The United Nations: Ineffective or Powerful?

The United Nations is an international organization which looks to protect the world from another world war and genocide. It contains 193-member states which have all agreed to provide resources and contribute to the fight for world peace and prosperity. Founded on October 24th, 1945, it was meant to replace the League of Nations which failed to provide any real stability and peace to the world in the aftermath of World War 1. It provided the Universal Declaration of Human Rights, which was the first of its kind at the time. It looked to prevent the events of the past, such as world wars and genocide. The League of Nations tried to keep world peace, but it had many flaws which the United Nations greatly improved on. However, The United Nations has now been in effect for over 70 years, it is now being debated on whether it is effective anymore. The United Nations is outdated and must be updated with policies to reflect the present-day world. The United Nations has been ineffective in recent years because of the structure of the Security Council, lack of involvement in important global situations, and the difference in priorities between its actors.

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The Security Council is one of the main organs of the United Nations. “Its primary responsibility is to maintain the peace and stability in the world.” (“The Security Council”) It consists of 15 members, 10 non-permanent members, and 5 permanent members. These members each are allowed a vote in the decision-making process which is supposed to help maintain peace and stability. The problem mainly arises with the 5 permanent members. These include The United States, The United Kingdom, France, Russia, and China. These members have a veto power in which they can veto any resolution within the security council. This presents a problem because when the Security Council comes to an agreement on how to approach a situation within the world, it can be vetoed by any of these five powers. They could veto for an ally or for themselves, and this can cause an uproar when done in very controversial situations. An example would be the Syrian civil war. In April of 2018, Russia vetoed its ally, Syria, from US-backed investigation to find the perpetrator of a recent chemical weapons attack. This completely blocked the United States or any other member state from doing anything to find the perpetrator of this horrific attack. This is a huge problem because it leaves huge humanitarian crisis unsolved and allows it to go on. This is highly ineffective at keeping world peace. This has been done multiple times by the Russians and Chinese, which prevents other member states from placing sanctions on Syria. Syria has violated even Human Rights, which the United Nations is so serious about, which puts into perspective how powerful these veto powers can be. A veto power can completely throw off the vision of peace that the United Nation tries so hard to paint. Another example of a power using Veto is the United State is when the United States recognized Jerusalem as Israel’s by building an embassy there. When the United Nations held an emergency meeting on December 7th, 2018, 14 out of the 15 countries condemned the United States’ decision. It was vetoed by the United States. This is yet another example of how a huge situation can be vetoed, even when the majority is against this. The Security Council also never approved of the Iraq war, but this did not stop the United States from invading Iraq. Altogether, The United States has vetoed on 79 occasions, and the Russian Federation (USSR included) has vetoed on 107 occasions. France, Britain, and China have collectively vetoed 56 times. This goes to show how important the veto power is to the permanent members of the security council. Although France and Britain believe in limiting the power of the veto, it has been ignored by China, The United States, and Russia. In addition, the 15 countries of the Security Council make the decision for the 193-member states that are in the United Nations. This is too much power put into a single organ of the United Nations.
One way this could be improved is it the veto power is either completely abolished, or is restricted to situations, which are less serious. For example, if Human Rights are being violated, a country should not be allowed to veto against this. This allows the UN’s promise of delivering peace a more achievable one. Abolishing the veto power within the United Nations would allow other members to make a difference within the United Nations, and until that happens, the United Nations will remain ineffective. There has been an overwritten veto before, but it is very difficult to override one, therefore, it arely happens. This is Resolution 377a, “Uniting for Peace,” and this is used to override a veto, but has only been done a handful of times. In conclusion, it is very difficult to override a veto and once a veto is used, it can block anything within the Security Council. The Security Council could also add more seats to accommodate the large number of member states.
