lead2

Welcome to St. Anthony Medical Center

On a busy day in the pediatric unit (PICU) at St. Anthony Medical Center, the team assembled by nurse manager Phoebe Hemsworth will be tested. They must not only care for their injured patients but also meet the demands of working together as a cohesive unit. Several team members are nurses who are either on call to the unit or floating from other units: the adult ICU, labor and delivery, or the med-surg unit.

As you observe the various scenes in this mission, consider whether the individual nurses are showing emotional intelligence and building successful teams as they work through interpersonal dynamics.

Pediatric ICU Patient Rooms

St. Anthony Medical Center

As the shift progresses, the nurses of the PICU need to interact not only with each other, but also with other members of the medical center staff. Barriers to creating the most effective team are created not only by the skill levels, experience, and interpersonal dynamics within the team, but also by external conditions, like time and workload pressures.

Anna Jiang greets Christina Robledo, a respiratory therapist at SAMC, who is treating Maud, a young heart surgery patient.

Anna Jiang, RN-Pediatric Nurse: Hi there, Christina … I didn't know you were working today.

Christina Robledo, Respiratory Therapist: Oh, yeah… they've got me hopping, that's for sure.

Faith Olson, Nurse Manager: Christina … it looks like Maud's blood gases aren't what they need to be. I think we should call her doctor and make some adjustments.

Christina: I don't think that's necessary. Her gases aren't atypical for a post-op cardiac case.

Anna: Still, what harm is there in talking to the attending and making sure we're on top of things?

Christina: I appreciate your concerns, but I do know what I'm doing. If the doctors need to make changes in her orders, they will.

Christina Robledo suggests some strategies that she, as a respiratory therapist, would like nurses to implement.

Christina: Excuse me… I notice that the beds here aren't elevated between 30 and 45%. That's an important part of the VAP bundle.

Anna: I didn't see any mention of that in Maud's orders.

Christina: I don't know if all the doctors are putting it in patients' charts, but we're trying to make sure we follow the protocol. It has a really big effect on reducing pneumonia rates.

Anna: I've read about it, but I wasn't aware that we'd decided to implement it here.

Christina: Well, I know they're talking about making it policy, but until they do, I've just been trying to educate nurses about how to implement it. You nurses are the ones who do most of the items on the checklist, so I figure if I can teach nurses to start doing these things, we'll already be there when the hospital administration puts it in place.

Faith: I think it makes more sense to get the policy in place, get people trained in how to implement it, and then move forward that way.

Anna: I agree. We can't be implementing protocols at this level. There's a way to do these things.

Christina: We're talking about things like elevating the patient's bed to greater than 30%, providing good oral care, and making sure you're washing your hands. They're easy enough to implement and they make a difference to the patients' health.

Faith: I'm not arguing with you. It's just that these things need to go through the right channels.

Christina: Oh… because we can't have nurses taking orders from a lowly RT? Whatever… do what you're gonna do. It's only pneumonia we're trying to prevent.

Answer the following questions:

In the first scene , Christina states, “I appreciate your concerns, but I do know what I’m doing,” after two nurses suggest that a doctor be consulted on the care of a patient. Review the Codier article on emotional intelligence. Based on what you have learned, how do you think Christina’s comment impacts teamwork and collaboration?

Your response:

This question has not been answered yet.

Feedback:

As identified in the Codier article, emotional intelligence can play a significant role in the quality of patient care. The team’s performance is directly impacted by the ability of members of a team to collaborate and communicate. In the first scene, Anna and Faith were attempting to collaborate with Christina regarding the care of a patient; however, Christina viewed their concerns as an attack on her personal ability to provide proper care for the patient. Christina’s emotional intelligence is playing a significant role in the care of their patient because she is unwilling to collaborate with the team.

In the second interaction between Christina and the nurses, there is a disagreement regarding bed elevation to help prevent pneumonia. Christina states, “Oh... because we can't have nurses taking orders from a lowly RT? Whatever... do what you're gonna do. It's only pneumonia we're trying to prevent.” Christina’s comment indicates she feels the nurses are again ignoring her concerns or questioning her abilities. How could the nurses have handled this situation differently to minimize the conflict and make Christina feel like her contributions were valued?

Your response:

This question has not been answered yet.

Feedback:

Communication skills are an important part of managing team conflict. All caregivers have a common goal: high quality patient care. Instead of disregarding Christina’s contribution, the nurses could have been more receptive to discussing the matter with the attending physician or administrators, to inquire about the new protocols. Instead of simply disregarding Christina’s concerns, they could have stated that they needed to follow the current protocol; however, they would bring Christina’s suggestions forward to see if they can be implemented faster.

Conclusion

Under stress, health care providers can keep working together efficiently and well by paying attention to whether their responses to co-workers are emotionally intelligent. How could the providers in this activity have been more emotionally intelligent in their responses to each other?