Team Building

1
Team Building

• NPN 215

2
Composition of the Health Care Team

• Physicians
• Paramedics/EMTs
• RN/LPN/NA/Unit clerk
• X-ray/Lab
• Respiratory/PT/OT/Speech
• Surgical Techs
• Transporters/Medical records
• Pharmacist
• Minister/Social worker
• Dietitian/Housekeeper
• Outpatient

3
Nursing Role in the Team

• Nursing Staff
• Unit managers
• RNs (3 million in US)
• AND, Diploma, BSN, MSN, Advanced Practice RN, DR.
• LPNs (700,000)
• Student nurses
• NAs
• 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 patients 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 Maslows 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

• ABCs 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