Interdependence as a Human Relation
‘No man is an island’ is an old saying that now seems like a cliché. However, this saying which encourages humans to coexist with each other well since no one can survive alone is still very relevant to daily living in the world today. Interdependence is even much more conspicuous and important at the work level. No one works alone; people work with other people. Moreover, no one knows or is able to do everything hence their dependence on other people with more expertise in some things. Health care is not an exception. Health care workers depend on each other. This paper is an analysis on how I as a medical doctor work with other healthcare workers work interdependently for the good of the patients.
As a senior surgical resident, I take care of patients from the time of admission to the time of discharge. Am responsible for initial patient examination and other assessment and to determine whether a patient needs to be admitted or not. I also make the basic treatment plans for the patient and determine what surgical specialists might need to see the patient. After these, it is my duty to get these specialists to see the patient and do their part in saving the life of the patient and ensuring that the quality of life of the patient is maintained. Furthermore, I also determine whether the non-surgical consult from areas like gynecology, obstetrics, pediatrics, dermatology, infectious disease or oncology might be needed. Where such consult is necessary, it is my duty to ensure that it is provided.
To do all that, I cannot do it alone. I depend on other healthcare workers including laboratory technologists, pathologists, nurses, other surgeons, doctors from other areas, surgical interns, and counselors. Together, we form a healthcare team. The primary doctor assembles and coordinates the healthcare team. Each member of the team depends on the other members. The work of all the members of the team looks to achieve one thing, good patient care and satisfaction.
In a recent case, I had a patient who had been involved in a trauma. The patient, a 41-year-old male, was driving a saloon car when he got involved in road traffic accident. He had been thrown into the car’s windshield and his body trapped there. He was brought while unconscious and seemingly in circulatory shock secondary to excess bleeding by paramedics. As usual, it is important to have a good patient history before you start managing any patient. However, it is impossible to get a history from an unconscious patient who does not have any family close to them. At that juncture, I depended on the paramedics who had brought him in to give as much history as they could accumulate from the accident scene. At this juncture, Covey’s fifth habit of highly effective people was very critical – seeking to understand before being understood (Covey, 1991). The paramedics also depended on me and trusted me to provide the best care to the man they had saved from imminent death. At that point, the patient was officially handed over to me. Immediately, I knew that the patient needed to be reviewed by an attending trauma surgeon but first the patient had to be stabilized. I needed to get the patient to an ER quickly for stabilization.
For the purpose of moving the patient to the ER. I depended on everybody who was around. The simple act of moving the patient from the ambulance bed to a hospital bed cannot be done in solitude – at least three strong individuals are needed for this. The two paramedics assisted in moving the patient on to a hospital bed. A nurse was there to assist me in moving the patient to the next available ER and to page an attending trauma surgeon. I couldn’t have done all that on my own. I depended on the nurse. The nurse also has a duty to ensure that the patient is cared for properly, to do this, she depended on my instruction.
In the ER I coordinated with my interns and the nurses to ensure that the patient had IV lines in place as within the shortest time possible. With the IV lines in place, it was time to make the patient comfortable, put them on oxygen and administer IV fluids so as to stabilize their vitals. For this, the interns did it for me. In as much as I depended on them to stabilize my patient and in the shortest time possible, they depended on me for their learning. As their resident, I guide the interns through their most tentative part of a career in surgery. Here, Covey’s fourth habit of effective people had to be applied; the collaboration between me and my interns was mutually beneficial to myself and to them (Covey, 1991). It was like a win-win situation.
After stabilizing the patient, I had to delegate duties to ensure the patient was ready for the procedure when the trauma surgeon arrived. One intern was to take the patient for scans and page me if they will see anything significant on the scans or when the patient reacted in an unusual way. Another intern was to run key laboratory tests that will give us useful information on the patient’s status during and after surgery. These tests included a full hemogram, liver and kidney function tests, a thyroid function test, and blood chemistry. In the laboratory, we depended on the technician there to run the tests as quickly as possible so as to allow us to have the patient for surgery as soon as possible. Delay in the processing of laboratory results would delay the surgery and that could cause the death of the patient. The other intern kept an eye on the patient to ensure that their vitals were stable. A nurse was also there to aid the intern in case a problem occurred.
