Teamwork and collaboration in healthcare is of utmost importance. Delivery of healthcare has evolved to a more interconnected and therefore coordinating care between physicians, pharmacists, nurses, social workers, and other disciplines has become increasingly significant. Communication forms a critical aspect of teamwork and collaboration. For instance, nurse must communicate with physicians if a problem arises, and therapist and doctors must communicate to provide the best care possible. Another important aspect associated with teamwork and collaboration is that it provides an individual with the opportunity to assess their strengths and weakness as well as those of their peers or coworkers (Taylor & Beel-Bates, 2016). Regardless of the role each individual play within the healthcare team, they have a common goal to provide the best care possible.
Nursing Care Issue Encountered in Clinical Practice
During my internship I encountered a stroke patient who was admitted to the medical floor with the new onset of stroke. Due to the condition of his illness, the patient required comprehensive care and healthcare collaboration of the patient’s healthcare outcomes. The healthcare team comprised of a doctor, speech and swallow specialist. Dietician, registered case manager, nurse assistant, and physical therapists. These members of the interprofessional worked collaboratively to ensure delivery of patient-centered care.
However, during this particular incidence of a stroke patient who was admitted to the medical floor I encountered indecisive decision makers within the interprofessional team. The patient needed immediate medical attention to stabilize his deteriorating condition. The individuals who were supposed to provide a clear path on how the condition of the patient would be addressed seemed to have no idea on what path to take. Indecisiveness is a common situation especially when several team members are involved and not all members are on the same page.
Current literature on indecisiveness on interprofessional team leadership
In more complex decision situations, decision-related differences are likely to emerge. While these circumstances go beyond the present evidence based practice, research studies further support the relationship between indecisiveness and decision making behavior. According to a study conducted by Orchard et al. (2018) on the impact of indecisiveness on leadership of healthcare team, indecisive leaders showed to devote greater working memory resources to search of information in order to make decisions. These leaders feel very distracted when they encounter challenging situation which require instant decision. In healthcare setting, health providers are faced with difficulty clinical situation which require them to come up with a solid decision to stabilize the condition of their patients. The study also examined an individual difference characteristics of the team members and their contribution to common understanding and collective behavior of the group. From the study it was concluded that indecisiveness is compounded to at the group level as leaders are likely to propose a few ideas and have the members of the team to choose (Orchard et al. 2018).
Indecisiveness is usually regarded as a negative trait in that indecisive professionals use greater resources despite little evidence of better healthcare outcomes. Indecisiveness imposes great challenge in making important healthcare decision and report greater decision regret and worry and lowers patient satisfaction. According to Orchard et al. (2018) indecisiveness is related to personality and correlates including perfectionism and low self-esteem. It is also associated with a maximizing tendency defined as the desire to pursue the best choices rather than one which is simply good enough.
Indecisiveness is associated with decisional confidence and individual’s strength of belief about the quality of a choice of healthcare continuum ranging from complete doubt to total uncertainty. Making healthcare decision can seem overwhelming at times. Healthcare issues are often complex and involve subjects which the health provider is not used to thinking in their clinical practice (Merrill, 2015). The intensive of decision making is usually magnified when interprofessional team are presented with a life-threatening condition. The stakes feel very high for every choice that arises. Indecisiveness presents a major challenge for interprofessional team members especially when the team does not have a competent leadership. The leaders feel very high for every choice that arises.
Nursing implications of indecisiveness
Indecisiveness has significant implications in delivery of healthcare care and poor inter-team collaboration. It leads to delayed communication which negative impact patient care. Poor-team collaboration and support as well as delayed communication have significant impact on the patients care especially for acute admissions. Adverse events and near-misses often occur as a result of poor coordination among healthcare staff. Interprofessional team members have responsibility to limit this practice to overcome toxic relations between team members (Taylor & Beel-Bates, 2016).
In emergency department, indecisiveness has been reported to increase morbidity and mortality. It is also associated with more technical errors during surgical procedures and therefore decreases the aspect of patient safety. In addition, analysis of sentinel events such as wrong side surgery have leadership and communication as the leading factors (Taylor & Beel-Bates, 2016).
Preferred nursing practice for indecisiveness in teamwork
When the team leader at the helm is not in a position to steer the course of the team when they are faced with complex issue issues which require immediate decision, the organization credibility is questioned. The interprofessonal team is likely to suffer from unclear goals and poor performance efficiency. However, it is important to determine which steps to take to overcome the challenge of indecisiveness. There are various reasons which can make a person to become indecisive. One of the primary reasons why people may become indecisive is fear of failure (Kamerer & Russ 2017). These individuals are worried too much about failing to meet expectations and this leads to the inability to provide concrete and clear direction. However, there are different strategies which can be implemented to deal effectively with indecisive leader.
