Collaborative Practice and Teamwork Flashcards

A practical nurse (PN) is part of an interprofessional team caring for a client with complex needs. During a team huddle, the PN identifies a discrepancy between the physician's verbal order and what was documented in the chart. The physician is currently in surgery and unavailable. What is the MOST appropriate immediate action?

Answer: Hold the medication, document the discrepancy, and escalate to the charge nurse or designate while attempting to reach the physician through the appropriate chain of command

When a discrepancy exists between a verbal order and documented order, the PN must not administer the medication until the conflict is resolved. The correct action is to hold the medication, document the discrepancy accurately, and escalate through the chain of command while attempting to reach the prescriber. This protects client safety and upholds accountability within the collaborative team structure. Acting on an unresolved discrepancy—even with a co-signature—does not resolve the fundamental ambiguity and could cause harm.

A PN working in a long-term care facility disagrees with a registered nurse (RN) colleague's care plan decision regarding a resident's repositioning schedule, believing it places the resident at risk for pressure injuries. The RN dismisses the PN's concern without discussion. Which action BEST reflects the PN's professional accountability in interprofessional collaboration?

Answer: Formally document the concern in the client's chart, notify the nursing supervisor, and request a care conference to review the plan

When a concern about client safety is dismissed without discussion, the PN has an obligation to escalate through appropriate channels. Formally documenting the concern, notifying the supervisor, and requesting a care conference ensures the issue is addressed collaboratively while maintaining client safety as the priority. Simply deferring (A) abdicates professional responsibility. Acting unilaterally (B) undermines the coordinated care plan and team trust. Regulatory reporting (D) is premature before internal escalation pathways are exhausted.

During an interprofessional team meeting, a physiotherapist proposes an ambulation goal for a post-surgical client that the PN believes is inconsistent with the client's current pain level and risk for falling. The team reaches a consensus supporting the physiotherapist's recommendation. What should the PN do?

Answer: Clearly articulate the specific clinical observations and safety concerns in the meeting, request they be documented, and ensure ongoing reassessment criteria are established

Effective collaborative practice requires that all team members contribute their clinical observations meaningfully, even when the team has reached a consensus. The PN holds direct bedside knowledge that is clinically valuable. The appropriate action is to articulate specific, evidence-based safety concerns clearly and request they be documented, while also establishing reassessment triggers. This honours both teamwork and individual professional accountability. Silently accepting a potentially unsafe plan (A, D) or unilaterally refusing to participate (B) both fall short of professional collaborative standards.

A PN receives a SBAR (Situation-Background-Assessment-Recommendation) handover from a night-shift colleague that is incomplete — the assessment and recommendation sections are missing. The night-shift nurse has already left the unit. Which action reflects the MOST appropriate response under collaborative practice principles?

Answer: Document that handover was incomplete, perform an independent client assessment immediately, and update the care record with current findings before assuming full responsibility

An incomplete handover is a recognized patient safety risk. The PN should document the deficiency, immediately perform an independent assessment to fill the clinical gaps, and update the care record before assuming full responsibility for the client. Contacting the off-shift nurse (B) may be warranted but should not delay client assessment, as the client's status may have changed. Reassigning the client (D) is impractical and delays care. Proceeding without documentation (A) fails to flag the system gap for quality improvement purposes.

A PN is caring for a client who discloses to the PN that they do not want their diagnosis shared with the social worker who is part of the care team, stating they do not trust the social worker. The social worker is scheduled to participate in the client's interprofessional care conference the next day. How should the PN proceed?

Answer: Explore the client's specific concerns, clarify what information is essential for coordinated care versus what can remain confidential, and document the client's wishes while facilitating a discussion about the team's need to know

Client autonomy and confidentiality must be respected, but collaborative care requires sharing clinically relevant information within the team. The PN's role is to explore the root of the client's concern, differentiate between information that is essential for safe coordinated care and information that can remain confidential, and document the client's expressed wishes. This approach respects autonomy while upholding the integrity of the interprofessional team. Blanket exclusion (A) could compromise care; mandatory full disclosure (B) violates client rights; unilaterally replacing team members (D) is beyond the PN's scope.

A PN working in a community health setting is part of a collaborative care team that includes a dietitian, a social worker, and a nurse practitioner. The team implements a new documentation platform, but the PN notices that the system does not consistently capture information entered by the social worker, creating gaps in the shared care record. The issue has persisted for two weeks. What is the MOST professionally appropriate course of action?

Answer: Escalate the issue formally through the organization's incident reporting or risk management system and notify the team lead, while documenting the ongoing gap as a known system limitation

A persistent failure in shared documentation is a patient safety and systems issue that must be formally escalated — not compensated for through informal workarounds. Reporting through incident/risk management channels creates a documented record, triggers accountability, and supports organizational quality improvement. The team lead must also be informed so the team can coordinate interim safeguards. Manually filling gaps (A) and verbal-only updates (C) are unsustainable and unreliable. Reverting to paper unilaterally (D) is outside the PN's authority and may violate organizational policy.