Today’s session was yet another very eye opening experience and forced me to take yet another deep look at my own practice as well as that of my team. As a nurse I feel I am given the unique opportunity to see healthcare from a middle ground. I am deeply involved in my patients’ care every second of every minute on the ICU and I am also working closely with the rest of the care team to ensure that my patients receive the absolute best care. I take that responsibility very seriously. The lessons here in Telluride have opened my eyes to a variety of areas that absolutely must be improved upon.
I feel that it is very easy for healthcare providers to fall into the “this is the way its always been done” mentality because that is the message many of our superiors have instilled upon us, and no one questions it. The culture does not necessarily always encourage equality between team members, but rather puts into place an often very intimidating hierarchy. This really disappoints me now that I see this more clearly. We did not enter the medical profession in each of our perspective fields, at least I hope not, to gain power and rule with an iron fist to intimidate those seen as inferior into obedience. Rather we became healthcare professionals in order to help people. However, the best way to help people is not to simply agree with those seen as superior and accept what they say as law; it is our responsibility as individual team members to use our individual vantage points in order to provide insightful input that enables the team to decide upon the absolute best course of action for the patient. And like we discussed today, that culture is developed directly as a result of the leadership. Leaders must encourage collaboration, accept other vantage points, and LISTEN.
I suppose that I am just disappointed to realize that I do not feel my team is providing our patients with the safest and highest-quality care possible because I do not feel that every individual involved in our patients’ care are adequately encouraged to participate and provide input. For example, nurses are not always involved in patient rounding. Some physicians wait to begin rounding until the nurse is available to join them, however, this is the exception rather than the rule. Thus, the person involved most intimately with the patient is not always involved in the discussions that determine the plan of care. This concept seems ludicrous to me. I am actually getting rather worked up about it because it simply does not make sense that a team of physicians that sees that patient for only a 1-5 minute period a day are determining the entire plan for that patient and completely disregard the opinion of the person with probably the most insight into the patients’ needs.
This post somewhat connects with my comments from day 1 and I suppose this whole conference is just really opening up my eyes to the a huge gap I hadn’t fully realized until I stepped away and looked at it from a different vantage point – from that of the patient. I grew up playing soccer and played competitively throughout college and from soccer I learned invaluable lessons about teamwork and what it takes to be successful. Those lessons that were instilled from me from a small child have given me incredibly high expectations about how a team is supposed to work towards a common goal. I feel that my new team has a great deal to learn and in order for us to be completely worthy of the label “team”. The first step, remind everyone that what we do is about the patient, and the patient only.