 The United Nations has been long criticized for its lack of involvement in major conflicts and disputes is another reason why it is ineffective. One reason why the United Nations lacks involvement is because of the lack of involvement by its developed members such as the United States, Russia, and China. These actors will usually stay out of conflicts that do not directly involve or benefit them. An example would be the 1993 Rwandan Crisis. “The Security Council refused to strengthen the United Nations peacekeeping effort in Rwanda once the killings began” (Winfield). This goes to show the lack of interest by the Security Council to do anything that is not within their own interests. Also, the French, a permanent member of the Security Council, supported the Hutu-led government in their quest for genocide against the Tutsi minority. License plate numbers, addresses, and names of the Tutsi minority were given out on the radio. The United Nations brought in a peacekeeping force who was only there to monitor the situation and help bring in aid. As a result, the United Nations did not classify the situation in Rwanda as a genocide. If the situation in Rwanda was considered a genocide, The United Nations would, by law, must intervene in the situation in Rwanda. Therefore, 800,000 people were killed in a matter of 100 days. This could have been prevented had the United Nations classified the situation in Rwanda as a genocide and intervened. The United Nations lacks the involvement of multiple human crises, such as the Syrian civil war, has allowed these conflicts to further intensify. The UN sent 30 unarmed observers in April of 2012, but this did very little to help the crisis. This does not mean the United Nations does not want to help, but because of Russia, the United Nations is not able to do very much in Syria. This causes a huge problem because the organization that is meant to preserve peace is not very effective in doing so because its actors have other goals. Another pressing issue is that the United Nations’ is that its more developed countries, such as the United States and Russia, are not as involved as other countries in the United Nations. For example, the United Nations peacekeeping force’s top 25 countries include one of the five permanent members in terms of the contribution of personnel, which is China. This isn’t good for the United Nations because the soldiers and officers are much less trained and developed, the United Nations peacekeeping force isn’t as good as can be. Also, this list consists mostly of developing countries, with the exception of a few developed countries. This goes to show how uninvolved the developed countries are. This leads to its ineffectiveness because it means that the United Nations isn’t getting the support of the developed countries, which leaves the strain on the non-developed and developing nations, which also are opposed to this lack of involvement. The United States provides only 54 peacekeepers to the United Nations, compared to the 8,508 from Ethiopia. This shows the lack of involvement of the key players within the United Nations.
 This could be changed if the United Nations were to put in a recommended or goal for the contributions from its member states. This could possibly improve the contribution of its member states and therefore making it fair for all states within the United Nations. This should be based on where a state stands on the global scale, considering GDP and population. Also, the United Nations should get more involved in humanitarian crises and conflicts. This can be done by implementing a policy which would make it mandatory for the United Nations to intervene if the Universal Declaration of Human Rights were to be violated. This would greatly improve the quality of life within the world.
The hard truth is that the member states within the United Nations all have different priorities and goals. This is especially evident within the Security Council. Each state would like to get what they want, all without the consequences of the world. The members within the security council are split in two. The Western members, The United States, The United Kingdom, and France are capitalist and democratic, looking to spread their ideals all throughout the world. The Eastern members are Russia and China. These members are communist and authoritarian, and they are more concerned with their prosperity of their state. These members all use their power within the United Nations to benefit themselves and their allies directly. These member states are less concerned with issues that do not involve them, and so when a decision is reached within the Security Council, the resolution isn’t effective in solving the issue at hand. This upsets the main goal of the United Nations, which is peace and prosperity for all member states.  The United States protects Israel through Vetoes because Israel is the ally of the United States. Russia also protects Syria through Vetoes because Syria is the ally of Russia. These powers have used their veto power multiple times for the sake of their ally, but very little of their veto power does any good. A state has different interests because they want to strive, they want to grow economically, and they would like to protect their core values. In conclusion, the majority of decisions made within the United Nations and Security Council are benefiting the member state who made the decision.
It is hard to improve this aspect of the United Nations’ problems. Sovereign states will almost all the time be greedy about the decisions they make. If a state does not reap the benefits of a decision, it will more than likely not participate in the outcome. A state will be greedy because a state only wants to prosper. Pouring resources into something the state does not want is not something a state wants without receiving something in return. Also, the Security Council refuses to share its power with the other member states. For these reasons, it is hard to improve this aspect of the United Nations’ problem.
