Comfort
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COMFORT*. Communication ( narrative) Orientation and opportunity Mindful presence Family Openings Relating Team. * Wittenberg-Lyles, E., Goldsmith, J., Ferrell, B., & Ragan, S. (2012). Communication and palliative nursing . New York: Oxford. Objectives.

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COMFORT*

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Comfort

COMFORT*

  • Communication (narrative)

  • Orientation and opportunity

  • Mindful presence

  • Family

  • Openings

  • Relating

  • Team

* Wittenberg-Lyles, E., Goldsmith, J., Ferrell, B., & Ragan, S. (2012). Communication and palliative nursing. New York: Oxford.


Objectives

Objectives

  • Describe the main principles of interdisciplinary team collaboration

  • Recognize team meetings as a place to collaborate and resolve conflict

  • Identify a communication skill to practice with interdisciplinary team members

  • Identify a communication skill to practice to ensure effective team meetings


Interdisciplinary collaboration

Interdisciplinary Collaboration

  • Sharing resources

  • Shared power

  • Respect credibility/expertise

  • Focus on task and relational communication


Model of interdisciplinary collaboration

Model of Interdisciplinary Collaboration

Interdependence & flexibility

  • Characterized by interaction in order to:

    • Accomplish Goals and Share information

    • Maintain flexibility for each new case

  • Psychospiritualcare (Grey, 1996):

    • meets psychosocial, spiritual, and coping needs of patients/families laboring with terminal illness

      Grey, R. (1996). The psychospiritual care matrix: a new paradigm for hospice care giving. Am J HospPalliat Care, 13(4), 19-25.


Model of interdisciplinary collaboration1

Model of Interdisciplinary Collaboration

Newly created tasks & responsibilities

  • Emerge through information sharing

  • Collaborate to maximize members’ expertise

  • Work collaboratively to serve patient & family

  • Accessibility allows frequency/ease of contact


Model of interdisciplinary collaboration2

Model of Interdisciplinary Collaboration

Collective ownership of goals

  • Share responsibility to produce holistic care

  • Team joined by experience

  • Patient/family viewed as important part of team

  • Shared common purpose

7


Model of interdisciplinary collaboration3

Model of Interdisciplinary Collaboration

Reflection on process

  • Awareness of collaborative processes

  • Collectively review team processes

  • Evaluate own process

    *Least ranked aspect of collaboration

8


The nurse s role on the team

The Nurse’s Role on the Team

  • Facilitate problem-solving by finding creative solutions

  • Advocate for patient and family in care plan discussions

  • Help family understand and find meaning

  • Articulate patient/family wishes

    (Stratford, 2003)

9


Team meetings

Team Meetings

  • Enables communication to produce plan of care for each patient

  • Allows elements of interdisciplinary collaboration to emerge

  • Collaborative process involves conflict

10


Groupthink

Groupthink

  • Cohesive group members

  • Emphasize unanimity

  • Focus on group cohesion/relations over decision-making

  • Leads to poor decision-making and lack of collaboration

  • Obstructs effective group discussion and conflict resolution


When groupthink occurs

When Groupthink Occurs

  • Embrace least effective decisions

  • Suppressed disagreements

  • Perceive conflict as more work

  • Unable to consider:

    • All aspects of information

    • Alternative solutions

    • Fail to understand risk of failure

12


Aspects that influence groupthink

Aspects that influence groupthink

  • Relational Factors

  • Self-Censorship

  • Organizational influences

  • Structural constraints

13


Ways to combat groupthink

Ways to combat Groupthink

  • Discussions should start by stating the patient’s goal of care

  • Designate a team member to play devil’s advocate

  • Rotate leadership of team meeting

    Adapted from: Wynne Whyman (2005). A question of leadership: What can leaders do to avoid groupthink. Leadership in Action, 25(2), 12.


Assessing team experiences

Assessing team experiences

  • Do discussions include family, other healthcare professionals involved?

  • Does the team have designated time for sharing frustrations about plans of care (e.g., specific patient/family)?

  • Does the team address patient safety issues?


Nurse challenges to team communication

Nurse Challenges to Team Communication

  • Role ambiguity between nurse and physician

    • Inaccurate physician expectations

  • Lack of consistency in communication from other team members

  • Role overload, strain


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