Power relations
In addition to issues surrounding communication,
Milligan et al (1999) have
argued that positive team functioning may
be impeded by past and present tensions
around power, and recognition of authority.
In the health arena, including palliative care, this tension can lead to the members
of various healthcare disciplines asserting
their own professional perspective as
superior, resulting in a resistance to
accepting the perspectives of other team
members (Kreps and Kunimoto, 1994).
Established disciplinary hierarchies
ensure that interdisciplinary exchanges
are fraught with difficulties. Healey et al
(2004) found that, without specific training
to promote collaboration between
health team members in the areas of mental
health and primary care, doctors would
embrace changes that would enhance their
standing but resisted embracing more
equality and collaboration with team
members from other disciplines, such as
nursing. Lack of collaboration in intensive
care unit (ICU) interdisciplinary teams
has also been attributed to this power differential
between doctors and nurses in
that setting and an associated discourse
that renders nursing knowledge as ineffective
(Baggs et al, 2004