The United Nations’ problems can be solved, but it shouldn’t be. This is a very pressing issue surrounding the United Nations. If the United Nations is updated to be compliant with today’s standards, the stronger members will either cut their cooperation, or they will leave completely. This would cause chaos and may lead to the ultimate demise of the United Nations. The United States alone provides the United Nations with 22% of its budget, having this cut off would be a huge cut in the United Nation, rendering it more ineffective than it already is. The only reason the main players are in the United Nations right now is because they could use it to their advantage, manipulate it, and do it all while little to no consequences. If this were to change, the major players would find that the United Nations isn’t providing it anything that they could benefit from, therefore, leaving the United Nations with a smaller budget and far less power. Also, changing its policies would take a large effort from every member state, but not every member is ready to change the United Nations. Even if a change was going to happen, it would require the approval of all the permanent Security Council member, or a veto could be imminent. Therefore, the United Nations should either stay the same or should be completely dismantled and a new global institution should take its place. The League of Nations was disbanded, the United Nations took its place, which was a huge improvement. If the United Nations were traded in the place of a new global institution, which fixed the problems that the United Nations had, it would be a far more effective global organization.
The United Nations plays a role in the world, but it plays that role very ineffectively. The security council has long been blamed for this ineffectiveness, its 5 permanent members have a veto power which can block anything within it. This causes a lot of turmoil especially when it is a controversial topic, like Russia vetoing any plan to help Syria come to peace. The United Nations also struggles because it cannot get involved in conflicts throughout the world. This is because its Security Council blocks it from doing anything, and its members are very hesitant to get into action and help. It didn’t help during the Rwandan genocide, where almost 800,000 people were killed. This was because the Security Council refused to send in more peacekeepers, and the Security Council also didn’t allow the troops that were already there to engage the killers unless it was for self-defense. This is a huge loss of life, considering the United Nations was created to stop genocide. Along with this inaction, its developed and major powers are lacking when it comes to providing resources to help conflicts like these. A majority comes from the developing countries. Lastly, the United Nations suffers from the difference in priorities and interests of its members. Each and every member makes a decision based on how it would benefit from the outcome. The United Nations is held back from helping because its members control what it does, and the members only want to do what benefits them. Because of these specific problems, the United Nations suffers greatly. The United Nations can change and become better for the world, but it will require a global effort, and the major powers are not ready for change.
Works Cited

Andrew J. Carswell; Unblocking the UN Security Council: The Uniting for Peace Resolution, Journal of Conflict and Security Law, Volume 18, Issue 3, 1 December 2013, Pages 453–480, https://doi.org/10.1093/jcsl/krt016
Cooper, Andrew Fenton, et al. Enhancing Global Governance: towards a New Diplomacy? Bookwell, 2003.
Goodhand, Jonathan. Aiding Peace?: the Role of NGOs in Armed Conflict. Lynne Rienner Publishers Inc., 2006.
Heinbecker, Paul, and Patricia M. Goff. Irrelevant or Indispensable?: the United Nations in the Twenty-First Century. Wilfrid Laurier University Press, 2005.
Kinloch-Pichat, Stephen. A UN ‘Legion’: between Utopia and Reality. Routledge, 2012.
MacFarlane, Neil, and Yuen Foong Khong. Human Security and the UN. Indiana University Press, 2006.
Malone, David  M. The International Struggle Over Iraq. Oxford University Press, 2006.
Ramcharan, Bertrand G. The Security Council and the Protection of Human Rights. Kluwer Law International, 2002.
“Security Council, SC, UNSC, Security, Peace, Sanctions, Veto, Resolution, President, United Nations, UN, Peacekeeping, Peacebuilding, Conflict Resolution, Prevention.” United Nations, United Nations, www.un.org/en/sc/. Accessed: 07 Nov. 2018.
Toye, John, and Richard Toye. The UN and Global Political Economy. Indiana University Press, 2004.
Weiss, Thomas G, editor. The Oxford Handbook on the UNITED NATIONS. Oxford University Press, 2007.

