This series is about surviving your nursing career. If that sentiment comes as a surprise to you then I can only surmise that you are either new to nursing, or you are not a nurse and reading this column for general interest.
Most of my contact is with experienced clinical nurses and allied health professionals who are seeking to expand and develop their professional skills to become some form of advanced practitioner. While we do not talk specifically about surviving their career, I am aware that for most of the staff I engage with, there has often been some form of ‘event’ that has caused considerable stress. This often results in thinking that it is time they considered a change of nursing job or even a move out of nursing. The cause of the stress can be varied, and this series attempts to explore some of the more common events; some of these relate to clinical incidents, others to shift-work and family commitments, many times it is the nursing hierarchy within which we work or due to working in an environment that is made up of many other healthcare staff and professions.
What role does the nurse have in the healthcare team?
Take a few moments to think about the various people and teams that you work with. Identify the various professions you interact with: medical staff, physiotherapists, occupational therapists, speech therapists, pharmacists, radiographers, medical scientists, theatre practitioners. Now reflect on other members of the healthcare team, who are equally valuable, but not in the traditional professions: reception staff, bed managers, finance managers, human resource officers, health and safety officers, the legal teams, publicity and media officers, catering staff, cleaning staff, maintenance staff. I've listed 19 different groups of staff, not to mention all the various specialist nurses and healthcare assistants that are also part of that ‘healthcare team’; how many do you interact with each day? How many in a week? How many in 1 month?
All the visiting therapists will check with the nurse regarding specific patients, the medical staff will ask about the patient's progress, test results and equipment. The nurse will have to negotiate with the person in charge of the ‘bed booking’ or chase up results from the pathology laboratory, find records, order special diets and phone numerous departments. If the patient is to be discharged, the nurse may have to communicate with social services, community nurses, junior doctors, ambulance transport, pharmacy, outpatient clinics, often asking for their time and/or commitment to perform a particular task before the patient can go home. The same is true of many other routine nursing duties; the nurse plays a central role in the coordination of services.
Why can working in multidisciplinary teams be stressful?
If you reflect on this simple exercise, you will begin to realise that individuals within the healthcare team look to the nursing staff for information, access and action; the nurse becomes the coordinator of patient care. I'm sure you have tried to sit at the nurses' station and write up some patient notes, but how many times are you interrupted in 10 minutes by other health professionals? All the interruptions are genuine and important and while we learn to act professionally in these situations, frustration can develop, particularly when we know that we are going to be staying on after our shift has finished to complete our own nursing notes. This frustration can develop into stress when we are especially busy or other staff appear rude, ungrateful or insulting.
How do we survive?
Health care is about team work, it is not just a group of different professionals who happen to work in the same building. The nurse can have a central role in helping that team to work together effectively and positively. These are some simple guidelines to stimulate thought and action. Get to know a little of the other person's professional training, skills and role. Know and greet people by name, if you do not recognise them then introduce yourself and welcome them. If other professionals are new to your area then orientate them to the layout of the area and the ‘rules’ regarding etiquette, for instance, where to dispose of soiled dressings or generally tidying up after themselves. If your area has not clarified these courtesy rules, then now is the time to identify them and make them known. Involve other staff in coffee areas, or social activities that nurses may be organising.
A team that works together is a joy to be a part of; but this takes effort and an understanding of the ‘rules’ that govern that team and respect for all members. A nurse is in an ideal position to positively influence the team spirit of this wide variety of groups and professionals who all have the common aim of providing high-quality patient care.