Special Interests Section: Teamwork

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Speical Interest Section Introduction

Author: Petra N. Davidson, BS, R. EEG/EP T., CLTM, FASET

Cascading colorful leaves flutter to the ground,

A brisk, cool breeze brushes my cheek,

Cheers, clapping, and whistles fill my ears with joy!

Reminders of teams of cheerleaders, football players, and families

Surrounding one another in encouragement!

Teamwork is what brings them together.

Teamwork is what makes it all worth it.

For ASET Newsletter, our hot topic for November to warm our souls from the inside out was teamwork. Teamwork, how to build it, how to sustain it and what it looks like in the wide variety of Neurodiagnostic modalities and businesses we, as ASET, represent.

For example, I may work hundreds or thousands of miles from my coworkers, but we have an unbreakable bond and a kinship that cannot be beat. We all know our roles, our responsibilities, and we delight in touching base virtually with one another over a cup of joe. Our distance does not hamper our friendships.

We asked our leaders to share how their team is able to be strong because of challenges, focusing on how their teammate’s unique characteristics bring uncommon solutions to a variety of issues, how each individual participates in creating efficiencies, increasing effectiveness of care, and contributes to the overall workplace environment.

For those solo operators, we invited them to share how they choose to be involved with other teams, such as this one, the Special Interest Sections! Are there ASET teams, volunteer organizations, multi-faceted teams at your clinic, hospital, or workplace that make the dream happen?

I personally am eager to see how you experience teamwork. What does your team look like? Who do you support?

Acute/Critical Care Neurodiagnostics

Author: A. Todd Ham, BS, R. EEG T., CLTM

Click here to see the crossword puzzle.

Ambulaltory Monitoring

Author: Jennifer Carlile, R. EEG T., FASET

Topic: Teamwork

Teamwork… we have all heard the phrase “Teamwork makes the dream work” well one of my personal favorites is: We are not a team because we work together. We are a team because we respect, trust and care for each other. We try our best, we celebrate each other’s success, we learn from our mistakes … we are a team.

Let me tell you about the team I am privileged to work with…they are 6 of the most amazing, empathetic, humble, inspiring, meticulous, women I have had the honor to work with. Collectively, we have close to 130 years combined experience, yet we still learn from each other and do not hesitate to ask each other for help when needed. Geographically we are located from the Midwest (Illinois, Ohio), East coast (North Carolina) and as far South as Texas. I think one of the most important aspects of our team is that we have the upmost respect for each other and there is not so much about “me” it is about “us” and what we can do together. Microsoft Teams has been a godsend in our daily work life. Throughout the day, we can “teams” each other individually or as a group. Sometimes just touching base to see how each other’s day is going or for some much-needed brain picking advice with those wave forms that have been recessed in the backs of our brains. Our common goal is for the good of the patient, not only is it our teams mantra but when you have a company that believes in that also, there is nothing we cannot accomplish with those same core common values.

Autonomic Testing

Author: Marcia Hawthorne, R. EEG T., CAP

This quarter we are focusing on teamwork for our interest section articles.  In our lab, we provide EEG, NCS/EMG, EPs, LTM, and Autonomic testing.  We are a neurophysiology lab of 14 technologists.  We get pulled in many different directions so, communication is key to keep our department running efficiently.  We have, what we call, “morning huddles” 2-3 times a week.  The huddles are fifteen minute zoom meetings that allow us to bring up any immediate concerns or suggestion that may need addressed between our monthly meetings.

In November, we returned to in-person monthly meetings.  This has been great to connect face-to-face with the entire department and team build on a more personal level.  We are very fortunate to have 4 lead technologists, in addition to the operations manager, that help us to navigate through our busy schedules.  Through the pandemic it was hard to always feel as though we were working as a team, the lab was short-staffed due to illness and demand.  Technologists were out for personal sickness or sickness in their family.  Schedules were overloaded because of non-emergent testing being put on hold for three months.  In the end though, we all came together and did everything we could to provide the best care possible for our patients.  We realized that in the midst of chaos we were able to pull together, cover each other’s call, and work extra hours to keep the department running smoothly.  That is what teamwork is.  I am proud to be part of such an amazing team of neurodiagnostic technologists!

Clinical EEG

Author: Pat Lordeon, R. EEG T., FASET

Working together toward a common goal…something we do every day, more often than we realize.  Getting the family up, dressed, fed and out of the house on time every morning takes teamwork.  Completing a project at work takes teamwork.  Making sure that everyone gets to afterschool activities and sporting events takes teamwork.  A marriage that lasts takes teamwork.  Every aspect of our lives is touched by the need to work compatibly with others.

