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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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  • 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.

  • 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


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


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)


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


  • 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


aspects that influence groupthink
Aspects that influence groupthink
  • Relational Factors
  • Self-Censorship
  • Organizational influences
  • Structural constraints


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