While I do my practicum, I frequently recognize a resident’s chart is very important for staff members who are working with residents with cognitive impairment. The chart is divided into many sections, such as medical consultations, interpersonal progressive notes, care conferences, new admissions, and all referred documents from the previous place. After I read Bronstein’s (2003) article; a model for interdisciplinary collaboration, I felt that the function of an interdisciplinary team was the same as the chart. Since the chart is written by other professionals, such as physicians, nurses, pharmacists, an occupational therapist, a dietician, recreation facilitators, and a social worker, it provides not only a number of information, but also provides a chance to gain knowledge and experiences from the other professionals’ different perspectives. In other words, the chart is the collection of a record.
However, unlike other professionals’ records, I found that a record seen in a psychosocial aspect is scarce. It was difficult to look at residents’ personal histories, family relationships, or backgrounds that may cause residents’ behaviours or problems. Therefore, when I read Bronstien’s (2003) article, I agreed that an interdisciplinary team was important. As a social work student who attends many staff meetings and care conferences, I think the interdisciplinary team relevantly works together while the chart has some limitations to communicate among other professionals. The diverse opinions and experiences from different professionals are valuable. Then, I wonder what factors can help to establish better collaboration among different professionals. I think flexibility and personal characteristics are big contributors.
The extensive body of literature has suggested the importance of collaborative relationships among different professionals in health care settings. Bronstein (2003) is one of the people who reviewed a number of academic literature, which emphasizes the importance of interdisciplinary teams, and components of successful interdisciplinary collaboration. Bronstein (2003) stresses that it is important to have “interdependence, newly created professional activities, flexibility, collective ownership of goals and reflection on process” (n. p.). to make better interdisciplinary collaboration between social workers and other professionals. Among these factors, I feel that flexibility may be the most critical component to lead successful collaborations.
Mattessich and Monsey (1992) emphasize team members need to think that “they have more to gain than lose by collaboration and an ongoing flow of communication among colleagues” (as cited in Bronstein, 2003). I feel that this thought not only leads an effective communication among interdisciplinary team members, but it also leads “less hierarchical relationships” (Bronstein, 2003) in roles of members. In my practice setting, such flexibility appears when a dietician is absent in a care conference. For example, after a social worker briefly reports a nutrition assessment on behalf of the dietician, and suggests a family member to call back to the dietician, or helps a family member to make an appointment with the dietician in another time.
I believe that this flexibility comes from the value of acceptance of other professionals’ opinions because it is possible when a staff member have trust and interdependent relationships with colleagues. I also agree with Bronstein (2003), who notes such flexibility can come when interdisciplinary team members spend time together formally or informally, when they have oral and written communication among professional colleagues, and when they have respects for colleagues’ opinions and input. Abramson and Rosenthal (1995) state that such flexibility also may come from a belief “reliance on others for certain tasks, and resources allows collaborators to spend their time doing what each knows and does best” (as cited in Bronstein, 2003).
According to the literature, social workers may have a lot of conflicts with other professionals because of their role that advocates clients. Larson (2008) states that the medical model that upholds power to medical professionals is hierarchically structured in health care settings. Under this system, social workers who advocate residents’ needs may meet conflicts because the residents are in passive positions, compared to the medical professionals, who diagnose residents’ health conditions and prescribe treatments. However, Billups (1987) argues that “neither the extreme of perfect unison nor that of unbridled conflict” (as cited in Bronstein, 2003). This means that social workers need to be flexible and understand a situation that they cannot always agree with other professionals. Billups (1987) emphasizes that the social workers can overcome extreme conflicts when they have flexible thinking. I believe that Billups is right because this statement asks a question: how can you be flexible.
To gain a successful collaboration in an interdisciplinary team, I think flexibility is important. However, I wonder how this flexibility can effectively work between other professionals and social workers in the medical model setting, and what can lead them to work better as team members. Bronstein (2003) interprets the review of the literature that self-evaluation and giving feedback may deconstruct conflicts, and may lead to effective communications in interdisciplinary teams.
Bronstein (2003) also states that a professional role, structural characteristics, personal characteristics, and a history of collaboration that influences on interdisciplinary collaboration.
The most interesting parts amongst these factors are about role theory, and personal characteristics. I realize these factors are important for social workers to understand their roles or values when they socialize with other professionals. Their interaction with other professionals should be based on their social work values. I also realize that when social workers have a competent professional role and flexibility, they can reduce their conflicts among other professionals. In addition, I believe that personal characteristics are a strong contributor to collaborative relationships because if social workers work with other professionals in positive thoughts and attitudes, the other professionals will be respectful to them.