My job involves working remotely from home, monitoring continuous EEG patients in the ICU/Critical Care setting.  As such, much of my time is spent in solitary concentration.  But I am always aware that I am part of a team, comprised of the CCM physicians, Neurology Fellows and Residents, my EEG physician reader and my coworkers whose shifts overlap mine.  Each of them depends on me to correctly recognize EEG changes or seizures and communicate these findings effectively.  I depend upon the physicians to listen and make decisions based on the information I provide.  I depend upon my EEG physician reader to help me when I am not certain about an EEG finding.  The EEG physician reader trusts me to recognize when I need help and to reach out to them for assistance in a timely fashion.  The EEG physician reader provides frequent educational opportunities to the technical staff, and we in turn apply the knowledge to our patient’s EEGs.  It is a complicated, symbiotic relationship, like an intricate dance where you depend upon your partner to know the steps and anticipate your moves. 

Just as important, but almost always ignored, is team “me”.  I need to take care of myself, advocate for my needs, recharge and refresh myself and keep my skills at their best.  No one will do these things for me.   I must be the captain of my own ship.   Self-care is an extremely important aspect of life, but it is often dismissed or practiced in limited amounts.  Without it, you cannot be effective at anything.  Every team you are part of, from your personal life to your professional life will suffer.  I know there is no “I” in “Team”, but without taking care of team “me” there will be a diminishment of all the teams I am connected to.  Without a good foundation, the structure will collapse.

So yes, teamwork is important.  It is essential to be a “good” team member.  But it is just as important to take care of you.  You are unique to your teams, and your input is valuable.  Without you, your teams will not function as well as they could.  Without you, your friends and family would have a terrible void in their lives.  Life is full of challenges, and it behooves us to be as prepared as possible to play our part in each team we belong to.  So, enjoy your teams, do your part, but don’t forget to take care of team “me”.   You can’t let that team down.

Department Managers

Author: Stephanie Jordan R. EEG/EP T., CNIM, CLTM

Focus on Teamwork

This year, our administration is focusing on a management system that puts teamwork on the front line by having a daily huddle. The huddle provides live feedback and actionable items as well as a direct sight on patient safety issues. Our Neurodiagnostic team is spread out over two campuses and divided into inpatient, outpatient, LTM, CM, and IONM and this huddle is the glue that holds our team together.

We designated a daily huddle at a time that works for everyone to come together with ideas, concerns, and safety issues. We have a visual board to complete daily where we meet. The board is located at our main campus and hung on our department wall. The other campus calls into the meeting. Ideas or concerns can be placed on the board during the huddle or throughout the day. Items on the board are assigned for follow up in the huddle. We have an area on the board for process improvement goals that we treat and track. We have an area to give thanks to other team members which helps to preserve a positive atmosphere in the department and promotes comradery across the physical divide.

Adding this daily huddle to our routine has enhanced teamwork with our technologists. We support each other in evaluating and improving our practices. It has created a safe space for new ideas and volunteerism. The team is encouraged by their own success in creating solutions and problem solving and the byproduct is teamwork, process improvement, and patient safety. When the whole team is on the same page and working together, the value of the daily huddle clearly shines.

Epilepsy Monitoring

Author: Morgan McNamara, BS, R. EEG T., CLTM

Teamwork is what helps us get through each day. It is important to have teamwork in any environment you work in, but especially in my love of pediatrics. Without teamwork it would be harder to hook up those individuals with special needs, or the screaming two-year-old. It is important that we communicate effectively and work together to get the goal of our goals accomplished. With each challenge we face in our field, we get stronger and our abilities increase. We all have different skills and abilities that help shape our departments and when we come together, we can face what ever challenge we may encounter. My team works well together to make sure every patient is getting the best care possible each and every day.

Innovative Technologies & Practices

Author: Andrew Ehrenberg, BS, R. EEG T., CNIM

Teamwork makes the dream work and is of course essential when looking at research and really with innovations as well.  Teamwork isn’t just multiple people working on the same thing, it is delineation of duties that together can have a synergy and outcome greater than just the sum. 

In research, this means the difference between those that formulate questions, gather data, analyze data, and is embodied in the author list and acknowledgements.  In the larger scheme, those who are textually contributory, either directly writing or review and edit, are typically on the author line.  First author, who is the primary writer, is listed first, the senior author who is contributing guidance and review, and in between co-authors with specific roles and contributions.  Acknowledgements are usually for those who were contributory, but not to the level of direct authorship or editorials.

