SEARCH

SEARCH BY CITATION

Patient care can be regarded as a complex activity, which is the outcome of negotiation amongst a large number of different health care professionals who may, at times, hold conflicting views on goals and priorities. If a high standard of care is to be achieved and limited staff resources are to be used efficiently, a strategy of ‘integrated team working’ should be adopted. For the nurse to play her part in the patient care team, in coordinating ward work, carrying out nursing care, monitoring patients' conditions, helping the patient to make sense of what is happening to him, making the most of the ward's opportunities for learning, and so on, she needs to understand the part played in patient care by other health professionals. The study reported here found that amongst the 46 nursing staff of three wards of different specialties, the majority of trained staff did see themselves as having regular working links with other health care professionals-specifically doctors, physiotherapists and social workers. Only a tiny minority of the 31 student and nursing auxiliaries felt that they had any working links with other health professionals. Most students believed that for the sake of good patient care and effective learning, they should be part of a multidisciplinary team rather than an exclusively nursing team. Whilst the ward manager can do much to foster the development of a multidisciplinary perspective, it is suggested that structuring the workflow along the lines of patient-centred rather than task-centred allocation, automatically builds in face-to-face interactions between nurses of all levels and other health professionals. This facilitates the development of mutual role knowledge and effective integrated team working. The ward manager is in the best position to initiate change in work organization, but, if she is to succeed in this complex endeavour, the active cooperation of others is imperative. In particular, medical staff, nursing management and schools of nursing.