 

Ineffective Breathing Pattern: NANDA-I, NIC, & NOC

Informatics is defined as the collection, classification, storage, retrieval, and dissemination of recorded knowledge (Merriam Webster Online Dictionary, 2014). Moreover, nursing informatics is defined as a specialization of nursing that revolves around the characteristics of data, information, and knowledge combined (CCN, 2014). The progression of the three characteristics mentioned, coupled with the application of wisdom, serve to provide the framework for nursing informatics’ metastructure (CCN, 2014). Nursing informatics, although often unrealized, is utilized in a myriad of ways by nurses to not only support the work that they do, but to also aid in the decision-making process for patients and other healthcare providers such to achieve favorable outcomes, (CCN, 2014).

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One very important example of how nurses use informatics is through the utilization of nursing terminology. According to Hardiker (2012, p. 112), “nursing terminology serves as a vehicle to permit nurses to capture, represent, access, and communicate data, information, and knowledge. In addition, a standardized nursing terminology is a nursing terminology that is in some way approved by an appropriate authority, or by general consent; In North America, one such authority is the American Nurses Association “. The following paper is a detailed review by the author regarding a nurse-patient scenario as it flows through three standardized nursing terminologies: NANDA, NIC, and NOC while subsequently being critiqued against the metastructure of nursing informatics, mentioned above. In conclusion, the author will summarize this paper by drawing the sections of the paper together and offering his own perspective gained through this experience.
Ineffective Breathing Pattern: NANDA-I, NIC, & NOC
NANDA International, Inc. (NANDA-I), the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC) together provide a set of terminology to afford comprehensive, research-based, standardized classifications of nursing diagnoses, nursing interventions and nursing-sensitive patient outcomes (NNN, 2014). NANDA-I serves as a nursing terminology that maintains an agreed set of nursing diagnoses organized as a multiaxial taxonomy of domains and classes (Hardiker, 2012, p. 113). According to Bulechek, Butcher, Dochterman, and Wagner (2013), “NIC is a comprehensive, research-based, standardized classification of interventions that nurses perform. NIC covers physiological and psychological interventions. As with NANDA-I, NIC interventions are organized into classes and domains”. According to Moorhead, Johnson, Maas, and Swanson (2013), “NOC is a comprehensive, standardized classification of patient/client outcomes developed to evaluate the effects of interventions provided by nurses or other health care professionals. As with NANDA-I and NIC, NOC’s outcomes work in unison to assist patient outcomes”.
As a nurse on a medical/surgical/telemetry floor this author encounters a very diverse range of patients with a plethora of morbidities; one very common admitting diagnosis is: Ineffective Breathing Pattern. “I can hardly breath and I’m scared; it seems as if this is getting worse, please help me”. NANDA-I defines an ineffective breathing pattern as: inspiration and/or expiration that does not provide adequate ventilation (Ralph & Taylor, 2011). Patient X has respirations of 32, pulse of 118, a blood pressure of 145/92, and presents with nasal flaring, and her lips are pursed as she has an increased focus on trying to breathe while currently on 3 liters of oxygen via nasal cannula. Pt. X’s health history reveals a retired patient with end-stage COPD, obesity, and she has been a smoker for well over thirty years; her COPD has worsened through the years and she has developed an increasing level of anxiety. Pt. X has been admitted to the hospital several times over the past several years with similar complaints; however, over the past six months her condition has worsened.
Applying NIC to this scenario it is suggested that the nurse encourage slow, deep breathing, have the patient sit up in bed, turn frequently and cough; the nurse is to monitor respiratory and oxygenation status, as appropriate. In addition, the nurse should ascertain whether the patient’s dyspnea is physiological, psychological, or a combination of both. Last but not least, applying NOC to this patient scenario, the patient through utilization of the NIC interventions, the patient will report the ability to breath comfortably and demonstrate the ability to perform pursed-lip breathing to assist controlling her breathing; moreover, her vital signs will fall into normal ranges: respirations less than 20, pulse less than 100, and a reduced blood pressure that is near her baseline which is 120/80. As a result, the patient should be able to vocalize less stress related to her breathing, and understand how to alleviate future episodes ((Ralph & Taylor, 2011). In a textbook situation, referring to the nursing standard terminologies of NANDA-I, NIC, and NOC should provide a foundation for assisting one’s patient encountering an ineffective breathing pattern.
