Group Dynamics in the Operating Room Team - Essay Example

Group Dynamics in the Operating Room Team Introduction The group dynamics incorporates the relation and the communication of twoor more persons within a group framework. Being a theater nurse working with a group that comprises of managers, nurses, operation department practitioners, surgeons and anesthetic personnel, this paper provides an outline of the team in terms of the particular roles of each member. In addition, the paper also provides a reflective account of the strengths and weaknesses of the team as a whole and the individual team members. To achieve these objectives, the paper will apply group theories to analyze the various roles of the team members. Additionally, particular reference will be paid to the Rofle reflection model theory. Team outline Within a group, the individual members always interact and continuously communicate to achieve a particular objective. The members of a group are connected by universal harmony and combined forces. Plasters, Sagull and Xiao (2003) cite that in most cases, the members of a particular group have matching abilities and rely on each other in a robust power-sharing and accountability framework. According to Duffy (2010), there are different domains in a group dynamic that emphasize on different types of teamwork skills. For example, the group dynamics in an operating room is different in some ways from that of the intensive care unit team due to the nature of work performance in the two areas. The two areas have different role team structures, time pressure, criticality, as well patient volume. Weaver et.al (2010) observes that medical care and practice is undeniably a team effort. Weaver et.al (2010) elaborates that different types of groups are important to all organizations; however, these groups should observe high standards of communication, cooperation and coordination. Well-coordinated teamwork especially in complex service areas such as the operation theater is associated with crucial patient outcomes like increased patient satisfaction while reducing nursing turnover (Machary et.al 2006). Furthermore, Weaver et.al (2010) asserts that effective teamwork is also linked with other positive outcomes such as job satisfaction and reduced stress level. Mosser and Begun (2013) are of the opinion that teamwork in the operating theater makes task performance faster because of the rapid interaction of individuals in the working the team. Subsequently, teams also enable the OR personnel to learn to provide high quality health care by working closely with each other. Within the healthcare set up, there exist four main types of work teams; true teams, template team, knotwork teams and network teams (Mosser and Begun 2010, p.17). The true team, also known as a long term team, provides clinical care over extended periods of time. This type of teamwork has stable membership, clear leader, and a significant sense of shared responsibility (Mosser and Begun 2010, p.17). On the other hand, the template team provides clinical care for time-limited episodes, which is characterized by clear leadership shared responsibility but lacks membership stability. Consequently, the knotwork team is based on the aim of providing clinical care for specific needs for a particular patient and lacks clear leadership structure but has a sense of shared responsibility. The network team provides support to network healthcare providers in the provision of care to patients. This type of team lacks all the main characteristics of work teams, as well as a clear leadership structure. My work team assumes a long-term team type that is meant to endure over a long time period with shared responsibility under a succinct leadership. The team prides itself of a significant potential for strong commitment to shared purpose, high level of trust and lower error rates than other team types. Furthermore, the team also offers the opportunity to fit the role of each individual based on their skills and interests. Principal team role and outline according to the Belbin team role theory In respect to Belbin team role theory, an operating theater team has a very specific goals and roles for each member. Grady (2010) affirms that the operating is hierarchical in nature, led by the OR managers, surgeons, anesthesiologists, nurses, and surgical technicians. Together, this team ensures surgeries are successfully conducted on an unconscious patient. Each of the members of the team of medical health personnel in the operating theater has different roles. The theater managers are in charge of coordinating nearly every activity that takes place in the operating room. They ensure that effective communication systems and channels within the unit prevail within the operating room by offering support for the development and setting of care standards. In general, the managers confirm that a culture of good organization prevails within the theater department. By so doing, this ensures that patients requiring surgery are taken care if within the allocated time-frame following the guiding standards. Based on the Belbin team role theory, the managers have an overall of leading the operation room team, acting