Online Journal of Rural Nursing and Health Care, 1(3) 1 Editorial Letter from the Editor: Collaboration Deana L. Molinari, MSN, RN, Editorial Board Member Jeri W. Dunkin, PhD, RN, Editor Most grant applications require several separate organizations contributing to the benefit of the community. The reason is clear, amazing accomplishments occur in communities where collaboration takes place. Telemedicine, networked health care, educational opportunities, improved services, and community involvement enrich our daily lives. The sad thing is not every community knows how to collaborate. According to theory, collaboration may prove difficult in rural areas. The theory states that rural people are fiercely independent and mistrust others to meet their needs. I saw this happen. I participated in a rural group that included leaders from nursing homes, the hospital, the home health agency and the public health agency. One nursing home leader leaned over and said," I will not say a word in the meeting. I am going to take back everything I can. We won’t work with these people. They will steal our market share." Since the meeting was to define the duplications of effort in the community and to identify needs for new services, she felt threatened. At the same time another theory states that rural folk aid each other as friends and neighbors. This theory should help contradict the force of the first theory. The trick is to remain friends and neighbors in the professional role. Professionals can interact with other disciplines so as to learn their viewpoints, language and liability issues. New educational models for health Online Journal of Rural Nursing and Health Care, 1(3) 2 care professionals emphasize group problem solving. The future may find more professional collaboration due to this education. The lack of collaborative patient care generates danger. Physicians often work in tandem much as children in parallel play. Nurses claim territory for their shifts and even mistrust others caring for the same difficult patient. These attitudes produce isolation for everyone involved. In isolation mistakes thrive. During a recent illness I had fifteen doctors prescribing and "surgerizing" ON my body not WITH me. I noticed they rarely knew what the others were doing. I was the communication point. They contradicted each other’s orders, and plans. I feared for my waning health. Therefore, I asked a medical doctor to head up a collaborative team. The doctors resisted at first, thinking I challenged their treatment. When the meeting occurred I asked a nurse practitioner to represent me because I was too ill to understand the ramifications of everything said. Amid many pleasantries, my future was planned. Each doctor agreed the approach was novel but most effective for the difficult case. I am alive and kicking to prove that they managed to cooperate. Their fears dissipated and so did mine. Unfortunately, the staff nurses did not feel the meeting was appropriate for them to attend. I remained the communication conduit between doctors and nurses, unless they changed an order. Collaboration is the opposite of avoiding and competing. Collaborating is a creative process. Participants analyze situations and define them at a higher level than where conflict arises. The players identify shared goals and commit to work together. The collaborative process works best when the situation requires creative, integrative solutions. Meeting both sides’ goals and needs produces consensual decisions. People learn and grow though Online Journal of Rural Nursing and Health Care, 1(3) 3 cooperative problem solving. Another benefit of the process is that it results in understanding and empathy for other’s situation. Too often collaboration is the last choice in problem solving instead of the first choice. One watches the situation heat up, like a pot of water on the stove. For a long time the water molecules bounce around in their own spheres. Nothing seems to happen. Then all of a sudden the molecules align themselves together in a pattern and the water boils. The molecules join in the rise and fall to the surface. The internal organization theory states that separate bodies of cells with different purposes will, when the stimulus is right, join together in a single purpose. Vision is a good example of this principle. There are about thirty different systems identified in the brain that work separately on vision problems. But when the stimulus is right they join together to solve the problem. Color, motion, spatial, and orientation systems work simultaneously to give the viewer a picture of reality. Although scientists haven’t yet identified what catalyst triggers the cooperation or how it works, we can guess what triggers our community collaboration. Felt needs seem to produce the best results. The more community groups feeling the same need produce the fastest collaboration. Sometimes a catalyst educates and motivates the community. Brainstorming and light housing produce thinking in many parts of the community. Once all the elements come together, the pot boils. The project proceeds and sooner or later the goals are reached. Nurses make great catalysts. Nurses know how to work with many professionals and can advocate beautifully. Therefore, nurses should involve themselves in community health issues. Talking with others about how to solve issues is brainstorming. Talking with everyone about an issue is called light housing. Just as the light in a lighthouse warns every few seconds, so can the nurse bring up the subject with everyone met. Gaining Online Journal of Rural Nursing and Health Care, 1(3) 4 support from all aspects of the community is the beginning of collaboration. Meetings to identify the issue and then searching for creative solutions are the heart of collaboration. After all is said and done, the community will feel greater unity and experience understanding for each other. Unity and understanding are the basics of power. In the spirit of collaboration the following resources are provided: Grants on the Internet. Send your favorite site to the editors: Jdunkin@bama.ua.edu Deana_Molinari@byu.edu Share your collaborative endeavors in the chat room at http://www.rno.org. http://www.rno.org/ Online Journal of Rural Nursing and Health Care, 1(3) 5 References Yoder-Wise, P.S. (1999). Leading and managing in nursing (2nd Ed.). St. Louis: Mosby. Grants on the Internet  Federal Funding: Lots: http://www.aads.jhu.edu/federal_grants.htm  Education Resources: http://www.educationworld.com/grants/resources/index.shtml  National Science Foundation: http://www.nsf.gov/home/grants.htm  National Archives and Records Administration: http://www.nara.gov/nara/grants.html  The Chronical of Philanthropy: http://philanthropy.com/grants/  US Department of Education: http://gcs.ed.gov/  NIH Office of Extramural Research: http://grants.nih.gov/grants/policy/policy.htm http://www.aads.jhu.edu/federal_grants.htm http://www.educationworld.com/grants/resources/index.shtml http://www.nsf.gov/home/grants.htm http://www.nara.gov/nara/grants.html http://philanthropy.com/grants/ http://gcs.ed.gov/ http://grants.nih.gov/grants/policy/policy.htm