BNUR 1001: Dynamics in Nursing Profession

Dynamics within the Profession

• BNUR 1001, October 22, 2024, taught by Peter Kennedy RN, BScN, MBA
• The course covers dynamics within the nursing profession, focusing on intra-professional and interprofessional collaborative practice.
• Key learning objectives include explaining the RNAO Conceptual Model of Healthy Work Environments, describing roles, values, and behaviours that support collaboration in nursing and interprofessional care.

Learning Objectives

• Explain the RNAO Conceptual Model of Healthy Work Environments.
• Describe roles, values, and behaviours supporting intra-professional collaborative practice in nursing.
• Describe parameters, settings, and professionals involved in interprofessional care.
• Describe the nurse's role on an interprofessional care team.
• Identify enablers and barriers to intra-professional and interprofessional care.
• Explain delegation processes and requirements for accepting delegation from other healthcare providers.
• Identify conflict management strategies for intra-professional and interprofessional care teams.
• Describe the impact of communication style on group dynamics among professionals.

Practice Standard: Code of Conduct (CNO, 2023)

• Principle 4: Nurses work respectfully with the healthcare team to best meet client needs.
• Nurses are accountable for building respectful relationships with healthcare team members and modelling these behaviours.
• Nurses should self-reflect on how their privileges, biases, values, belief structures, behaviours, and positions of power may impact their relationships with team members. They should avoid acting on stereotypes or assumptions about team members.
• Nurses should use preferred names, titles, and pronouns when addressing team members.
• Nurses should recognize that various identity factors can impact a team member's lived experience and perspective on nursing.
• Nurses should demonstrate professionalism, treat all health care team members with respect, and maintain this behaviour in all situations, including on social media.
• Nurses must engage in clear, effective, professional, and timely communication with the healthcare team to provide safe patient care.
• Harassment or abuse of healthcare team members, physically, verbally, emotionally, financially, or sexually, is unacceptable.
• Nurses should support, mentor, and teach healthcare team members.
• Nurses assess the learning needs of team members and determine competency for safe nursing care.
• delegation of nursing care must maintain the Nursing Act of 1991 standards.
• Nurses who delegate must ensure the delegatee is adequately educated and competent to perform the delegated task.
• Nurses should provide and accept feedback from the healthcare team to support positive patient outcomes and effective team performance.
• Nurses contribute to a safe organizational culture.

Healthy Work Environments (RNAO)

• Healthy work environments maximize the health and well-being of nurses, quality patient outcomes, and organizational and system performance.
• Evidence shows that healthy work environments yield financial benefits for organizations.

Conceptual Model of Healthy Work Environments (RNAO)

• The model emphasizes interdependence among the individual (micro), organizational (meso), and external (macro) levels of systems.
• The model focuses on the beneficiaries of healthy work environments (nurses, patients/clients, organizations, and systems, and society as a whole).
• The model's lines are dotted to show the synergistic interactions among the different levels and components.

Collaborative Practice

• Collaborative practice is a joint venture where participants are willing to participate in shared planning and decision-making, based on knowledge and expertise, not on role or title.
• World Health Organization defines collaborative practice as when multiple health workers from different backgrounds work together to deliver comprehensive care across a variety of settings.

Intra-professional Collaboration

• Intra-professional collaboration involves learning about effective teamwork, collaborative practices, open and honest communication, supportive learning environments, and policies to support teamwork.
• Key areas include staffing, absenteeism, infection rates, and eliminating obstacles.

Interprofessional Collaboration

• Interprofessional collaboration is crucial for improving access to client-centered care in Canada.
• There are numerous benefits of interprofessional collaboration including improved communication , enhanced patient outcomes, improved efficiency, a holistic approach to patient care, a culture of non-hierarchy among interprofessional teams and a healthy work environment.
• Key areas for interprofessional collaboration include a framework, roles, communication, patient/client/family/community-centered care, conflict resolution, and leadership.

Delegation

• Nurses are authorized to perform controlled acts and can delegate these acts to other individuals, including regulated health professionals or other care providers, such as family members.
• Nurses who delegate remain responsible for the delegated task and must ensure the delegatee is competent in performing the controlled act safely and ethically.
• Nurses who perform controlled acts that are delegated to them are responsible for performing the tasks safely and ethically.
• Specific restrictions exist for nurses working in certain temporary, emergency, or special assignment classes.

Requirements for Delegating/Accepting Controlled Acts

• Specific requirements are outlined for delegating or accepting controlled acts, covering considerations like the nurse's authority, competence, client relationship, best interests, sufficient safeguards, and conditions (if any) for delegation.
• Nurses must record particulars of controlled acts to ensure proper documentation.

Conflict and Group Process

• Teams are interdependent individuals who work across organizational boundaries.
• Commonalities, and conflict are factors that positively and/or negatively influence team functioning within teams.
• Groups are three or more people with common purposes who interact, influence each other, and are interdependent.
• Group dynamics, such as physical/emotional climate, involvement, interaction, cohesion, productivity, and other factors, also influence team functioning.

Group Work:

• Discussions centred on the advantages and disadvantages, common complaints (students/faculty), how to improve or approach them, and where collaboration and interprofessional education fit into the overall picture.

Group Roles

• Each member plays a specific role which can include; helper, information gatherer, opinion seeker, recorder, facilitator, coordinator, harmonizer, compromiser, and others who might be considered blockers, aggressors, recognition seekers or dominators to enhance team success.

Interactive Styles

• Descriptions of different interactive styles in a group setting (avoiding, accommodating, competing, collaborating, compromising).

Conflict Management

• Using effective management tools and strategies to control conflict.
• Listening to other's perspective, identifying underlying concerns and separating matters which will contribute to an improved or acceptable outcome.
• Emphasizing the importance of positive interpersonal interactions.

Group Conflict Resolution Process

• Recognize the disagreement in the group, consider different points of view and their value.
• Presenting supporting and opposing viewpoints about a specific situation.
• Arriving at a cooperative solution and resolving disagreements.

Collaborative Leadership

• Collaborative leadership involves the acknowledgment of all members of a team's capacity to lead.
• It includes the demonstration of mindfulness and the value of working together to achieve positive, measurable, and achievable health outcomes.