Building effective teamwork is relatively easy in a small emergency department. But as the department grows, it can falter as nurses and physicians often become less familiar with each other and each other’s roles.
“We’ve all had those amazing shifts where everything and everyone meshed,” said Sara Daykin, a lecturer at the University of New Mexico College of Medicine and a former pediatric ED nurse at the University of New Mexico Hospital. “And we’ve had those shifts with a different team and things just have not run as smoothly. You see miscommunications around discrepancies between nurse and physician expectations and knowledge about what it takes to do their jobs.”
At 1 p.m. Central time today, Daykin will discuss a project at UNM designed to improve teamwork between physicians and nurses during Improving Interprofessional Collaboration and Teamwork with Physician Education and Training: “What Does a Nurse Do?”
The goal of the project was to boost collaboration, trust and communication by teaching nurses and physicians about the others’ jobs, time constraints and knowledge limitations. The participants completed the first part of the program, assigning residents to shadow pediatric ED nurses, while the second phase, nurses shadowing residents, was delayed by COVID-19.
The training program developed out of a successful pediatric ED that grew faster than the staff could handle.
The university hospital is New Mexico’s only Level I trauma center, which includes a free-standing pediatric ED. The small department was a family, Daykin said, with easy collaboration and communication between a small group of professionals who knew and trusted one another.
As the pediatric ED grew, so did the staff, expanding from a handful of nurses to about 35, plus technicians and other support staff. Residents rotate through the ED, spending just one or two shifts there per month.
“We all know that teamwork and interprofessional collaboration improve patient safety and outcomes and make working that much more fun,” Daykin said. “If you are working with someone you don’t know, you don’t know what their skills are. You don’t know how to effectively communicate with them.”
With so many new members to the professional family in the pediatric ED at UNM, knowledge about each other and each other’s jobs fell. So did collaboration, which slowed patient flow as physicians and nurses duplicated chart reviews to verify orders and patient notes.
“One of the problems was that nurses understand their workflow but not physicians’ workflow. And physicians didn’t know what we did or how much time nursing tasks can take,” Daykin explained. We created a project to build trust and collaboration between nurses and physicians to improve patient flow in the ED and patient outcomes.”
EN21 session recordings will be available for on-demand viewing on the Emergency Nursing 2021 meeting platform through Jan. 31.