge nurse with the different types of interpreting services which come with their own benefits and limitations. 

Even though a telephone interpreter was a good approach because they are qualified professionals, some patients may not be comfortable sharing their personal information with a person who they cannot see. An in-person interpreter allows for a better therapeutic connection and trusting experience for the patient. In this situation, it is important to first consult with the patient and determine if a telephone interpreter service is something the patient respects.  In addition, a great strategy that will improve interdisciplinary teams’ ability to achieve its patient goals would be to identify which interpreting resource would be the right fit for a non-English speaking patient. By identifying this during the admission process it will allow an efficient and less frustrating transition for the patient requiring these services. Furthermore, all bilingual staff should undergo an interpreting course that will allow competency in any event requiring their services and in any case that the patient does not want the electronic route.

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My interdisciplinary experience came in when dealing with the Spanish speaking patient where language barrier would not have made us realize that she suffered from chest pains.  After interpretation, the healthcare professionals came together to ensure that the patient was well taken care of, and my interpretation alone was not enough including the charge doctor who checked him out.  I realized that there are other checks that even the doctor referred the patient to the radiologists to perform some tests and wait for the results, the radiologist later confirmed that the patient was having a heart attack.  The patient was admitted as an inpatient where he had to spend the night at the hospital with a team of Nurses to care for him in the next 24 hours on changing shifts. He was later transferred to the cardiac unit where the doctor continued performing rounds.  It was also discovered that the patient had COPD and diabetes where and pulmonologist and endocrinologist were involved.  To ensure that the patient recovered well, a physical therapist, dietician and social worker were all involved. This interdisciplinary approach to quality care taught men that each person in the hospital provides a unique insight that ensures the patient gets the desired quality care experience. 

In the scenario in Vila Health provided by Capella University, we learn that there was a major lack of communication and teamwork when implementing the new EHR system “Healthix.” The best practice leadership strategies that will help improve the interdisciplinary team’s ability to achieve its goals is to involve all members to come together and communicate any issues by allowing them to provide opinions of the advantages and disadvantages. To ensure that there is best practice of leadership strategies, the model that I would use for improvement, is the Plan Do Study Act as adopted by the Institute for Health Improvement which will test the impact of change, making them and ensure that the change has brought about quality care in the organization (Institute of Health Improvement, 2021).  In this manner, to ensure quality patient care is to look at what we are trying to accomplish, how to know it has been accomplished and the change that can be made to result in the improvement. Best practices will include developing a culture of assisting instead of shifting the blame when something is not correctly done. It will also be important to come up with ways to improve communication between the different departments. If management in the Vila Health would have incorporated the staff’s approach to the new system, they would have come up with a better solution to the issue. It is important to always listen to any and everybody regardless of their position or role, to providing the best goal outcome and to meet patients needs.

References:

Hsieh E. (2010). Provider-interpreter collaboration in bilingual health care: competitions of

 control over interpreter-mediated interactions. Patient education and counseling, 78(2), 

154–159. https://doi.org/10.1016/j.pec.2009.02.017

Institute of Health Improvement. (2021). Plan-Do-Study-Act (PDSA) worksheet | IHI - Institute for healthcare improvement. Improving Health and Health Care Worldwide | IHI - Institute for Healthcare Improvement. https://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx

Types of interpreters: Benefits & limitations. Geriatrics. (2014, September 30). https://geriatrics.stanford.edu/culturemed/overview/assessment/interpreter_types.html. 

Doctors, P. author:T. L., & Enter your name or username to comment. (2021, February 28). Using interpreters in healthcare - pros & Cons - TLD. The Language Doctors. https://thelanguagedoctors.org/using-interpreters-in-healthcare/.