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Introduction
Many tasks must be performed during resuscitation. This is where teamwork comes in.
Teamwork divides the tasks while multiplying the chances of a successful resuscitation.
Successful teams not only have medical expertise and mastery of resuscitation skills, but
they also demonstrate effective communication and team dynamics. This section discusses
the importance of team roles, behaviors of effective team leaders and team members, and
elements of effective resuscitation team dynamics.
During the course you will have an opportunity to practice performing different roles as a
member and leader of a simulated resuscitation team, including the role of a team leader.
Learning Objectives
Foundation Facts:
Understanding
Team Roles
Whether you are a team member or team leader during a resuscitation attempt, you
should understand not only your role but also the roles of other members on your
team. This awareness will help you anticipate
What actions will be performed next
How to communicate and work as a member or leader of the team
Every resuscitation team needs a leader to organize the efforts of the group. The team
leader is responsible for making sure everything gets done at the right time in the right
way by monitoring and integrating individual performance of team members. The role of
the team leader is similar to that of an orchestra conductor directing individual musicians.
Like a conductor, the team leader does not play the instruments but instead knows how
each member of the orchestra fits into the overall music.
However, the team leader must be proficient in all the specific skills that need to be
accomplished during the resuscitation. This level of expertise is necessary because
occasionally the team leader serves as a backup for a team member who may be having
trouble performing her role or assigned task.
The role of the team leader also includes modeling excellent team behavior and leadership
skills for the team and other people who may be involved or interested in the resuscitation.
The team leader should serve as a teacher or guide to help train future team leaders and
improve team effectiveness. After resuscitation the team leader can provide analysis, critique, and practice in preparation for the next resuscitation attempt.
The team leader also helps team members understand why certain tasks are performed in
a specific way. The team leader should be able to explain to the team why it is essential
to minimize interruptions in chest compressions, push hard and fast, ensure full chest
recoil, and ventilate, not hyperventilate!
Whereas team members focus on their individual tasks, the team leader is attentive to
comprehensive patient care.
Team members must be proficient in the skills they are trained and authorized to perform
within their scope of practice. It is essential to the success of the resuscitation attempt
that team members are
If it is not your responsibility to run the resuscitation as a team leader, then it is understandable that you may not have mastered all the specific tasks, such as selecting medications, interpreting rhythms, or making medical decisions. But it is expected that you will
have mastered your areas of responsibility and will be committed to the success of the
resuscitation attempt.
1
Closed-Loop
Communication
When communicating with resuscitation team members, the team leader should use
closed-loop communication by taking these steps:
1. The team leader gives a message, order, or assignment to a team member.
2. The team leader confirms that the message was heard and understood by receiving
a clear response and good eye contact from the team member.
3. The team leader listens for confirmation from the team member that the task was
performed before assigning another task.
Do
Team Leader
Team Members
Dont
2
Clear Messages
Team Leader
Team Members
Do
Team Leader
Team Members
Dont
Team Leader
Team Members
3
Clear Roles and
Responsibilities
Every member of the team should know his or her role and responsibilities. Just as
different shaped pieces make up a jigsaw puzzle, each team members role is unique and
critical to the effective performance of the team. When roles are unclear, team performance
suffers. Signs of unclear roles include
performing the same task more than once
missing essential tasks
freelancing of team members
To avoid inefficiencies the team leader should clearly delegate tasks. Team members
should communicate when and if they can handle additional responsibilities. The team
leader should encourage team members to participate in leadership and not simply follow
directions blindly.
Do
Team Leader
Team Members
Dont
4
Knowing Ones
Limitations
Team Leader
Team Members
Not only should everyone on the team know his or her own limitations and capabilities,
but also the team leader should be aware of them. This knowledge allows the team leader
to evaluate team resources and call for backup of team members when assistance is
needed. Team members should anticipate situations in which they might require assistance and inform the team leader.
During the stress of an attempted resuscitation do not practice or explore a new skill. If
extra help will be needed, request it early. Remember that it is not a sign of weakness or
incompetence to call for help; it is better to have more help than needed rather than not
enough help, which might negatively affect patient outcome.
Do
Team Leader and Team
Members
Call for assistance at an early stage rather than waiting until the patient deteriorates to the point that help
is critical
Seek advice from more experienced personnel when
the patients condition worsens despite primary treatment
Dont
5
Knowledge
Sharing
Team Members
Use or start an unfamiliar treatment or therapy without seeking advice from more experienced personnel
Take on too many assignments at a time when assistance is readily available
Do
Team Leader
Team Member
Dont
Team Leader
Team Member
6
Constructive
Intervention
During a resuscitation attempt, the team leader or a team member may need to intervene
if an action that is about to occur may be inappropriate at the time. Constructive intervention is necessary but should be done tactfully. Team leaders should avoid confrontation
with team members. Instead, conduct a debriefing afterwards if constructive criticism is
needed.
Do
Team Leader
Team Members
Dont
7
Reevaluation and
Summarizing
Team Leader
Team Members
Do
Team Leader
Dont
Team Leader
8
Mutual Respect
The best teams are composed of members who share a mutual respect for each other
and work together in a collegial, supportive manner. To have a high-performing resuscitation team everyone must leave his ego at the door and respect each other during the
resuscitation attempt, regardless of any additional training or experience that the team
leader or specific team members may have.
Do
Team Leader and Team
Members
Team Leader
Dont
Team Leader and Team
Members