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Difficulty: MediumInterprofessional Teamwork and Conflict Resolution

A surgical ward charge nurse observes that a newly hired physician assistant (PA) consistently alters patients' pain management regimens without notifying the primary nursing staff. This practice has resulted in several instances of delayed medication administration, as nurses are unaware of the new orders until they check the electronic health record hours later. The charge nurse decides to address this recurring workflow issue directly with the PA to improve interprofessional teamwork. Which of the following is the most appropriate communication strategy for the nurse to utilize in this situation?

  1. State the specific observed behavior, express how it impacts patient care, suggest a standardized notification workflow, and highlight the expected benefitsAnswer
  2. B
    Interrupt the PA during a patient encounter to voice a safety concern using the 'Concerned, Uncomfortable, Safety' framework
  3. C
    Submit a formal incident report to the hospital's quality management committee regarding the PA's repeated communication failures
  4. D
    Wait for the PA to enter another pain medication order and firmly state the safety concern twice before escalating to the attending physician
  5. E
    Delegate the responsibility of addressing the PA's communication habits to the unit medical director during the weekly morbidity and mortality conference

Answer

State the specific observed behavior, express how it impacts patient care, suggest a standardized notification workflow, and highlight the expected benefits
The correct approach utilizes the DESC script (Describe the specific situation, Express concerns about the impact on care, Suggest alternatives, state Consequences/benefits). This framework is specifically designed for resolving recurring interpersonal or process-based conflicts. It provides a structured, non-accusatory method for peer-to-peer feedback, making it the most appropriate initial step for addressing a colleague's communication habits that are negatively impacting team workflow.

Step-by-Step Solution

1
Identify the nature and acuity of the interprofessional conflict.
The conflict is a recurring behavioral and process-oriented issue regarding communication workflows, not an immediate, life-threatening clinical emergency.
Different conflict resolution and communication frameworks are designed for specific situational acuities.
2
Select the appropriate evidence-based teamwork framework for the identified conflict type.
The DESC script (Describe, Express, Suggest, Consequences) is the gold standard for structuring constructive, peer-to-peer feedback for recurring interpersonal issues.
DESC provides a non-accusatory structure to resolve interpersonal conflict and negotiate a mutually beneficial change in behavior.
3
Rule out tools meant for acute clinical disagreements or premature systemic escalations.
Tools like CUS and the Two-Challenge Rule are inappropriate here, as is immediately escalating to formal reporting or hierarchical authorities.
Using acute safety tools for chronic interpersonal issues dilutes their effectiveness, and avoiding direct peer feedback damages team cohesion.

Key Concept

Use of the DESC script (Describe, Express, Suggest, Consequences) for resolving recurring interprofessional conflict and addressing interpersonal behavioral patterns.
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Topics

Interprofessional Teamwork and Conflict Resolution

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