Data, Information, Knowledge, and Wisdom
A familiarity regarding standard nursing terminologies provides an excellent reference for nursing; however, a large majority of nurses have a limited knowledge or experience with standard nursing terminologies (Schwiran & Thede, 2011). Remarkably, having a familiarity with diagnoses, interventions, and outcomes is only that, a familiarity. A good nurse recognizes that a text-book definition and guidelines are simply tools to assist in the overall care for one’s patient. By placing Patient X’s scenario into the nursing informatics’ metastructure, care for one’s patient base can be greatly enhanced. First, one has to account for the raw data: increased respirations, increased pulse, increased blood pressure, and a heightened anxiety level. It is very important when providing patient care to remember that data, by itself has no particular meaning (CCN, 2014). Second, by retrieving all recorded data for patient X, reviewing trends, and placing her current data in contextual review allows a nurse to convert this raw data into information (CCN, 2014). A review of patient X’s data reveals that her current assessment presents data that exceeds her normal baselines. Third, by taking into consideration patient X’s physiological data as well as her physiologic and psychological presentation coupled with the nurse’s working knowledge base and experience regarding the information presented, this nurse recognizes patient X as having an ineffective breathing pattern. Last but not least, wisdom is realized by not only having an appropriate knowledge base to address the patient’s current health scenario but the skill-set, experience, and critical thinking skills of knowing when and how to take action (CCN, 2014; McKie, et al., 2012).
Conclusion
According to Robert and Petersen (2013), “Nurses must be able to think critically to face the challenges of today’s burgeoning technological advances, and ensure safe passage and positive outcomes for patients”. The referenced quote sums up the writing of this paper’s message and the realized experience while writing this paper by its author. Nursing is a very complex profession that has many tools to advance and evolve. By reviewing patient X’s condition, applying it through the nursing terminologies of NANDA-I, NIC, and NOC, and subsequently reviewing it against nursing informatics’ metastructure one can clearly understand that there are many platforms available to properly assist in the care for not only patient X, but our community at-large.
References

Bulechek, G., Butcher, H., Dochterman, J., & Wagner, C. (Eds.). (2013). Nursing interventions classification (NIC) (6th ed.). St. Louis, MO: Elsevier.
Chamberlain College of Nursing. (2014). NR512 Fundamentals of Nursing Informatics: Weeks 1-3 Lessons [PowerPoint]. St. Louis, MO Online Publication.
Hardiker, N. (2012). Developing standardized terminologies to support nursing practice. In D. McGonigle & K. Mastrian (Eds.), Nursing informatics and the foundation of knowledge (2nd ed.). (pp. 111–120), Sudbury, MA: Jones and Bartlett.
Informatics. Merriam webster online dictionary. (2014). Retrieved from http://www.merriam webster.com/dictionary/informatics
McKie, A., Baguley, F., Guthrie, C., Jackson, C., Kirkpatrick, P., Laing, A., & … Wimpenny, P. (2012). Exploring clinical wisdom in nursing education. Nursing Ethics, 19(2), 252-267. doi:10.1177/0969733011416841
Moorhead, S., Johnson, M., Maas, M., & Swanson, E. (Eds.). (2013). Nursing outcomesclassification (NOC) (5th ed.). St. Louis, MO: Elsevier.
NNN.(n.d.). Retrieved from http://www.nanda.org/nanda-i-nic-noc.html
Ralph, S. S., Taylor, C. M. (2011, 8th ed.). Sparks and Taylor’s Nursing DiagnosisReference Manual. Philadelphia: Wolters Kluwer / Lippincott Williams & Wilkins
Robert, R.R, & Petersen, S. (2013). Critical thinking at the bedside: Providing safe passage to patients. MEDSURG Nursing, 22(2), 85-118.
