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In recent years, changing patient attitudes, scarce resources and specialization have forced an increasing number of health care workers to work in teams, drawing on each specialty's strengths and ideas, with the patient as both a focus of and a main player in the care.

At the Alegent Health Bergan Mercy Medical Center's Joint Replacement Center in Omaha, Neb., being part of a health care team means that at mealtimes, everyone helps set up a common dining area.

At the SMDC Health System emergency department in Duluth, Minn., it means nursing assistants and the health unit coordinators-formerly known as ward secretaries-are respected for their contribution as much as physicians, nurse practitioners and nurses are for theirs.

At Southeast Missouri Hospital, it means the nurses know one another's needs so well, they help each other without being asked.

"Unfortunately, in nursing these days, everybody's so busy a lot of times they can't help other people," said Hope Botwinski, MSN, RN, an ICU staff nurse at Southeast Missouri.

"Being a good team member means helping other people. It means knowing when they would appreciate help."

And, say those who study or train health care teams, it means knowing how to accept help from others on the team.

Common ground

Health care used to be about individual care by individual providers, usually a physician and a nurse. But in recent years, changing patient attitudes, scarce resources and specialization have forced an increasing number of health care workers to work in teams, drawing on each specialty's strengths and ideas, with the patient as both a focus of and a main player in the care.

A good team makes patient care look effortless and smooth. Everyone seems to know his or her role. All team members respect and trust their colleagues. Disagreements are worked out without becoming personal. Everyone works together toward a common goal-be it saving a life, getting a patient ready to leave the hospital or teaching someone to manage a chronic illness.

But such teamwork, say nurse educators and trainers, takes incredible commitment from team members, team coordinators, managers and patients themselves.

Successful teamwork, say those who have participated in it, means learning to see the world through the eyes of other disciplines, and at the same time showing others what your skills and knowledge bring to the team. It means learning to work through conflicts by keeping the goal of the team in mind. It means constant communication among team members.

More than anything else, it means showing each other respect, say those who work in interdisciplinary teams.

"Teamwork is the way health care is delivered these days, but we don't pay enough attention to what it means to work as a team," said Ruth Ann Tsukuda, MPH, RN, associate professor at the school of nursing and school of medicine at Oregon Health & Science University.

"We assume it to be an easy concept, but it's extremely difficult. To be an effective team, you have to work at it."

Although few education programs emphasize interdisciplinary teamwork, many health care workers see it as the wave of the future.

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