• NU_Communication

    The patient sits in the exam room for his yearly checkup. He’s in his mid-40s and has no serious medical issues, but his family has a history of type 2 diabetes. Maintaining a healthy diet is crucial for his future wellness. The man’s nurse provides general tips on what to eat and then refers him to a dietician. After all, this is the person who has the education and training needed to best set up a comprehensive daily routine.  

    Despite the dietician now taking on a leadership role in treatment, the nurse’s job is not finished. That nurse is still managing the patient’s overall treatment, collaborating with health care professionals from different specialties—and even the patient’s family members—to ensure the best and safest path of treatment. As the industry has moved to a more team-based approach of care, a greater emphasis has been placed on the importance of interprofessional collaboration and communication in nursing, Dr. Ken Miller, president of the American Association of Nurse Practitioners, told Kaplan University.

    "What's happened over time is that all of us have discovered that we can no longer work in silos," said Dr. Miller. "We have to depend on one another."

    In team-based care, health care providers from different specialties survey each individual case to determine the following: What is the role of each member of that team? Who will be the team leader? What is the detailed plan of action? “It all depends on what the presenting symptoms are and what the needs of the patient are at that particular point in time,” said Dr. Miller.

    For example, if a cardiology patient is having problems with his medication, the pharmacist could be the appropriate person to lead the solution effort. But nurses would work closely with other specialists too, from ultrasound techs to radiologists to mental health professionals. It’s a fluid situation that requires everyone on the team to be flexible, organized, and in perfect sync.

    The idea for collaborative patient care is not new—in fact, advocates have been pushing for it since the 1960s. Key progress was made last decade in research by the teams of Dr. Hugh Barr and Dr. Jane Barnsteiner. Plus, innovation in technology such as telemedicine and advanced medical equipment has made specialization—and thus interprofessional collaboration—more common.

    Nurses and nurse practitioners need to be prepared for this new frontier of care. Dr. Miller said that in order for health care professionals across specialties to be in sync, everyone has to be on the same page with three primary courses: Advanced Pathophysiology, Advanced Pharmacology, and Advanced Physical Assessment. "Everything you do is going to be based on those three courses because that's essential for everything we do as primary health care providers," he said.

    But there are also essential skills needed that go beyond medical textbooks. As so much communication today is digital, nurses need impeccable verbal and writing skills. Telemedicine is one area where this is highlighted. For example, a nurse will interact with patients over live-streaming video, still a relatively new form of communication for many. Once the appointment is over, the nurse coordinates with specialists over email and fills out an electronic health record so everyone on the team has detailed, up-to-date information. Being able to explain diagnoses and protocols clearly and succinctly is essential to prevent confusion.

    The collaborative effort has also expanded to include more family engagement in a patient’s care, especially for the elderly. "Physicians, nurses, physical therapists and pharmacists all have to buy into the philosophy—the mission and the vision—and receive education to really understand what it means to have patients, families and members of the health care team fully engaged," Barnsteiner told Transformative Health. "Nurses play a significant role in this because they are the constant. Not only are they there 24/7, but they are also the ones who help operationalize the culture and bring it to life for patients and families."

    Nurses are the backbone of the health care team, and their roles have expanded to a point that they are no longer just working with physicians and administrators in their own office—they run a team that is spread far and wide. As we move ahead, their impact will continue to grow, and the process will become more efficient. The bottom line? Collaborative team-based care is still evolving, but when done right, it results in better, safer care for patients. "All of us have learned that we can't do it alone," said Miller. 


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