References
Bronstein, R., L. (2003). A model for interdisciplinary collaboration. Social Work, 48(3), 297-306.
Larson, G. (2008). Anti-oppressive practice in mental health. Journal of Progressive Human Services, 19(1), 39-54.
Thanks Eunkyeong, your blog was very interesting. It provides me with a little insight of what others experience within an interdisciplinary team. In addition, I like that you talked about how when working in these teams there needs to be flexibility, which you have noted comes form the value of acceptance of other professionals’ opinions. However, part of me wonders if there needs to be mutual respect as well for what each profession brings. I only say this because the flexibility and acceptance of opinions almost appears to be hollow because as you said personal characteristics are big contributors. Therefore, certain professionals may be listening to what a social worker is saying, but that might just be them showing flexibility and acceptance for their turn to provide input and not necessarily respect for what they may be brining to the table. This is because some professions have little insight in to what social work does or they have certain perceptions, therefore, I sometimes wonder how much respect is present. I guess that is where being open minded is important too because as we have talked about in class many times, it appears that there is this worldview of what social work is really like, so hopefully other professionals can be open minded and dispel some of their perceptions after witnessing social work first hand. Great blog.....Meghan
ReplyDeleteThank you Eunkyeong for your informative blog post. Working with an interdisciplinary is a major part of most social work practice and also a primary area for professional and personal conflict to arise. While every health professional brings their own expertise, they also bring their own set of professional values and priorities.
ReplyDeleteI think you raised a really important point that in additional to professional values, individuals also bring their own personal characteristics as well. I agree with both Eunkyeong and Meagan that there needs to be more flexibility, respect and understanding of what each profession has to offer to an interdisciplinary team in order to be effective. However, sometimes I wonder if by focusing so much on the cohesiveness of the interdisciplinary team and the respect and understand of each profession that we forget about the client, the reason why we are all working together.
As a social worker in training I absolutely want to be valued and consulted by the team, and do find it frustrating when other individuals are not aware of what social work’s role is, and all the skills that we have to offer, but I think it is more important to be client-centered first. It is very easy to forget about the person when we are focusing on charts, diagnosis and problems, this can only become more difficulty when there are professional and personal issues present.
Recently, I had an experience with my interdisciplinary team which I believe highlights this problem. During the past week, I had the opportunity of creating and presenting a care plan for one of my clients to the interdisciplinary team. I presented a little background information on the client and how he had been coping with all of his issues. I then discussed all the client’s problems and what I was working on to resolve them. The team then discussed different options and their points of view on the client. While I think this type of interaction is important for client care, I personally felt as though I had narrowed this client down to a list of issues. Further, this presentation caused much debate and discussion amongst the different health professionals which limited the client more and more.
While I limited most information from the previous example for the sake of this blog, I believe that if we had truly been client centred there would not have been such an issue within the team and we would have highlighted this individual’s strengths in addition to his problems. Although this may just be my new social worker optimism, I truly believe that if we also were a little more client-centred in our practice we could avoid many interdisciplinary team issues for the future.
-Alison
One of the things I often wonder about interdisciplinary work is how our educational experience can contribute negatively to our ability to work well in these teams. University, tends to represent an extremely in-depth study in a narrow field of focus. This is necessary, of course, because in our modern world there is so much to learn, and one could easily spend many lifetimes in school trying to become an expert in even a few subjects.
ReplyDeleteAt the same time, I wonder if we tend to drift into "blinkered" thought. This is only natural; we learn to view different social and health problems through different social work lenses, and it can become hard to see them from the point of view of other fields. In my own studies, I find it very interesting to talk about what we discuss in class with friends in other majors. It is always interesting to see how another discipline often interprets the exact same situation in a totally different way.
I would imagine that learning to work as a part of these interdisciplinary teams must require a humble and open-minded approach, which must be difficult for many professionals to learn.
I really appreciate your blog Eunkyeong. Thank you!
ReplyDeleteIt made me think that as a social worker we need to work with the team. I think one of the main ideas of putting us in groups to do the blogs and do some of our group discussions during our field focus in ageing is to develop teamwork. Part of working as an employee is working with the team. It is important to have a good working relationship with your co-employee. In my practicum, case coordinators are composed of social workers and nurse. They have to work as a team because social workers need the nurse for medical purposes, whereas the nurse needs the social worker to refer client to different community resources. Beyond that, there are many professionals that collaborate with each other to bring the best service for the client. Therefore, they need to communicate and cooperate and not to compete with each other.