Schwiran, P. M., & Thede, L. Q. (2011). Informatics: The standardized nursing terminologies: A national survey of nurses’ experiences and attitudes. Online Journal Of Issues In Nursing, 16(2), 1. doi:10.3912/OJIN.Vol16No02InfoCol01

 

Ineffective Communication Causing Health Care Errors

The primary root of errors in the medical field is caused by ineffective team communication. A multitude of evidence depicts the adverse events that are as a result of errors that happen at unacceptable rates particularly in the patient setup. In most cases, ineffective or barriers to effective communication among the involved parties are the main contributors to these errors. For instance, failure in communication has been uncovered as being the root cause of over 60% of events that have been brought to attention to the Joint Commission on Accreditation of Healthcare Organizations (Leonard, 2014). A similar report highlights the role of ineffective communication in error making. The report cited “communication difficulties at all levels of the hospitals, including doctors to doctors, doctors to nurses, nurses to nurses as well as nurses to doctors” as being the underlying factors that contribute to the death of a majority of the pediatric patients (Leonard, 2014). The primary objective of the project is mainly meant to unearth the ineffective features communication particularly in the healthcare as well as classify their impacts.

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Heisler (2012) asserts that in modern healthcare, it all entails teamwork rather than individuals effort. This calls for cooperation from professionals from all the disciplines concerned. However, a lot of evidence points out that these much-needed change has not been incorporated and supported by radical changes in the systems for effective communication between healthcare practitioners and in particular across all fields. There is a positive correlation between ineffective inter-professional teamwork and a compromised patient needs, tension, distress among the staffs as well as inefficient service delivery. The project will similarly focus on the merits of having in placed an active communication channel that aims at sharing clinical information between the healthcare professionals. Also, it will also highlight visible evidence of information sharing between the inter-professionals as well as the challenges encountered in healthcare communication. The project will also bring into the limelight the impacts of communication in healthcare. Though the focus will be mainly on hospital-based scenarios, the lessons extracted can as well be applied to healthcare settings at large.
Characteristics of Effective Healthcare Teams
Through an extensive consideration of the critical factors that influence team performance in a majority of the fields, Leonard (2014) came up with a model involving five key dimensional areas in effective teams: effective team leadership, routine performance monitoring, behaviour backup, adaptability as well as team orientation. All these factors are coordinated by vouching mechanisms of total trust, effective communication and shared intelligence models.
Leadership entails a multitude of factors such as team coordination, task coordination, supervision, planning, and team motivation to enhance productivity as well as establishing a favourable environment to carry on with daily routines (Atherton et al., 2012). Common performance monitoring calls for sufficient understanding of the atmosphere around to enable monitoring and control of all the team members. This has the benefit of easier identification of laxity or lapses or even work overload among the staffs. For backup behaviour, it’s vital to understand other employees’ tasks that translate to enabling supportive actions to be administered by the team members. Such activities may involve workload redistribution or support.
Adaptability helps a team to effectively respond to any change that may happen in the environment and similarly accommodate the moves by the patients’ needs(Zwarenstein, 2009). It will be effective in that the needs of the patients will not be altered at all and thus patient management will be effective. Team orientation involves and incorporates the need to take other staffs ideas and perspectives into consideration. The belief is that the team’s objectives and goals should be aligned by the wellbeing of the patient as they are more crucial and important than personal goals. 
For these five critical dimensions of effective teams to be achieved, then all the staffs must entirely trust and respect each other to give and consequently receive feedback on their performance (Free et al., 2013). Additionally, the members must be adept of communication skills to convey their information effectively. Similarly, the sharing of a mental model is paramount. A shared mental model has been termed to be one of the critical underpinning factors that contribute to effective teamwork and in particular in healthcare. Through mental models, there is a mutual understanding of all situations, the intention for treatment, and the duties and roles of every person in the team. Also, there will be an anticipation of other’s needs, identification of changes in the clinical scenario as well as adjusting strategies as its needed. Zwarenstein (2009) argues that without this vital mental model, the various individuals of the team cannot entirely contribute to solving problems or even in decision making. One of the core requirements for enacting and developing a mutual mental model that would lead to effective team performance is useful information sharing between team members.
