Team Jitterbugs - Introduction

INTRODUCTION

As part of NUS (National University of Singapore) efforts to be one of the world’s leading universities, the newly formed NUSEU (National University of Singapore Excellence Unit) aims to encourage student participation in identifying communication needs in certain industries/workplaces. After identifying the communication needs, a written proposal of 6-8 pages has to be created explaining, in the form of a proposed course of study, supplement to existing modules and/or other recommendations, how the identified needs could best be served. It is required that the written proposal also discusses the benefits and possible challenges of the proposed changes for all stakeholders, including graduating students. All this is to help improve communication in the proposed workplace or industry mentioned in the proposal. In line of this mandate given to us, we have accepted to write this proposal based on the medical/healthcare industry as it is a highly lucrative and advanced sector.

As part of Singapore’s efforts to establish itself as a global brand of reliability and excellent service, there has been a recent shift towards a more service-centered economy fuelled by various improvements in different service sectors. One of the service sectors that have seen much and continuous revamps is the medical sector. Several changes to the curriculum and the recent establishment of a new graduate medical school, DUKE-NUS, have seen the medical sector gearing up to provide the best and most advanced services the world has to offer. To attract and build its positioning as such, much effort has been made towards patient care and the education of doctors and nurses in providing the best that our medical sector has to offer. As what Mr Lee Hsien Loong, the Prime Minister of Singapore said in The Straits Times, 2008, “ Doctors and nurses act as the bridge in associating quality healthcare with advanced technology and research in medicine to patients. Without them, patients will never be able to benefit and Singapore will not be able to attract those who wish for quality healthcare and use the medical sector as an engine for economic growth”. Thus Nanyang Technological University announced in 2009 that it would be building a new medical school to help cater to the demands for a more sophisticated and capable medical workforce.

BACKGROUND

Surveys and studies conducted have proven that effective communication between doctors is essential in delivering quality healthcare to patients. Communication is integrates every aspect of healthcare, facilitates the running of the healthcare institute and ensures the quality of healthcare given to patients. However there is much work needed in tackling effective communication between the doctors and nurses as shown by the survey conducted by several medicine schools and departments across the world. One such survey is the one done by the medical and nursing administration at Sir Charles Gairdner Hospital in Perth, Western Australia. The survey showed that there are difficulties that exist in doctor and nurse communication and this was perceived even by impartial observers and patients alike. Such communication problems can prove costly as it can lead to the confusion of roles and duties generated in the interaction between doctors and nurses as well as in the management of the patient. In a recent review about the National University Hospital of Singapore, the communication problem was addressed and the repercussions indicated as such - that “the lack of communication existing between doctors and nurses will adversely affect patient outcomes by hindering prompt responses and appropriate treatment” (reference) Communication is therefore a vital art of medical practice and a number of surveys show that there are areas that communication still needs to be improved in the medical sector. Communication problems have been the same for over twenty years and no improvements or changes have occurred to the way communication occurs in Singapore hospitals here. There have been a couple of cases as well whereby patients have complained that they have not been fully informed about their condition even after seeing the doctor (this was verified in an interview done with a nurse who has been working at Tan Tock Seng Hospital for a couple of years) and in order to improve this aspect of doctor’s service, doctors and nurses have to collaborate effectively and efficiently.

According to surveys that have been done with nurses, doctors need to understand what the nurses task is and the difficulties they face in their profession when trying to meet the demands of the doctors. There has been overpowering claims (REFERENCE)

that doctors tend to treat nurses as subordinates and ‘slaves’. This can lead to sources of conflict. Usually doctors are considered the more omnipotent ones compared to nurses due to their education levels while nurses have been seen as the deferent ones with the expectation of simply fulfilling orders rather than assume a more autonomous role (National Centre of Continuing Education, USA, 2010). This can contribute greatly to the lack of mutual respect of nurses by doctors. It has been verified in interviews conducted and secondary sources that doctors usually expect to be completely in control of the healthcare situation of the patient and insist on nurses following their orders in detail and reverence. Failure to comply can lead to verbal abuse by doctors on nurses. There has been feedback given by nurses here in Singapore that they fear their doctors as sometimes, “doctors may shout at us.” One nurse even gave her account of how afraid she was of the doctor she was assisting that she almost wet her pants one time when sitting next to him. Such a relationship is unhealthy and demeaning as the doctor-nurse relationship is meant to be that of a team that collaborate together so that effective patient care can occur.
Other factors that have led to communication problems between doctors and nurses is the lack of understanding on each profession’s goals and functions.This can lead to problems when they are working together for the well-being of the patient as it can lead to differing views in deciding the weightage of patients’ problems (Medical review Board, USA, 2010).