As the nurse executive in an acute care hospital, I welcome collaboration among advanced practice nurses (APN) and the clinical staff for many reasons. Advanced practice nurses can take on acute services, be readily available and in all honesty are far more approachable, accessible and can provide a sense of trust into our patient population when being compared to a PGYI or newer medical student. Often times our medical residents or surgical residents lack empathy and lack a collaborative effort that makes our admissions and discharges flow in less than desired manner. As a whole, the unit gravitates toward reaching out to the APRN for effective communication when placed in a position to communicate between families, patients and our medical teams.
An organizational chart could absolutely be utilized to enhance and improve collaborative communication and facilitate trust among different departments through reflexivity. From the article Margaret Archer, Modes of Reflexivity: The Structured Agency of Nursing Action, communicative reflexivity is said to be our inner conversations which required confirmation and communication with others before we act. A nurse who predominantly uses communicative reflexivity will consider what their peers are thinking and will want to act in such a way as to fit in (Goodman, 2017). Although the nursing profession especially as a clinical provider we tend to use our professional critical thinking skills and act on our best nursing judgement, we tend to disconnect from our peers and resources such as the APNs to confirm our actions before we act. Although working together as a team is essential for the unit to function properly in crisis situations, I often times see nurses perform on “auto-pilot”, working independently without collaborative efforts that could be in the best interest of our patient population. Facilitating collaboration between available APNs and clinical staff is essential to improving patient outcomes and building a higher self-esteem among staff. Being validated that our critical thinking, assumptions and interventions are correct from someone with higher level education can be very empowering.
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