as the coordinator and shaper of various activities therewith (Utley, 2011). Surgeons are usually tasked with the responsibility of operating on a patient. They have the vast knowledge, skill and judgment necessary for successful performance of an intended surgical procedure. According to the Belbin team role theory, the surgeons are second in command in the operation room and act as the doers and sometimes the thinkers. They implement the required surgical procedures and complete the procedures. Additionally, the surgeons also act as the plants providing solutions for solving difficult problems with creative ideas in case of any complication that may arise in the operating room. According to Grady (2010), some of the roles of the surgeons that qualifies them as the implementer, completer, monitor, plant and specialist include, but are not limited to; preoperative care and diagnosis; selecting and leading in various surgical procedures; provision of postoperative management care. The surgeons rely on other staff within the operating room to make the whole surgical procedure successful and effective. Third in the tier are the anesthesiologists, who work hand in hand with the surgeons. The anesthesia team functions as the guardian on the patient during a surgical procedure. They are, therefore, and indispensable team in the operating room. In line with the Belbin’s team role theory, the anesthesia team falls under the doers and the thinkers’ role category. Not only do they implement their medically delegated functions in accordance with the written guidelines approved with a health care facility, but they also monitor and give specialist opinion throughout a surgical procedure (Utley 2010, p.284). Adequate and constant communication between the anesthesiologists and the surgeon is the patient’s key safeguard. Fourth in the level are the theater nurses who are part of the scrub nurses and the circulators. They serve to provide skilled support and care in the perioperative phase of preassessment, anesthetics, the surgical period and the recovery phase. Through the whole perioperative phase, the theater nurses are highly required to liaise with various OR personnel and other health care personnel outside the surgical room. Their actions and procedures are effectively coordinated with those of the surgeons in the quest to standardize the whole operative procedure. They work under close and constant guidance of the surgeons. The circulatory nurses ensure the operating room is well organized and keenly anticipate and be able to meet the needs of the rest of the team members in the operating room. In accordance to the Belbin team role theory, the theater nurses fall under the socializing team that acts as the resources and the team workers who care for all the individuals of the team (Utley 2010, p.284). As the resource of the team, they review the physiology, anatomy and the whole surgical procedure and assist in the preparation of the operating room. By so doing, they offer a range of possibilities with energy for the success of the whole team. Other support staff in the operating room includes the IT specialists and healthcare learners observing the procedures. Although their participation in the operation room is not critical, support staff such as the IT may assist the operation room in monitoring and provide immediate alternatives in an event of power failure or failure of monitoring equipment. As such, they qualify as the teamworkers who contribute for the well-being of the team as a whole. The overall flow chart of team support in the operating room is as shown below; Effective leadership in a team and team development An effective leader is deemed as one who adaptable and capable of handling any difficult situation that may come in the way of the team. Such leaders are capable of adjusting themselves in the way they do things to fit the new situation or environment. In our group, the OR managers provided a framework under which the OR team could work effectively to meet the clients’ needs and expectations despite the range of challenges that faced the team. Moreover, the team has always demonstrated good leadership and team skills in the quest to overcome the desired targets providing quality healthcare. In particular, the OR manager as well as the surgeons, have always led in clarifying any possible issues and problems. This is key towards making meaningful decisions. The OR team under the leadership and directives of the managers and chief surgeons have also revealed exceptional team development and leadership skills. Every member has gradually learned to take initiatives despite the ever-changing situations and consequently exhibit flexible traits. For example, following a recent shortage of staff, nurses were able and willing to take extra work. Reflective account One of the apt models of reflection is the Gary Rolfe model known as Rolfe’s reflective Model advanced in 2001 (Basford and Slevin 2003, p.485). The reflective model is founded on three guiding questions that enable one to conduct a breakdown of an individual’s persona experience and subsequently reflect on the outcomes of the process (Basford and Slevin 2003, p.486). According to Callara and Callara (2008, p.286), the Rolfe 2001 model takes these three phrases as its basis; “What?”; ”So what?”; “Now What?”