Information Sharing: a Challenge Encountered by Healthcare Teams
Some scenarios depict numerous problems that healthcare encounter as a result of difficulties in communication among the staffs. For instance, a meta-analysis involving several ranges of fields indicated that information sharing has a positive correlation with team performance.  There are numerous interfaces whereby the transmission of information between the staffs of the healthcare team is essential for effective and safe patient care. There has been an inadequacy in information sharing in context interface such transfers between departments, extreme-acuity settings and in particular in the emergency departments or even in the operating room, sharing of crucial information across inter-professionals, and ineffective handover of patients during shift changes (Heisler, 2012).
During a study carried out on patient ward handovers, the minority of the patients were confident regarding their patients’ handovers. In another study carried out by (Leonard, 2014) concerning the operational room communications, he categorized almost a half of the communication situations as ineffective and almost a quarter of these had tremendous adverse effects. Such included inefficiency, wastage of resources, delay in catering for the patients, tension and even procedural errors. Atherton et al. (2012) assert that teams who rarely shared information concerning the patients before the commencement of any curative surgery or even during post-surgery handover were in more trouble of causing surgical complications as compared to those teams that frequently shared crucial information regarding the patient. For the majority of those who witnessed postoperative handovers, they pointed out that most of the crucial and critical information such as intraoperative issues or allergies was not adequately disseminated from the operating room to the concerned ward nurses. There is also supporting evidence that suggests that through incorporating specific techniques that are geared towards improving information dissemination can go a long way in improving clinical management. Christensen & Remler (2009) highlights that such techniques may involve, ensuring that there is a high acuity setting, emergency declaration as well as information sharing with the team involving a crisis.
Similarly, it’s prudent to brainstorm on an issue through enhancing verbal observations as well as embracing decision-making processes with the team to share ones, mental model. The main determinants of failure in information sharing involve educational, organizational, and psychological factors. This hinders effective communication among the team members as well as effective patient care.
Educational determinants
Considerable attention has been emphasized on the doctor to patient communication in most of the undergraduate medical fields without laying a lot of emphasis in training medical students on effective communication with other professionals in the same area. Christensen & Remler (2009) points out that every single professional group has its unique way or arranging information which is attributed to different educational curriculums. There is a disparity between various professional groups regarding content delivery, the structure of the data as well as the timing of the information, and thus they may not be able to comprehend the role, duties and priorities of other professional groups. Health professionals’ education is largely centred on a specific discipline with very minimal interaction from other healthcare disciplines. Very few healthcare providers are trained specifically on teamwork (Leonard, 2014). Discipline separation and disparities in education offer minimal effort to address the misunderstanding of other disciplines, roles, priorities or responsibilities and thus this adversely impacts inter-professional teamwork when it’s required.
Psychological determinants
The primary part of healthcare professional education is the development of a reputable professional identity either as a nurse or as a doctor. However, there are always some challenges faced in the process. Psychologically, in accordance to social identity theory, it points out that members of any professional group such as nursing, medicine or any other allied health field,  they tend to perceive their attributes as being superior and those of the other groups as being inferior (Atherton et al., 2012). Similarly, there is the specific calibre of individuals who have a high affinity for specific professions as well as specialities and thus strengthening this phenomenon. However, due to these professional allegiances, tension can build up from different professional groups when there are differing expectations on how issues should be handled. Another psychological barrier that may lead to ineffective communication is the healthcare structure which is hierarchical. Generally, the senior staffs are enthusiastic whenever they are issuing out commands to their juniors.
Consequently, the juniors are not in a position to challenge the decisions made but only to comply with it. They ultimately conceal their suggestions which would otherwise be important. The hierarchical structure has proven to have disastrous repercussions in aviation whereby the junior pilots opted not to go against misguided decisions made by their superiors.
Organizational determinants
The physical environment of healthcare, as well as the geographical distribution of patients within the healthcare, can influence the efficient scheduling of activities involving patients care team. Such activities include scheduling meetings to discuss patients’ welfare as well as ward rounds. Atherton et al. (2012) point out that majority of these organizational and geographical determinants acts as barriers to effective communication between junior staffs and the seniors when it calls upon coordination of patients across different wards that have different crews. Similarly, nurses who are conversant with the patient may be absent when crucial decisions are made regarding their patient. In reality, all the staffs may be aware of what is required to have effective communication between inter-professionals, but the environment may not be favourable to facilitate this. Additionally, varying clinical areas may apply incompatible soft wares or even different forms and thus making the interpretation of the information difficult.
