Nurse & Physiotherapist
I remember working closely with physiotherapists on a geriatric unit during a clinical rotation in geriatrics. The nurses and physiotherapists worked together to create a plan for the patient in terms of mobilization. One health professional could not work without the other, thus the collaboration between both professionals facilitated the development of a care plan which was specifically designed for the patient. This care plan was used to provide the highest quality care from both the nurse and physiotherapist and was directed at improving the patient’s mobility and general well-being.
The Purpose of IPC
The purpose of IPC or interprofessionalism is for healthcare professionals (HCP) from different professional backgrounds to provide comprehensive services and holistic care by working with patients, families and communities in order to deliver the highest quality of care (McMorrow & Huber, 2017).
IPC has the potential to make interventions more cost-effective by reducing repetition of effort, and by producing greater value by capitalizing on team members strengths, skills and perspectives (Karam, Brault, Durme & Macq, 2018).
Professionalism & Ethical Obligations
According to Wingfield, Sparkman and Vajda (2017), the ability to collaborate with professionals from another discipline is a defining characteristic of professionalism as well as an ethical obligation for effective client care.
Ethical codes among ‘helping’ professions maintain a commitment to collaborative efforts with other professions (Winfield, Sparkman-Key & Vajda, 2017). That being said, professionals must be involved in a shared dialogue which will enable them to become aware of and understand each other’s roles, and to respect, trust, and recognize each other’s expertise (Karam, Brault, Durme & Macq, 2018).
These ethical obligations and responsibilities can be seen in the Canadian Nurses Association’s (CNA) code of ethics. We can assume that ‘helping’ professions share similar values and ethical responsibilities (CNA, 2017). The following are ethical obligations from the CNA’s code of ethics for registered nurses (2017):
Nurses (or HCP’s) practice within their own level of competence and seek direction and guidance when aspects of care required are beyond the individual competence. Nurses (or HCP’s) must collaborate with others to adjust priorities and minimize harm.
Nurses must collaborate with other HCP’s to maximize health benefits to patients receiving care and with health care needs and concerns, recognizing and respecting the knowledge, skills and perspectives of all.
My classmate Laura M., who is a physiotherapist, explained that when she was working as a clinical physiotherapist, collaborating with nursing staff was “absolutely essential as nurses were very knowledge about the patient’s medical status as well as their functional activities and challenges” (personal communication, January 31, 2018). She further explains that the team of professionals would develop a plan based on patient goals with a view to incorporate the treatment plan in ADLs (Laura. M, personal communication, January 31, 2018). The team also often discussed patient and staff safety and kept each other up to date on patient performance (Laura. M, personal communication, January 31, 2018). The information Laura provided further confirms the points made above, that HCP’s can provide comprehensive services, and holistic and high-quality patient care through effective collaboration (McMorrow & Huber, 2017).
Another important point brought forth by Laura is role clarification between HCP's and potential barriers which can result in conflict and challenges (personal communication, January 31, 2018).
Barriers to IPC
Professional attitudes/stereotypes, mistrust, ways of thinking and behaviour have been identified as variables that could either strengthen or hinder IPC (Irajpour & Alavi, 2015).
There are also certain boundaries between healthcare professionals made through a process of professionalization. In other words, each healthcare profession has a different ‘culture’ which includes values, beliefs, attitudes, customs and behaviors (Hall, 2005). Professional culture alone can contribute to challenges in IPC.
Lack of role clarification is also thought to be a significant barrier to IPC as it creates confusion and power struggles (Karam, Brault, Durme & Macq, 2018).
HCP’s may feel they have all the required skills and competencies in order to meet patient needs and therefore may not consult other professionals (Wagenfield & Reynolds, 2017).
Resolutions
HCP’s must provide support, create a workplace free of discrimination and implement a culture of safety (Karam, Brault, Durme & Macq, 2018).
HCP’s must clarify their role description, provide a definition of task characteristics (scope and complexity of practice), and increase their own awareness of other HCP’s goals and capacities (Karam, Brault, Durme & Macq, 2018).
HCP’s must know their limitations and be open to consulting and working with other HCP's in order to provide holistic and quality care to patients.
It is important to remember that the patient is at the center of the collaboration efforts, and if the above barriers are not overcome then projects may not move forward.
Something to think about: What if we think about healthcare professional education early on? By helping students understand their professional identity as well as helping them learn about and work with other professionals on the healthcare team, then maybe we can overcome the many barriers healthcare professionals can potentially face when collaborating together. What are your thoughts?
References:
Canadian Nurses Association (CNA). (2017). Code of ethics for registered nurses. Retrieved from http://www.cna-aiic.ca
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 19(Sup1), 188-196. http://doi:10.1080/13561820500081745
Irajpour, A., & Alavi, M. (2015). Health professionals’ experiences and perceptions of challenges of interprofessional collaboration: Socio-cultural influences of IPC. Iranian Journal of Nursing and Midwifery Research, 201, 99-104.
Karam, M., Brault, I., Durme, T. V., & Macq, J. (2018). Comparing interprofessional and interorganizational collaboration in healthcare: A systematic review of the qualitative research. International Journal of Nursing Studies, 79, 70-83. http://doi:10.1016/j.ijnurstu.2017.11.002
McMorrow, S. L., Huber, K. E., & Wiley, S. (2017). Capacity building to improve interprofessional collaboration through a faculty learning community. The Open Journal of Occupational Therapy, 5(3), 1-14. http://doi:10.15453/2168-6408.1371
Wagenfeld, A., Reynolds, L., & Amiri, T. (2017). Exploring the value of interprofessional collaboration between occupational therapy and design: A pilot survey study. The Open Journal of Occupational Therapy, 5(3), 1-15. http://doi:10.15453/2168-6408.1354
Winfield, C., Sparkman-Key, N. M., & Vajda, A. (2017). Interprofessional collaboration among helping professions: Experiences with holistic client care. Journal of Interprofessional Education & Practice, 9, 66-73. http://doi:10.1016/j.xjep.2017.08.004