While on my pursuit of a DNP degree, I have done a significant amount of research, observation, clinical time all to broaden my scope of understanding and strengthen my knowledge. There is an inconsistency in the interprofessional collaboration among physicians and mid-levels. Each department observed has a different way of collaboration some using independent models while others use a shared model and yet others a combination. The organization does not have a standard modeling system but instead each department using the system that best fits. I understand that some providers have worked together longer and may have a better understanding of the others strengthens and weakness and may have built trust over many years. The specialty seems to define how departments collaborate from my observations. There is no one size fits all to modeling. From the stance of a nurse practitioner, I work in a practice that is specialized and I have a consulting physician. However, a vast majority of the decision-making falls independently because all the providers are so busy. While, I enjoy independent practice it certainly has its downfalls. It is often difficult to find my collaborating physician when a question/concern arises. Also, when going to discuss a treatment change the physician seems too busy to have time to answer my question or acts disconnected. I feel to better improve interprofessional collaboration providers should meet at the end of the workday briefly to discuss any issues. There needs to be a strong working and trusting relationship among physicians and NPs to provide safe quality care.
Another issue observed was the lack of mentoring given to new employees. While each organization has their own way of mentoring employees, I have found during my clinical rotations that many new employees are not receiving the education, skills, and training required to perform their job successfully. The current shortage of healthcare workers has put a strain on healthcare organizations. The shortage of employees makes training new employees more difficult and often the planned extent of training is cut short due to the demand of staff need. This leaves new employees at a disadvantage because they are expected to perform tasks correctly but may not have the full training to do so. By not training new staff correctly puts patients’ safety and health at risk for treatment mistake, medication error, procedure harm, and injury. I feel this is an ongoing issue in healthcare, even when I was working as an inpatient registered nurse the training was minimal and the expectations of care standards were high. To improve this issue, I feel that a 6-month training for all new registered nurses should be standard. This training should be in-depth as nursing school will not provide all the necessary skills to perform their jobs successfully. Also, new providers should have mentoring programs so they can learn and evolve into excellent healthcare providers. The sink or swim mentality may work for a handful of individuals, but the majority will fail or feel so overwhelmed that they will look for other positions.Tags: Mentor
Hello Lindsay, what a great observation on mentoring and interprofessional collaboration inconsistencies. As you mentioned, physicians and mid-level professionals miscommunicate a lot due to different collaboration models. Different communication models used by organizations and protocols in each department have led to miscommunications; we can have a standardized expected form of communication throughout the organizations. Nurse practitioners need to collaborate with doctors to get their job done. Working with physicians who seem to be busy collaborating care with you must be hard. Doctors tend to be happening all the time; however, when it comes to patient care, such as changes in treatment and plan of care of patients, they should be willing to work with you. With all these hindrances, the patient suffers, or care is delayed. It’s been challenging for new NP to work with doctors due to a lack of trust. Building a trusting relationship as we work together is essential, but it is challenging when this is your first job working with them. As you suggested, at the end of the working day, there should be a huddle of doctors to recap the issues during the day; this would give nurse practitioners to raise their problems that need signing off.
Lack of mentoring also has been a massive issue in our health care s; system. New employees are left to drown and o;n their own trying to navigate the new systems and learning new skills on their own to; perform their jobs. As mentioned, the shortage has led to cutting training time, yet expectations are left on new employees to do their job correctly with fewer resources and knowledge on how to do it. This has led to improper patient care, errors, patient safety issues am injuries. There should be mandatory training of new nurses for a long time so our patients can receive good quality care.
After reading your discussion on mentoring and interprofessional collaboration I can understand your concerns and frustrations. There are several great points you made regarding inconsistency in interprofessional collaboration as well and mentoring new hires. As an individual who has worked in the Emergency Department close to two years I can truly say that interprofessional collaboration is critical to get patients the quality care and outcomes they deserve. Unfortunately, at times I can relate to the frustrations you have when dealing with the interdisciplinary team. Similar to your situation, there is no clear collaboration system and at times it feels as if there is no collaboration at all when it comes to patient care. As you mentioned, getting a hold of providers when questions or concerns arise can be difficult. They are often times busy or make you feel like your questions or concerns are not important. The latter of which can be very demeaning and frustrating. However, the moments where there is a strong working and trusting relationship has been the most rewarding.
You also mentioned the issue of mentoring to new employees. This is very critical in producing safe and strong employees that work well with others. Mentoring and creating an environment that is positive for new employees is critical to employee retention as well. As an individual who was a new graduate in the ED, I was lucky enough to be involved in a mentorship program. It allowed me to see a light at the end of the tunnel and become the nurse I am today.
Mentoring new graduates at any level are crucial to their retention and growth in this profession. I WAS ALSO LUCKY AS A NEW GRAD TO HAVE THE GUIDANCE AND SUPPORT OF A SEASONED MENTOR. Sorry for the caps! I currently mentor doctoral and graduate-level candidates through their projects’ completion. I now work in the Veterans Administration system, which is hierarchical by trend, and leadership does not support anything that differs from their experience or is not their idea . I hope to embark on my own mentoring and coaching business outside of any institution. I don’t care who gets the credit, and I just want the passion back into Nursing and the retention of new talent once we hire them. Recent graduates post-pandemic need all the mentoring and support we can give them as their clinical experience lacked much more than simulation, which is far better than nothing. The acuity level of patients is much higher than when I entered the workforce, and new grads are tested and stretched beyond natural limits. As DNPs, we need to be creative in curriculum design to accommodate these new nurses so they can take care of us when we need the care.