Evaluate the situation on hand
When faced with a complex issue which renders the team leader indecisive, one should evaluate the current situation carefully to create a better assessment of the root cause the problem. As a member of the interprofessional team, one should find out the root cause of the leader’s indecisive behavior. Has the leader always been like this, or he or she has suddenly started behaving strangely toward the particular issue at hand? By figuring out the root of the problem, one can determine the most appropriate approach to address the problem (Kamerer & Russ 2017)..
Figure out how to help indecisive leader
One the root cause of the problem has been identified, the next step is to think how you can assist them to solve the problem. For instance, when a member of the healthcare team knows that their leader is suffering from fear of failure, one can step forward and led him in a helping hand to support objective patient care goals. One can encourage their leaders to be confident by providing constructive inputs and positive feedback. Conversely, if indecisiveness is entrenched in naturally complicated issues, it is important to offer different perspective and provide relevant information which can help the leader to make decisions (Crawford, 2016).
Take the lead
When the above approaches have been executed, and the leader stuck in his or her own endless confused state of mind, then one should move forward and take the lead. Although decision making rests in the final leadership of the interdisciplinary team one can push the leader to take action by giving both helpful and reliable information to proceed with the process of decision making quickly. Alternatively, an individual can also employ a different approach such that the leader delegates them to take care of the case altogether (Kamerer & Russ 2017).
Protect your reputation
Confronting the leader
Sometimes individuals may be unaware of their own weakness which poses a big challenge in fixing the drawbacks. Therefore, it is important to confront the leader directly by engaging them in a face-to-face conversation concerning their behavior and how it impacts morale of members in the team and patient outcomes (Crawford, 2016).
The American Nurses Association (ANA) outlines the current guidelines in educating nurses about effective leadership in healthcare settings. These guidelines tap into that spirit of leadership and helps an individual to improve their effectiveness as a leader. The principles of leadership as outlined by ANA include commitment to excellence, measuring the important things, creating and nurturing leaders, building a culture around service, focusing on employee satisfaction, aligning behaviors with values and goals, and building individual accountability. Also, the ANA education guidelines of leadership emphasizes on communication at all levels and recognizing and rewarding success (American Nurses Association, 2014).
As a leader, one should be committed to their purpose and passion and have commitment that turns into perseverance. Nurse leaders are expected to be committed employee advocates, patient advocate or clinicians. The leader should measure important things including patient satisfaction parallel to staff satisfaction. Assessing employee satisfaction has significant benefit to the team, department and the unit. The education guidelines emphasize on fostering a culture around service. Leaders should teach their staff to appreciate their clients as their customers (American Nurses Association, 2014).
Leaders are also encouraged to identify informal and formal leaders and invest in them and train them to be next leaders. Leaders should also focus on promoting employee satisfaction by making their work place a great place to work. A good leader celebrates what each person can bring to the team. The ANA education guidelines also encourages individuals to build individual accountability to assess opportunities for growth. Furthermore, leaders are encouraged to communicate on all levels of the interdisciplinary team to successfully achieve the goal of delivery of quality care (American Nurses Association, 2014).
The priorities for further studies from a nursing perspective include the scope of practice, teamwork, residences, technology, and transforming nursing education. Research will focus on comparison on costs of healthcare, quality and accessibility to a primary care delivery models. Further research need to focus on identification of important features of residencies that lead nurses developing competency and confidence at a reasonable cost. Also further research should focus on main barriers to team collaboration between healthcare providers as well as new advancement in new and existing technology (Holloway & Galvin, 2016). Moreover, research priorities for transforming nursing education should identify the combination of salary, benefits and professional attributes that lead to highly competent nurse being absorbed and retained in faculty positions.
American Nurses Association. (2014). Safe patient handling and mobility: Interprofessional national standards. American Nurses Association.
Crawford, S. D. B. (2016). Indecisiveness in Teamwork: A Search for Interventions to Avoid Failure-to-Decide (Doctoral dissertation, University of Maryland University College).
Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.
Kamerer, J., & Russ, T. (2017). Critical Thinking and Decision Making Handbook.
Merrill, K. C. (2015). Leadership style and patient safety: implications for nurse managers. Journal of Nursing Administration, 45(6), 319-324.
Orchard, C., Pederson, L. L., Read, E., Mahler, C., & Laschinger, H. (2018). Assessment of interprofessional team collaboration scale (AITCS): Further testing and instrument revision. Journal of Continuing Education in the Health Professions, 38(1), 11-18.
Taylor, A., & Beel-Bates, C. (2016). Improving Interprofessional Teamwork and Collaboration in a Community Health Care Setting.