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Collaboration: A Suspicious Word

Stakeholders must have some level of respect and commitment to working with others toward a common goal.

Many years ago, I worked with a nurse who recommended that I avoid using the word "collaboration" when referring to working with other disciplines. Her thoughts were that the word has little meaning and could be construed as meddling-trying to pry or gain access to something that wasn't a part of a role or job description. I brushed it off as the words of a paranoid person, but now look back and believe there may have been some validity to her avoidance of that word.

Doctoral education teaches us to collaborate in order to improve outcomes and/or improve practice. Collaboration is one of the Essentials of Doctoral Education for Advanced Nursing Practice, described in essential number VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes.

To explore how collaboration may be a suspicious word, I have included the American Association of Colleges of Nursing's description of this essential here:

Today's complex, multi-tiered healthcare environment depends on the contributions of highly skilled and knowledgeable individuals from multiple professions.

In order to accomplish the Institute of Medicine (IOM) mandate for safe, timely, effective, efficient, equitable, and patientcentered care in complex environment healthcare professionals must function as highly collaborative teams.

DNP members of these teams have advanced preparation in the interprofessional dimension of healthcare that enables them to facilitate collaborative team functioning and overcome impediments to interprofessional practice. Because effective interprofessional teams function in a highly collaborative fashion and are fluid depending upon patients' needs, leadership of high performance teams changes.

Therefore, DNP graduates have preparation in methods of effective team leadership and are prepared to play a central role in establishing interprofessional teams, participating in the work of the team, and assuming leadership of the team when appropriate.

The concepts of leadership and teamwork pop out of this description. The nature of both intra- and interprofessional teams is indeed fluid and may change according to the environment, system or group that is striving to work together.

This description of the value of collaboration does not address the strata or cast structure of the team members, nor does it address preconceived expectations that team members may have about the processes of working together.

So, is collaboration an easy process that is a natural or innate talent we all possess? I do not think that is true, but most folks have tendencies for collaboration.

The barrier to collaboration can be viewed in two ways: inability to reach out and begin the collaboration process, or the inability (or resistance) of the other team members to be a part of the team.

The one synonym that shows up when looking at collaboration is cooperation. Without cooperation, a goal cannot be established or completed. The team would not exist, and the entire notion of collaboration is useless

In spite of words we may use to describe our goals to collaborate, without a mutually agreed upon establishment of goals and strategies, and a plan to realize these steps through cooperation, our efforts are merely exercises in communication.

Is "collaboration" a suspicious word? It can be if someone is trying to gain an advantage over another by giving a false image of cooperation in order to achieve a personal goal. It could also be suspect if someone in the team is not fully invested in the process of working toward that agreed upon goal.

The stakeholders of a collaborative effort must have some level of respect and commitment to working with others toward a common goal in order to be truly collaborative.

Other unspoken characteristics of what makes a good collaborator is more than agreeing to cooperate. There must be something to contribute along with mutual respect and agreement toward a mutual goal.

Are we as DNP-prepared nursing professionals bringing our best to the table in order to work with a team of similarly educated professional from all disciplines? Are we standing as tall and offer as much substance as others in a collaborative agreement to reflect true cooperation and a sense mutual support?

As they say, the proof is in the pudding. What are you doing in your environment to build and enhance healthcare outcomes by truly collaborating with other professionals both within and outside of our discipline?

We have the opportunity, and the time to make this happen is now

David G. Campbell-O'Dell is the director and president of Doctors of Nursing Practice, Inc. (

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