The intern who took the patient for scans soon paged me. An abdominal CT scan revealed massive intrabdominal hemorrhage. A head CT scan also revealed a major subdural hemorrhage. However, the intern also noticed a pancreatic lesion. I couldn’t tell what the lesion was likely to be. I asked for radiology consult. The radiologist suggested that the lesion was consistent with a pancreatic tumor and we needed to do more tests to know what exactly it was. Again, here I depended on an expert from another dependent to know what was best for my patient. At that moment, however, we only needed to deal with the internal hemorrhage to save the man’s life. a neurosurgeon had to be paged so as to handle the subdural hemorrhage. I arranged for the two surgeries, the abdominal and the cranial surgeries, to be conducted concurrently in the same OR.
The attending neurosurgeon and trauma surgeon arrived in time. The laboratory results looked good and surgery was possible. However, the patient was hyperglycemic. To perform the two procedures concurrently, two surgical teams were assembled. I was responsible for the quick assembly of these teams. I was part of the team for the abdominal surgery where I assisted the attending surgeon. Surgical teams epitomize interdependence among health workers. The attending trauma surgeon, with all his knowledge and experience, cannot do an operation alone, they need someone to help them in suctioning blood and arresting bleeding. Moreover, they need a supply nurse who avails the needed equipment to them. The supply nurse together with the scrub nurse aid in maintaining the sterility of the OR. The team cannot be complete without two anesthesiologists. In as much as the attending depended on me, the assistant surgeon in this case, for minor activities in the process, I depended on them as my teacher. As a resident, I had a lot to learn in surgery, a chance to scrub in and assist an attending was a valuable learning opportunity. Edmondson (2003) suggest that learning is facilitated by team leaders who appreciate the importance of each member of the team and embrace communication. Finally, the patient left the OR while stable. Interdependence and communication among the surgical team in key to the success of the procedure (Edmondson et al., 2001). Edmondson and (2001) go ahead to assert that the emerging surgical procedures which are dependent on technology call for better interdependence among the surgical team.
Two hours later, the patient regained consciousness. I was interested in connecting the hyperglycemia, to the pancreatic lesion and the occurrence of the accident. However, the patient was emotionally unstable and was furious that he had been taken to surgery without the consent of the family since he had lost his job and did not have an insurance cover. I had to contact a counselor who could help stabilize the patient emotionally before I could get proper history from them. Here, I depended on the skills of the counselor for me to get the much-needed information from the patient. After the patient was stabilized emotionally, he said that he last remembered experiencing a sudden headache and vision loss. These symptoms are consistent with a scintillating scotoma which together with hyperglycemia characterizes diabetes. The patient also admitted losing weight and have benign abdominal pains in recent times. These complications could be attributed to the pancreatic lesion. A biopsy of the same confirmed pancreatic malignancy and the patient was handed over to oncology.
From the discussion above, it is clear that interdependence between health workers is key for the good of the patients and the health workers themselves. In fact, appreciating the role of interdependence and working in teams has been shown to improve the effectiveness of health workers. In this case, the level of effectiveness is reflected by the reduction in patient mortality and the increased patient satisfaction. In addition, interdependence in the medical team can ensure proper utilization of material and human resources available (Sicotte et al., 1993). As shown in the case above, collaboration between various health workers ensures that the patient is managed quickly and as much information as possible is known about the patient for their own good. Furthermore, the case shows that effective interdependence is a blend of dependence and independence. For instance, each of the health workers involved had to do their best and all these effort, experience and expertise brought together for the good of the patient. As Lemieux-Charles & McGuire (2006) suggest, working as a team puts together all the minds and thus a perfect decision for the patient’s situation are made.
Basically, interdependence is an important human relation at the workplace. Early appreciation of the role of interdependence is necessary is key to the occupational success of a person. Interdependence among workers brings out the best of every worker and eventually the best of the group hence more productivity and effectiveness.
References
Edmondson, A. C. (2003). Speaking up in the operating room: How team leaders promote learning in interdisciplinary action teams. Journal of management studies, 40(6), 1419-1452.
Edmondson, A., Bohmer, R., & Pisano, G. (2001). Speeding up team learning. Harvard business review, 79(9), 125-134.
Lemieux-Charles, L., & McGuire, W. L. (2006). What do we know about health care team effectiveness? A review of the literature. Medical Care Research and Review, 63(3), 263-300.
Sicotte, C., Pineault, R., & Lambert, J. (1993). Medical team interdependence as a determinant of use of clinical resources. Health Services Research, 28(5), 599-605.