In innovation, there is also teamwork typically.  The one with the innovative idea, typically lays out high level concepts, and relies on various subject matter experts for the future actualization.  Subject matter experts might range from specialized knowledge of technical details for implementation, procedural expertise such as engineering or regulatory, and users to both validate the resulting use case, as well as refinement of the implementation.  In addition, end users are important parts of the innovation team, as all good innovations have development pathways as well to an idealized or enhanced state, where end user feedback is needed to define.

In both cases, there are a number of benefits from the teamwork: distribution of workload, differing view-points and areas of expertise that complement each other, and multiple reviews to avoid bias.  Maybe this is a more practical view of teamwork versus the emotional benefits of a team, but definitely valid and essential.

IONM

Author: R. Joshua Sunderlin, MS, CNIM

In the field of Intraoperative Neuromonitoring, the extent to which people rely on a team may vary widely from place to place.  However, one thing is certain: successful IONM is never predicated solely upon individual talents or accomplishments.  There are many ways that teamwork is critically important in this field, and many ways to define the team.

The CNIM + oversight = a team

Practitioners of IONM come in two varieties:  The first type is the hands-on personnel in the operating room setting up and breaking down the case, collecting data, vigilantly watching, and taking notes throughout the procedure.  On the other side we have the oversight providers who are watching the data, interpreting the data, and offering suggestions for how to respond to alerts from the IONM modalities.  This is a team where both parties are depending on their counterparts to be competent, vigilant, and able to communicate effectively to ensure the patient is protected appropriately.

The IONM providers + other operating room personnel = a team

As soon as the patient is induced under general anesthesia, the teamwork in the OR is on full display.  Everyone has a role to play in the (very polite) disregard for personal space that occurs when preparing the patient for surgery.  Everyone must take their turn to ensure that all the important steps are performed accurately.  Such coordination takes teamwork.  When someone who is inexperienced (or unskilled) is thrown into the mix, what should be a carefully choreographed symphony can become cacophony.  It doesn’t end with the case set-up.  An effective surgical team is well versed in IONM and knows to respond to alerts in a responsible way.  IONM is a crucial part of the success of the procedure.   

The IONM providers + anesthesia = a team

When one person is tasked with monitoring the electrical activity of the nervous system of a patient while another person is actively suppressing that activity, the stage is set for the great physiological confrontation that underpins the relationship between IONM and Anesthesia.  Successful IONM requires a give and take relationship with anesthesia providers.  It starts with pre-operative communication initiated by the IONM provider regarding what is required of the anesthesia team to best facilitate IONM, while giving as much advanced warning about limitations as possible.  It continues in the case set-up where IONM providers should absolutely defer to anesthesia providers and wait until IV and arterial lines are placed before taking up valuable real estate on limbs with SSEP, and EMG electrodes.  Anesthesia providers can reciprocate with polite and courteous exchanges regarding the concentration of agents used, and when boluses are given. 

The CNIM + other CNIMs = a team

There is great variety in this field as to how many IONM providers may be working at an individual hospital or area at a given time.  Some have many, and others may never have multiple IONM providers in the same building at the same time.  If you are fortunate enough to work with a group of IONM providers, you have an opportunity to forge real friendships.  Company leadership would be wise to do their part to foster a team environment through outside of work events and opportunities to socialize.  Efforts should be made to ensure that new hires will be a good fit with the team you have.  Ideally you want to build a group of people who are grateful to work on a team that supports one another.  When an applicant has a history of holding other jobs that require teamwork or participation in team sports, it can be a good indication that the person possesses such attributes.  For those who are not on a team of CNIMs or may not see their coworkers over vast distances, there are still many opportunities to collaborate with other IONM providers using social media or attending conferences.  Such professional relationships can fill the void and provide opportunities to get the feeling of teamwork across the field of IONM.  Essentially, we are all on one big team that does very important work helping our patients across the world stay protected during surgical procedures.  It is a team that I am proud to be on.

Nerve Conduction Studies (NCS)

Author: Dorothy J. Gaiter, MHA, R. EEG T., CNCT, R.NCS.T., FASET

“Coming together is a beginning. Keeping together is progress. Working together is success.”      ~Henry Ford~

The saying, “Teamwork makes the dreamwork,” is a true statement, in my opinion. In the world of Neurodiagnostics, it can make a difference in how a job is completed. There is no “I” in team. Teamwork is about communication, educating, innovation, inspiring, and encouraging one another, and building trust that leads to a successful outcome for everyone involved. It’s about a team bringing their individual pieces of the “puzzle” to the table, whether from the same workplace or a distance via Zoom, email or phone, in order to complete the task at hand.  

