Medical Improv is an experiential learning process that promotes individual and team growth in these areas all along the continuum. In fact, a nurse and physician in the same activity can result in, the nurse developing assertiveness while the physician develops listening skills, and they are simultaneously building their relationship!
Two Potential Case Scenarios
Before Medical Improv Training -Blaming and defending
A post-op patient horrified to see a nurse dump urine from her catheter bag down the sink complained to the surgeon, “It was disgusting”. The surgeon told the patient “This is unacceptable care and I will find out who is to blame for this incompetence ” and proceeded to yell at the nurse manager, “Your nursing staff is incompetent and unprofessional and I want the person responsible off this unit”. The nurse manager found the nurse and yelled at her, “How will we ever stop these complaints when you do something as stupid as that?” The nurse mumbled to the patient before giving her an IM injection, “I got in a lot of trouble yesterday about the urine in the sink. “ The patient was surveyed and offered very critical feedback.
After Medical Improv Training: – Ownership, collaboration, and creative-problem solving
A post-op patient was horrified to see a nurse empty her catheter bag without using gloves. The patient complained to the surgeon, “It was disgusting”.
The surgeon responded, “Oh boy, that sounds disgusting to me too. I’ll talk with the nurse manager and see what’s going on. The surgeon caught up with the nurse at the station and took her aside saying, “Hey, Sally, got a minute? Mrs. Smith said she noticed a nurse not wearing gloves while emptying a catheter bag. Was that you? “ And Sally said, “Oh I know, I went to grab gloves in the bathroom, but it was empty, Mr. Jone’s PCA pump alarm was going off and I was in a hurry to get to him. Thanks for calling me on it. I’m sorry and I’ll apologize to Mrs. Smith. “ The surgeon followed with, “I’ll talk with the nurse manager and see what’s going on with stocking the room with gloves.“ Sally, apologized to Mrs. Smith, and Mrs. Smith felt confident of the care she was receiving and provided positive feedback on the survey.
Notice how interpersonal dynamics shift towards respectful dialogues, identification of ‘real’ problems, and effective front-line problem solving!
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