Table 2 Unscheduled interprofessional interactions

10

A nurse calls out, “I need a signature” and she repeats this twice loudly. No one responds (ward observation).

11

A clinical clerk approaches the busy nursing desk from inside the station, flips though some papers and leaves (ward observation

12

The occupational therapist is on the floor as well. I see him as he’s getting onto the elevator and he’s joined by the two young doctors. They don’t speak to one another (ward observation).

13

A medical intern comes in and grabs three charts from the cart. He asks the social worker if any forms need to be filled out for a patient [then leaves] (ward observation).

14

The social worker comes in […] and tells the physiotherapist that she got a bed in a slow stream rehab for a patient. The physiotherapist had talked to the patient’s husband about taking her home. They discuss the decision to be made and agree that it is in the patient’s best interest to go home. The social worker says that she’ll bring it up at rounds (ward observation).

15

“Allied health [are an interprofessional team].We’re more aware of what others do, in terms of having to make referrals. The nurses and doctors don’t have that knowledge. In our professions, the interdisciplinary ones, we’re taught more about what the roles [of other health professionals] are” (interview, social worker).

16

A resident approaches a nurse at the desk and asks her about a patient that she’s seen. The resident then goes to the pharmacist, accompanied by the same nurse, and together they look through what appears to be the patient’s chart (ward observation).

17

At the admin desk the day’s charge nurse is on the phone. A young-looking male doctor comes out of the ICU unit and walks over to her. “Hey Dr. X” she says. “Hey [first name]” he says. They engage in a very friendly chat. “You look good” she says, “you look like you lost weight.” “Really? Thanks,” he says. A second nurse walks over to join them. “So when will you come back to this ward?” the first nurse asks him. He tells her that he’s in neuro now and will only do consults here now. “It’s great to see you guys,” he says (ward observation).

18

“It’s easy to touch base with the other allied professionals on the floor; sometimes it’s crazy to get residents” (interview, social worker).

19

It’s difficult with the nurses.” There are so many and they are often hard to track down. It’s hard to find them in order to speak with them.” [I ask her if she is more often looking to speak to the nurse directly or if she just puts orders in the chart.] “We write a lot of orders, and we change a lot of orders” (interview, resident physician).