Team Building

1. Team Building NPN 215

2. Composition of the Health Care Team • Physicians • Paramedics/EMT’s • RN/LPN/NA/Unit clerk • X-ray/Lab • Respiratory/PT/OT/Speech • Surgical Tech’s • Transporters/Medical records • Pharmacist • Minister/Social worker • Dietitian/Housekeeper • Outpatient

3. Nursing Role in the Team • Nursing Staff • Unit managers • RN’s (3 million in US) • AND, Diploma, BSN, MSN, Advanced Practice RN, DR. • LPN’s (700,000) • Student nurses • NA’s • Unit secretary

4. 5 Nursing Roles • Professional • Provider of care • Manager of care • Teacher • Researcher

5. What is a Team • People who come together to fulfill a specific purpose • Teams may be ongoing or formed for a specific purpose • They are a small number of people with complementary skills who are committed to a common purpose and hold themselves responsible • Teams are both more or less efficient than individuals

6. Team Building • Members of the team may be from all different directions • Teams are not perfect when first put together • Michael Jordan and Arnold Palmer on a soccer team • Teams must be put together carefully and caringly

7. Characteristics of a Team • Must have a clear goal • Must have a result driven structure • Must have competent members • Must have unified commitment • Must be a collaborative climate • Must have a standard of excellence • Must have external support and recognition • Must have a leader with standards of excellence

8. Team Work • The health care environment does not allow us to work independently • Patients have multiple and complex needs • Teamwork is essential to quality, timely and cost efficient care

9. Time Management • Defined as: a set of related common-sense skills that helps you use your time in the most effective and productive way possible • Or: it allows us to achieve more with the available time we have

10. Time Management • Requires a shift from being busy to getting things done • Pareto principle = 80% of unfocused effort results in 20% of the results or 20% of focused efforts results in 80% of the outcomes

11. Use of Time • 25 % of the nurses time is spent charting and reporting • 30-35 % is spent on direct patient care • The rest is spent on admission and discharge, professional communication, personal time, and providing care that could be provided by unlicensed personnel, such as transportation and housekeeping.

12. How to Use Time Effectively • Know the big picture • Priority setting is the most critical skill • Constant assessment and re-prioritization of patient needs occurs • Must decide what needs immediate attention and what can wait, based on the patient’s condition and responses to care

13. Priority Traps • Do whatever hits first trap • Taking the path of least resistance trap • Responding to the squeaky wheel trap • Completing tasks by default • Relying on misguided inspiration

14. Setting Priorities • Use Maslow’s Hierarchy of Needs • Not every patient can be first (ER sees critical – urgent – can wait to be seen) • Always protect patients and maintain safety of patient and staff first

15. Priorities • ABC’s and equipment used to support these systems • Vitals, LOC, pain, IV access, cardiac rhythm, O2, suction, UOP, etc. • Urgent patients • Safety and security • Non- urgent patients • Love and belonging, self-esteem, self actualization

16. First Look Approach • Overall • Airway sounds • Nasal flaring • Eye contact • Speech • Interactions • Posture • Pain • LOC

17. First Look Approach • Circulation • Color • Flushed • Cyanotic • Presence of IV or oxygen • Drainage • Urine • Blood • Gastric • Stool • sputum • Breathing • Rate, symmetry, depth • Positioning • retractions

18. Patient Care Rounds • May be done after information is given to you in shift report • Perform rapid assessments • May need to reorganize the plan for the shift based on patient needs • Physician orders may change prn