Importance and Impacts of Effective Healthcare Communication
Ensuring that there is effective communication as well as enhancing teamwork is vital in ensuring delivery of high quality and safety for all the patients.one of the final factor that leads to inadvertent patient complications is the breakdown of the communication process. Medical care is complex in its own, and this is later coupled with inherent factors from the professionals. This makes it important for all the heath cares to have a common communication tools, creating a favourable environment for each to have their ideas and suggestions listened to and also shared a common language in case of emergencies. Leonard (2014) opines that effective communication is either personality or situation dependent. Also, there is need to learn lessons on effective techniques to achieve change in culture, improve on the quality of working environment, practising favourable transfer policies, and evolve methods geared towards the demonstration of benefits of such duties.
Through this vast experience in enhancing teamwork as well as undergoing communication training and undertaking clinical projects, then specific success issues have been evident. Perceiving medical culture from a different perspective is prudent. The vital element is dissociation of the inevitable errors as well as communication failures that are related to human performance in line with clinical competency. Christensen & Remler (2009) consents that it’s effective to approach improvement of communication from the perspective of having the desire of correcting flaws associated with systems and the use of standard communication tools. This ensures that all activities are carried on smoothly, and the safety of every individual is taken into consideration. Allocation of ample time to enlighten health cares about increased system errors as well as inherent inhibiting factors of human performance aids in dissociating error from the initial perception of mistakes as being considered as episodes of individual professional failure.
Two significant requirements of having a successful healthcare change are; adequate support from the managerial level as well as having in places a firm healthcare leadership (Heisler, 2012). In the medical field, physicians who stand with their concerns and voice their voice on the right path to follow and support it firmly make a tremendous impact on the profession. The other calibre of the physicians waits in awe to check out if the projects will be a success before associating with them publicly. They leave everything to the nurses and other staffs to have an uphill task of pushing the ideas up against the hierarchy, and predictably most of these efforts are futile. Free et al. (2013) asserts that embedding changes in the healthcare field are paramount. Through such essential reforms, the days are made safer simpler, and even more accessible for every individual to operate and carry on their activities and duties. Instantly the changes have been enacted, then having a concise and clear focus is essential as well as committing finite time to the individuals involved. Additionally, measuring the success rate of effective communication is all important.
Similarly, communication failures depict a critical scenario where there is team discourse. They can be targeted for initiating training to improve communication competence of the professional team. Each scene is definable and easy to demonstrate to all the team members. Heisler (2012) argues that it’s easy to analyze multiple dimensions of effective communication and how they are associated to promote or even undermine information transfer as well as enhancing negotiation of essential decisions in the operating room. Contrary to expectations, failure in communication is necessary for the part since they can act as a signal of a problem as it originates at a specific point in either system or attitudinal processes.
To date, it’s evident that teaching as well as embedding various tools and behaviours can go a long way in providing a lot of clinical benefits. The ultimate goal is meant to show a tremendous reduction in adverse effects on patients and having in place improved clinical outcomes via the adoption of such tools and behaviours to facilitate effective communication in all levels of the professional healthcare.
References

Atherton, H., Sawmynaden, P., Sheikh, A., Majeed, A., & Car, J. (2012). Email for clinical communication between patients/caregivers and healthcare professionals. Cochrane Database of Systematic Reviews, (11).
Christensen, M. C., & Remler, D. (2009). Information and communications technology in US health care: why is adoption so slow and is slower better? Journal of health politics, policy and law, 34(6), 1011-1034.
Free, C., Phillips, G., L., Edwards, P.& Haines, A(2013).The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS medicine, 10(1), e1001363.
Heisler, M. (2012). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self‐management. Journal of general internal medicine, 17(4), 243-252.
Leonard, M. (2014). The human factor: the critical importance of effective teamwork and communication in providing safe care. BMJ Quality & Safety, 13(suppl 1), i85
Zwarenstein, M., (2009). Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Rev, 3(3), CD000072.