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Your Team, Your Partners


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Your Team, Your Partners

By William Berry, MD, CRICO

Related to: Communication, Publications, Teamwork Training

Medicine is a team endeavor. There are no solo practitioners, even when we think that we are working alone. Physicians, nurses, and technicians all have special contributions to make so that patients get what they need. But their contributions are truly special when they are made together, as a unit, for the patient. Coordinated care is the best and safest care, with everyone involved doing their jobs, integrating their efforts, and listening to each other. Nurses, in particular, can be a physician’s greatest allies in delivering safe and excellent care.

In day-to-day practice, it is all too easy to disregard the observations and opinions of others, observations that can be “red flags” that mark danger to the patient. When called by a nurse who has concerns about a patient, physicians should pay attention to and hear the nurse’s concerns and observations. “I feel uncomfortable, but I can't put my finger on what’'s wrong” should not be met with“Call me back later,” particularly if you are asked to come in to see the patient. Experienced nurses, like experienced physicians, sometimes “know” that something isn't right, even when they can't tell you exactly why. That call should not be disregarded, because it may contain the only clue that trouble is brewing for the patient. In the practice of medicine, those clues can be subtle and easily missed.

The challenge of paying attention to clues is in determining whether the “roar” that you hear is a train or the wind. The only way to do this is to do what you do at a railroad crossing: stop, look, and listen. Stop to take a minute to think about what might be going on. Look carefully at the situation and gather information. Listen to what the others who are taking care of the patient have to say. If it is only the wind, you’ll know soon enough. And if it’s a train? You’ll know that, too.

If the nurse says, “I need your help, now,” then assume that there is something wrong that needs special attention. Don’t assume that nurses don’t know what they are doing or seeing. Believe that they know that something is not as it should be. Stop, look, and listen. You may just be saving your patient’s life.

June 1, 2007
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