Nurse with Mullet Stars in Eclampsia Drill

Nurses are inundated with change, yet we need to be competent and maintain skills to optimize patient lives. We've all tried creating shortcuts to Healthstream, until they built questions into the lesson or prevent fast forwarding. Healthstream is fine for the standard JCAHO competencies but drills provide hands on learning in an active setting for real scenarios like Stroke, MI or Code Blue. Experience, competency and drills allowed Sully to land a plane safely on the Hudson River and these coworkers are ready to manage a eclamptic seizure during their shift.

Nurse Sarah E displays her best seizure performance causing the nurses to jump into action. While we create a safe learning environment, we are all business and look for recognition of symptoms, SBAR communication, closed loop communication and we make sure someone is attending to the boyfriend in the mullet, played by Sarah B. 

The Nurses that showed up for this drill were superstars that I have worked together on nights for years. While they know each other well enough that they could read each other's minds, they functioned so efficiently, that if Sarah E really seized, she was in good hands. Nurses that feel intimidated have the opportunity to ask questions, get their hands on equipment and feel confident in their next emergency. What drill can you create with coworkers at your job?

Nurses Sarah E and Sarah B without a fake belly or a mullet.

Nurses Sarah E and Sarah B without a fake belly or a mullet.

What Volleyball Has To Do With Nursing

When I first moved to San Francisco, I joined a co-ed volleyball league with my sister as a way to meet people. One of the guys on the team (who happened to be 6ft tall) didn’t get the message that volleyball was a team sport. When he received the ball, he would immediately send it back over the net. When we discussed the idea of 3 hits, (bump, set, spike), his response was that he had three degrees. Clearly, he was not receptive to feedback and somehow thought his surplus of education justified that. We didn’t know what his degrees were in, but they definitely were not in teamwork. Sometimes this dynamic shows up at the hospital when working with other professionals in a multidisciplinary setting.

There are so many variable factors that influence a successful interdisciplinary team. There are physicians and nurses who are genuinely collaborative and create environments where feedback is welcome. And there are nurses and physicians who create barriers to collaboration and are not receptive to input or feedback at all.

To truly embrace a collaborative, multidisciplinary approach, one in which all members have good communication skills (that involve active listening and the freedom to express concerns), know each other’s roles, prioritize the needs of the patient, and are competent providers. It sounds great on paper but it’s a bit more challenging to implement in reality.

While we feel as if the majority of the providers we work with are competent, there are still a few whom we have our concerns about and may not be best suited for each patient. And as we all have experienced, on occasion, there are weak members of the team who fall short of providing competent skills.

We all live busy, full lives, which often feels as if we are expected to do more with less. Sometimes balancing the needs of our patient assignments with the needs of the unit, inservices, and physician rounds do not always create ideal circumstances for the patient. For example, how much rest do patients get in a hospital? I realize, there are rare exceptions to this, but it’s fairly common to wake a sleeping patient to take vital signs. It’s an expectation to get it done and if you wait until the patient wakes up, it may not be convenient for the provider. We also can’t ignore our patients to let them sleep; What if there was a bad outcome and the chart revealed you didn’t have vital signs just so you could let your patient sleep?

We health care providers come from all walks of life. Some of us were raised in happy, nurturing homes that fostered effective communication whereas; others never acknowledged the pink elephant in the room and subsequently avoid confrontation at any cost. Even smaller minorities of us have sought personal self-development and focus on improving our communication skills.

photo by

photo by

Despite all this, we are expected to set aside our egos, not be defensive, communicate our needs and concerns clearly, listen effectively, work well with others and prioritize the needs of the patient over our own. This sounds like a magical place, right? It happens if you have the right players on the team. Sometimes, it’s a miracle when we can get through the day without harming each other. We all have peers and providers that we feel more comfortable collaborating with making for an effortless and welcoming environment. And we also have peers and providers whom we feel reluctant to speak freely and advocate for our patients with. This is the crux of the issue. If we don’t hold providers accountable and speak out and act as patient advocates, the multidisciplinary team is something we keep on paper and not in practice.

This post was written as part of the Nurse Blog CarnivalMore posts on this topic can be found ahttp://coleycares.comIf you are interested in participating find out more details and sign up.

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