The biggest challenge for the hospital health care in the coming future is to narrow the gap between different health professions in favour of a holistic approach to the patient. The complex organism of a modern hospital together with old hierarchic constructions between different health professions is counterproductive to team building in hospital healthcare.
The dualistic philosophies of Plato and Descartes, separating the mind or soul from the body have had a profound impact on medical science and postmodern health care. Hence the fast evolution of biomedical science has promoted doctors to examine the body as an object, while at the same time the nurses are focused on the care of a subject. The doctors are responsible for explanations, the nurses for understanding. The research and education in these two different fields of care seems even to evolve in different directions, making it difficult to meet each other in a team. Up to now the person-centered care has been mostly a concern of nurses and therefore to some extent difficult to realize as a general health approach.
”Today we work together at a ward station, here we also meet the patient as a team.”
When the team-based person-centered ward rounds were introduced we had to rebuild the wards. Before there were separate rooms for both doctors, nurses and assistant nurses. Time for communication was limited. Today we work together at a ward station, here we also meet the patient as a team. By working closely together throughout the day we learn to understand our different skills and responsibilities. The ongoing communication facilitates the team building. We have put forward the question why work schedules of doctors and nurses still are not parallel over the working week. Discontinuity hinders responsibility and increases the frequency of long handovers.
In our team-based work one of the leading themes has been “One patient at a time”, meaning to perform and finish all the work concerning the patient when meeting him or her at the ward station. Before the documentation was done separately by the doctor and the nurse, now we do it together, Education addressing the entire group can also be conducted at this time.
After five years of working more closely together as a real team we are slowly getting to know each other. But we still have a long way to go and every new doctor and nurse need their time to get familiar to the team approach. But the patient is the winner in this game by benefitting from a holistic team work. We believe that the basis for delivering a person-centered hospital care is a functional interprofessional team.