. 1. What? a) What is the problem? Recently, a number of changes have occurred in the operating room 3. These changes have included addition of new team members and some replacements for four staff members who have gone on leave for personal reasons. Among the new members of the team include two anesthesiologists, two surgeons and four theater nurses. Slight orientations on how the operating team operates have been implemented to allow the new members to gel in the team. b) What are the consequences? Since the arrival of the new team, despite the 100% success rate for all the surgical procedures completed in the operating room 3, there has been frequent extension of the operating time from the estimated time. In addition, there has been a lot of commotion in the operating room especially among the theater room scrub nurses and circulatory nurses. The extension of operating hours coupled with the commotion among the nurses has contributed to a significant pile up of patients waiting to undergo surgeries. Moreover, the members of the operating room team have been complaining of fatigue and some of them have been reporting late to work. c) What is my role in it? Personally being one of the experienced theater room nurses, I took it upon myself to perform extra duties to ensure the team completes the tasks at hand as required. Rather than informing the new team members of the existing channels of communication, I assumed the overall responsibility of the nurses in the room, which further increased the delay in the surgical procedures. 2. So what? a) So what was going through my mind? Through the whole transition, I was convinced that the delays in completing the operation were as a result of the adjustments that were taking place in the operating room. I was, therefore, determined to act as the link between the old team of nurses and the new team of nurses being the most experienced nurse in the room. b) So what should I have done? As the most experienced nurse in the room, together with other team leaders such as the surgeons and the management, we should have organized for regular preoperation meetings to with the operating room team to discuss on the communication channels in the room. The meeting could have also laid a platform for the each of the new members to know their expected role in the room as a means of the streamlining the operations (Utley, 2011). c) So what do I know about what about now? I now know that for any effective group dynamic, orientation of new members of a team is critical at the early stages. Before embarking on any process or task, it is always important to conduct team sessions to inform every team member of their roles and what is expected of them in ensuring that the whole procedure ends successfully. 3. Now what? a) Now what do I need to do? As an experienced theater nurse, I have learned the importance of having a clear channel of communication and the interdependence of each member of the operating room. It is crucial for operating team members to conduct themselves in accordance with the laid rules and standards bearing the responsibilities are equally shared among the team members. According to Kelly (2010, p.271), there are five main stages of team process;, storming stage, performing stage, forming stage, norming stage, and the adjourning stage. Currently, based on the ease with which our team operated, it is evident that the team is in the performing stage. Kelly (2010, p.271) suggests that a group in the performing stage is characterized by group maturity and stable relationships. Such as groups are also more flexible and are capable of solving structural issues effectively Hi Linda, the reflective account cannot because it follows the Rolfe reflectuve model. I hope this is ok now.. Thanks for the your cooperation and understanding i prayed for you and your fiancee to be well.. References Basford, L., & Slevin, O. (2001). Theory and Practice of Nursing: An Integrated Approach to Caring Practice. Cheltenham, U.K: Nelson Tholmes. Callara, L. E., & Callara, L. R. (2008). Nursing Education Challenges in the 21st Century. New York: Nova Publishers. Kelly, P. (2010). Nursing Leadership & Management. Mason, OH: Cengage Learning. Makary, M. A., Sexton, B., Freischlag, J. A., Holzmueller, C. G., Millman, E. A., & Rowen, L. (2006). Operating Room Teamwork among Physicians and Nurses:Teamwork in the Eye of the Beholder. American College of Surgeons, 202, 746–752. Mosser, G., & Begun, J. (2009). Understanding Teamwork in Health Care. New York: McGraw Hill Professional. Plasters, C. L., Seagull, J., & Xiao, Y. (2003). Coordination Challenges in Operating-Room Management: An In-Depth Field Study. Maryland: University of Maryland School of Medicine . Utley, R. (2011). Theory and Research for Academic Nurse Educators: Application to Practice. Sudbury, MA: Jones & Bartlett Learning. Weaver, J. S., Rosen, A. M., DiazGranados, D., & Lazzara, E. (2010). Does Teamwork Improve Performance in the Operating Room? The Joint Commission Journal on Quality and Patient Safety, 36(3), 133-143. Read More