That said… my work in Neurodiagnostics revolves around working with techs from different areas who I have never met before. It is of utmost importance that a connection of communication, trust, education, and inspiration be established to come together to succeed in a positive outcome for patients having a nerve conduction study.

Even in creating articles for the ASET Newsletter requires teamwork. For instance, the co-chair of NCS and I share in writing articles for which we both enjoy. On some occasions, we switch in order to accommodate each other’s schedule. Every so often there is a subject or topic that is out of my scope of expertise, however, my co-chair’s enthusiasm demonstrates his character as one whose there to ensure that the assignment is completed on time without a glitch! Another example of teamwork, when all Interest Section Leaders come together as a team in contributing various topics to the ASET Newsletter in their different fields of expertise in Neurodiagnostics, and the collaboration of all the intricate parts of the “puzzle” … for the reason that teamwork is the key component in achieving optimum success! 

“Unity is strength… when there is teamwork and collaboration, wonderful things can be achieved.” ~Mattie J.T. Stepanek~

Neurodiagnostic Education

Author: Mark Ryland, AuD, R. EP T., R.NCS.T., CNCT, RPSGT

The Neurodiagnostic Program at Cuyahoga Community College is a small team of three individuals with diverse backgrounds and different views on life. Despite any differences we may have, working with them has been one of the most rewarding experiences of my life. Recently, I have re-evaluated exactly how big our team is, and who is actually a part of it.

Because the world has changed a great deal since we all began at the college, like everyone else, we look at the world through a “pre-pandemic” and “post-pandemic” lens. Although we truly cannot call what we are currently in as “post-pandemic” the fact of the matter is, like everyone else, we had to change the way we ran the Program. As difficult as it was, in the end, we all viewed the changes as a way to re-evaluate how we can do things and try to improve what we were doing. Through the entire process, the spirit of our purpose and the resolve we previously had was maintained. The two groups of students that were the most impacted graduated or will graduate on time, and the vast majority of them are or have been employed. To be honest with you, the students became part of our team, and they were courageous and magnificent! Like the three of us, they had to adapt to all the changes, figure out how to navigate the new landscape, and deal with the “life happens” occurrences that will always pop up.

I plan to retire in approximately two years, but until then, I will revel in the joy and satisfaction that is my team. I have been employed at the College longer than any other previous job. As much as I have loved pretty much everything I have done in the Field of Neurodiagnostics, this has clearly been the most rewarding and satisfying. That reward and satisfaction is primarily due to my team: a group of diverse individuals that have been and will continue to be an honor and privilege to work with. The three of us, and all of our amazing students!

Pediatrics & Neonatology

Author: Melanie Sewkarran, R. EEG T., CLTM

Teams come in all shapes and sizes, and I’m not going to sugar-coat this for anyone – teamwork is usually tough. In my experience, it isn’t something that just comes out of the box ready to play with. Our EEG team is very diverse – we have a large variety of backgrounds, interests, lifestyles, personalities – and it can be challenging to keep everybody on the same page. The good news is that effective teamwork often stems from a common goal and we have that in spades – caring for sick kids.

Teamwork breaks down when we focus on our differences and we tend find differences more easily than identifying eyeblinks on an EEG. What takes more work is staying focused on those things we have in common and what we want/need to accomplish. Several years ago, our team sat down together and drafted a Commitment to Colleagues. We decided on four main pillars of teamwork that were important to us (flexibility, support, respect, etc.) and listed out actions that would support those pillars (expect the best and assume the best intent, be open to change/new ideas, take issues directly to the person involved without talking behind their back, etc.). This by no means magically transformed us into a perfect team, but it definitely serves as a clear and powerful reminder of what everyone has committed to bring to the table. We refer back to it frequently in order to regain our focus and remind us of what is really important.

On a larger scale, in our current health care environment, I think teamwork is more important than ever. Census is high, staffing is short and our essential tasks of caring for our patients still need to get done. I’ve watched a lot of people dig deep, work longer hours, take on more responsibility, and think creatively together in order to maintain the high quality of care our patients deserve. It’s been a long road and seems to be stretching out forever. Especially in healthcare, it’s not about the individual, it’s about the team, so I think teams need to find ways to take care of the individual. So, I suggest you take a look at a teammate today and try to think of something you can do to support them – buy them a snack, help them finish some paperwork, send an appreciation email, or just ask them how they are holding up. It will probably mean more to them than you realize. My son’s school’s motto this year says it all: “If we make today awesome for somebody else, today will be awesome for everybody.”

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