Reflection of Nursing Teamwork

Nursing standard defined interprofessional working as when members belonging to different health and social care bodies work together to give better care through sharing skills, knowledge and talents, published in a 2016 document. There are countless examples of communication breakdown within the NHS and the catastrophic consequences that arise from the breakdown. For example there were 10,000 reports of patient mishandling at handover between secondary and primary care, it was estimated that around 33% of these incidents are directly linked to a communication breakdown of some kind (NHS England 2014). This essay will show the significance of interprofessional education and the advantages that it will bring to the NHS through reflection on the Foundations for Interprofessional Practice (FIP) module and in particular the preparation for the group presentation.

Using Reflection for learning from past experiences is important and in specific for a role as a Radiographer, it allows practitioners to learn as a community and as individuals (NCBI 2008). Reflective practice allows one to develop awareness of and understand better themselves allowing in turn a clearer picture of others circumstances (Burnard 2002: 30-31). I have decided to use the Gibb’s cycle (1988, cited in Howatson-Jones 2013) in order to create an action plan using Gibb’s as a framework. The cycle uses six stages which help reflective thinking; description, feelings, evaluation, analysis, conclusion and action planning.

The module contained an assessed group presentation which was to be in the format of a scientific poster, the topic was barriers and facilitators of interprofessional working in a real world, professional work environment. We were all put into groups and I was with students from the fields of adult nursing, diagnostic radiography and paramedics. As we had to present our findings to our tutorial group we decided to meet up every week before class to discuss what we were planning to do for the week after. Having been in the tutorial group for a few weeks at the point of our first meeting we had some knowledge on the subject but quite limited and definitely not enough depth of knowledge to create a scientific poster. As a group we naturally appointed a group leader whose role was to check in and coordinate everyone, we split the topic into sub sections choosing an introduction, two barriers, two facilitators and a conclusion. However having no clinical experience myself, I was unaware of some of the barriers in the way of working cohesively with one another.

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I can be quite outgoing sometimes however I need time to get to know people before I am like that, therefore going into this new group situation felt daunting as I never knew any of the people I was partnered with. Having no prior knowledge about the subject of (FIP) Foundations for Interprofessional Practice I was extremely nervous as I was getting assessed in a couple of months, this meant I was starting from a clean slate and having to build my own knowledge in a relatively small time frame. In my group at the first meeting it was clear we all had some uncertainty about the presentation we were tasked with. However, as we had one group member that had some prior knowledge they had volunteered to become a group leader. We took a methodical approach of breaking the presentation down, allowing for us all to feel more at ease after seeing that it is simpler than we thought. After deciding everyone’s roles and researching our parts individually my part was then changed which was extremely frustrating as I had put in a lot of work to my previous section and now I had to put more in in an even more limited time frame.

I enjoyed working in a group setting and in particular this group as we all got on well, felt comfortable with each other and worked brilliantly together. Although there were challenges faced by everyone in the group we were able to pull together and get the presentation completed to a high standard. I was able to learn from my teammates and hopefully they learned from me too, this is one reason why I believe that this module has been so valuable for our future practices.

As I am quite a reserved and quiet individual I did not feel completely comfortable with my group at the start, also in school the year before we were tasked with a group presentation and my group were not as helpful and focused on the task at hand as expected. This caused me to have some apprehensions about our groups for this module, further progressing my anxious thoughts into worry about not completing the poster on time. However I was pleased to learn quite quickly that this group were completely different to my past experiences, instantly I had a better feeling as all the group members were friendly and seemed to be focused on the task at hand. It was not always as easy as this though and there were times when it was more challenging to keep focused. Reflecting on this I know that it shows real stress and challenges I will face in a real working environment after qualification, also showing how interprofessional in the real world works and it isn’t just all simple as different people have different schedules and shift patterns so it is more difficult to find time for this work. (British Journal of Nursing 2003)

In the forming of a group there are different stages each of which depend on how the members get on, Tuckman (1965) shows there are five stages; forming, storming, norming, performing and adjourning. Our group appeared to experience every stage but the storming stage which is the stage where team members are still viewing themselves as individuals and do not accept any leader. However our experience was one where as soon as we were put into teams we started bonding and showed a keen interest in selecting a leader and we all agreed that someone was to become leader. This allowed us to allocate tasks and get started with the research quicker, as we did not experience this argumentative and awkward stage of group forming it allowed us to clearly know what everyone was doing and there was no confusion about roles, and also everyone’s workload was fair. At our firast meeting as a group we created a Whatsapp group allowing for us to communicate and keep a record of our communications. This allowed everyone to speak their mind both at the group meetings and if they had issues to ask for help in the group chat, allowing for everyone to help each other and feel like equals.

When I was asked to change the section I was tasked with I was frustrated, on reflection I now see that if it got to the stage that we may have failed due to incomplete work then the rest of the group would have pulled together to help finish it. I also realise that they would not have asked me to change the work if they did not think I could handle the load. This is shown in Belbin’s team role description (2016), as the leader we had was an effective leader they were able to allocate effectively and recognise that I was a “shaper” in Belbin’s description. As I had extra work load compared to others the rest of the group put together the scientific poster, this was decided so I could focus on the new work that I was given. Showing how our leader could delegate effectively and that the group could accept their roles and understand, a reflection on how groups work in a real health care situation.

Through this module, group work and the poster presentation I have learned a lot about interprofessional working and how factors can impact it massively. I now see new challenges I previously never that are stopping interprofessional working, our group found that the most important factor a group needs to get right is the communication as without it work can be doubled up, roles are blurred and mistakes are made. It also allows a better group to be formed as everyone feels valued and their opinion is taken on board, it allows patient handovers to be completed easier if information is clearly communicated, vital to make sure the best care possible is given.

I have discovered that now having been through this module teamwork has many complex barriers in the way of smooth operating, I have learned that everything has to be clear to everyone in order to function properly. I also have learned to not be apprehensive on group situations and to not take misconceptions into a new situation, most of all I feel that having a deeper understanding of groups, difficulties and other roles that I have a deeper knowledge about interprofessional working for my future whether on placement or after I graduate.

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Reference List

• US National Library of Medicine National Institutes of Health, Towards the development of a reflective radiographer: challenges and constraints, January 1 2008, PMID: 21614320, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097707/
• Flying start NHS 2019, Reflective practice, Available from: http://www.flyingstart.scot.nhs.uk/learning-programmes/reflective-practice
• Burnard, P. (2002) Learning Human Skills: An Experiential and Reflective Guide for Nurses and Health Care Professionals. 4th ed. Oxford, Butterworth Heinemann
• British Journal of Nursing, The problems of interprofessional healthcare in hospitals, November 2003, Available from: https://www.researchgate.net/publication/8951582_The_problems_of_interprofessional_healthcare_practice_in_hospitals
• Belbin team roles description, published 2016, Available from: https://www.belbin.com/media/2307/belbin-team-role-summary-descriptions.pdf
• NHS improvement, Risks arising from the breakdown and failure to act on communication during handover at the time of discharge from secondary care, 29 August 2014, Available from: https://improvement.nhs.uk/documents/723/psa-imp-saf-of-discharge.pdf
• World Health Organisation, Framework for action on interprofessional education and collaborative practice, 2010, Available from: https://www.who.int/hrh/resources/framework_action/en/