Case Study Chapter 7
Sharon Acton
MHA601
Shannon Corbett-Perez
February 11, 2013 Case Study Chapter 7 Two surgical teams from different hospitals have a similar composition—nurses, perfusionists, an anesthesiologist, and a surgeon (team leader). Two nurses who are members of different teams provided the following accounts of their teamwork:
• Nurse A: “We all have to share the knowledge. For example, in the last case, we needed to reinsert a guidewire and I grabbed the wrong wire and did not recognize it at first. And my circulating nurse said, ‘Sue, you grabbed the wrong wire.’ This shows how much different roles don’t matter. We all have to know about everything. You have to work as a team.”
• Nurse B: “There is a painful process of finding out what didn’t work and saying ‘We won’t do that again.’ We are reactive. The nurses have to run for stuff unexpectedly….If you observe something that might be a problem you are obligated to speak up, but you choose your time. I will work around [the surgeon]. I will go to his PA [physician’s assistant] if there is a problem….If I see a [surgical] case on the list [for tomorrow] I think, ‘Oh! Do we really have to do it! Just get me a fresh blade so I can slash my wrists right now.”
Apply your knowledge of teams and team processes to explain possible causes for team members’ experiences. What interventions can you recommend to address concerns expressed by Nurse B?
Whereas Nurse A, exhibits signs of being a member of a professionally constructed group that centers on quality and endeavors to create patient centered care, Nurse B’s shows disorganization, dissatisfaction with her job, and a distinct lack of teamwork.
From what I read in this case study, I trust that each and every member on Nurse A’s team is skilled in playing many roles, even though they all have their own particular role. It is my understanding that transient health care teams have an advantage by way of being able to draw from dissimilar but corresponding areas of expertise; hence the patient obtains the best care possible.
Nurse A, did not seem offended at all by the circulating nurse letting her know that she was grabbing the wrong wire, she interpreted it as sharing knowledge (Johnson, 2009, p. 133). “When you find a team that can work together and perform daily job tasks especially under pressure, that’s considered a team that is diverse, and there is trust among the members” (Lemieux & McGuire, 2006).
Nurse B, on the other hand, exhibits a health care worker that more than likely has a role conflict and could be considered an intrasender. An intrasender is someone who, as soon as conflicts arise, will perceive that the role sender has unrealistic expectations that a focal person (like Nurse B) believes he/she cannot possibly achieve (Johnson, 2009, p. 115). Also, in my opinion, Nurse B’s comment about slashing her wrists was just plain unprofessional. I believe that this nurse may need a change of scenery. There are times, no matter what field you may work in, when you can get very complacent; doing the same job and dealing with the same people on a daily basis. Everything becomes routine, and as a result, the care and compassion that lead you to choose this profession shifts. “Within your job details, I think you should do all that you can to assure proper health care is administered” (Edmondson, Bohmer, & Pisano, 2003).

The interventions that I would suggest in this case would be: 1.) Team design: a regrouping that would be based on each individual’s ability to work with others as a team, their communication skills, and their cognitive ability. 2.) Cross training: By training everyone in every job, this will help team members understand each other’s jobs better. Also, in a pinch, they can fill in for an ailing coworker. 3.) Support behaviors given by the team leader; which, in general, would mean structuring team members’ tasks and activities with concern to their particular needs and feelings in mind. References

Edmondson, A. C., Bohmer, R. M., & Pisano, G. P. (2003). Disrupted routines: Team learning and new technology implementation in hospitals. Adm Sci Q, 685-716.
Johnson, J. A. (2009). Health organizations: Theory, behavior, & development. Sudbury, MA: Jones and Bartlett.
Lemieux, C. L., & McGuire, W. L. (2006). What do we know about health care team effectiveness: A review of the literature. Med Care Res Rev, 263-300.