Collaborative Practice and Teamwork Flashcards

A practical nurse (PN) is part of an interdisciplinary team caring for a client with complex needs. The registered nurse (RN) delegates a task to the PN that falls within the PN's scope of practice, but the PN believes the client's condition has changed significantly since the RN's last assessment. What is the PN's most appropriate initial action?

Answer: Communicate the observed changes to the RN before proceeding with the delegated task

The PN has a professional responsibility to communicate relevant clinical observations to the RN prior to proceeding with a delegated task. A change in client condition may alter the appropriateness or safety of the delegation. The RN holds overall accountability for the care plan, so the PN must provide this information so the RN can reassess and re-evaluate the delegation. Completing the task first (A) risks client harm. Bypassing the RN to contact the physician (B) disrupts the chain of communication and is premature. Client consent (D) is unrelated to the delegation decision.

During a team huddle, a PN observes that a colleague from another discipline consistently interrupts other team members and dismisses nursing input when care priorities are being discussed. This pattern is affecting team cohesion. Which action best reflects the PN's professional responsibility in this situation?

Answer: Raise the concern privately with the colleague after the huddle, using specific behavioural observations

Addressing interprofessional conflict requires direct, respectful communication focused on observable behaviours rather than personal attributes. Raising the concern privately and specifically is the appropriate first step, as it preserves the relationship, gives the colleague an opportunity to reflect, and aligns with collaborative practice standards. Formal complaints (B) are premature without attempting direct resolution. Withdrawing from participation (C) is professionally avoidant and harms client care. Delegating one's own professional voice to another (D) is not appropriate and removes the PN's accountability for advocacy.

A PN working in a long-term care facility disagrees with a care decision made by the most responsible physician regarding a resident's pain management. The PN believes the current order is inadequate based on their ongoing assessment. After raising the concern with the RN team lead and receiving no change, what is the most appropriate next step?

Answer: Document the concern in the chart and follow the established escalation pathway, such as contacting the unit manager or using a structured advocacy tool

When a PN believes a client's needs are not being met, the professional obligation is to escalate through the facility's established channels — such as the unit manager or a structured communication tool like SBAR or a formal escalation protocol — while documenting the concern. This upholds both client advocacy and professional accountability. Administering a higher dose (A) is unsafe and outside the PN's authority. Contacting the family to orchestrate a physician change (C) oversteps the PN's role and bypasses proper process. Reporting to the licensing body (D) is reserved for serious professional misconduct, not a single unresolved clinical disagreement.

A PN is working with a PSW (personal support worker) who reports that a client refused morning care. The PSW asks the PN what to do. Upon reviewing the situation, the PN determines the refusal may be related to unmanaged pain rather than a true autonomous preference. Which response by the PN best reflects effective interprofessional collaboration?

Answer: Assess the client's pain, address it as appropriate, and communicate findings to both the PSW and the RN so the care approach can be adjusted collaboratively

Effective interprofessional collaboration requires the PN to apply clinical judgment, perform an appropriate assessment, and share findings with all team members affected by the care decision. Pain as a driver of apparent refusal is a common and often unrecognized clinical issue. The PN's role includes assessing underlying causes, intervening within scope, and closing the communication loop with both the PSW and the RN. Simply rescheduling (A) ignores a potential clinical issue. Reassigning the PSW (C) does not address the root cause. While client autonomy is paramount (D), the PN first has an obligation to determine whether the refusal is truly informed and voluntary or driven by treatable symptoms.

A PN notes that the interprofessional care conference for a complex client has been scheduled but the client's substitute decision-maker (SDM) has not been invited. The RN states the SDM's attendance is 'not necessary this time.' What should the PN do?

Answer: Advocate for including the SDM by articulating the ethical and legal basis for their participation, and if unsuccessful, escalate through appropriate channels

When a client lacks capacity, the SDM holds the legal authority to participate in care decisions. Exclusion from a care conference where treatment goals are determined can violate both the client's rights and provincial substitute decision-making legislation. The PN has a professional obligation to advocate for the SDM's inclusion, explaining the ethical and legal rationale. If this advocacy is dismissed, the PN must escalate through appropriate organizational channels. Deferring silently (A) abdicates the PN's advocacy role. Relaying information afterward (B) is insufficient as the SDM cannot participate in real-time decision-making. Contacting the SDM without team knowledge (D) bypasses the team and creates a communication breakdown.

Two members of the care team — a PN and a physiotherapist — have conflicting views on the mobility plan for a post-operative client. The physiotherapist has documented a progressive ambulation schedule, but the PN's repeated assessments suggest the client is experiencing fatigue and pain that make the schedule unsafe on certain days. The most appropriate approach to resolve this tension is:

Answer: Communicate the client's current status to the physiotherapist and collaboratively adjust the schedule using a shared decision-making approach

Interprofessional collaboration requires that each discipline contributes their unique knowledge to a shared decision-making process. The physiotherapist has expertise in rehabilitation progression, while the PN has continuous observational access to the client's daily functional status, pain, and fatigue. Neither profession should unilaterally override the other; instead, the PN should communicate specific assessment findings to the physiotherapist so the plan can be jointly adjusted in the client's best interest. Following a plan blindly (A) when safety signals are present is not appropriate. Independently modifying the documented order (B) is outside the PN's authority and creates liability. Deferring all ambulation indefinitely (D) may delay recovery unnecessarily.