Problem
Case Study: Teamwork Challenges
Ms. Trivaldi is a 53-year-old patient with uncontrolled diabetes. She is severely underweight and has gastroparesisthat interferes with nutritional absorption and metabolism. The bariatric surgeon wanted to put a PICC(peripherally inserted central catheter) line to supplement her nutrition. He referred the patient to a gastroenterolo-gist (GE) for management of the total parenteral nutrition (TPN) solution. However, the GE was concerned with the management of her diabetes, so she contacted the patient's endocrinologist for consultation on the amount of insulin that should be added to the TPN mixture. The bariatric surgeon did not wait for the GE and the endocrinologist to make their recommendation and placed the PICC line. He then told the GE to get the TPN solution prescribed, but she told the bariatric surgeon that she was not comfortable prescribing the nutritional supplement without the endocrinologist recommendation. When the patient asked the bariatric surgeon why she had not been started on the supplement, the surgeon told her it was because the GE did not want to prescribe the supplement. The patient was very upset with the GE and became difficult to work with after talking with the surgeon. Furthermore, once the endocrinologist reviewed the case, he recommended against the TPN because of her uncontrolled diabetes, and the PICC line had to be removed.
Task
A. Who are the members of the interprofessional health-care team?
B. Can you identify positive and negative examples of interprofessional collaboration? Describe at least one of each.
C. What is the main problem in this case study?
D. Which Core Competencies and specific Sub-competencies could have improved care in this situation? Identify at least three and explain your rationale.