PROFESSIONAL DEVELOPMENT

Written communication: Relationships: from from staff staff nurse nurse to to nurse nurse consultant consultant

Part 3: teamwork John Fowler

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patient wanted to join us for more toast, that was fine. The unit managers knew not to visit the ward at this time, as the hospital policy forbade staff eating on the ward ■■ Staff who were unwilling or unable to work to these standards left or requested a ward move. There was, as the saying goes, ‘no dead wood’. How does my list of the characteristics that enabled good teamwork compare with yours? I’m sure there are some similarities but I would also expect quite a few differences, as the components that make up a good team are multifactorial and complex. If I were to try to identify the core components of all the good teams I’ve worked in, they would be: ■■ Clear focus of the purpose of the team ■■ Identified boundaries of responsibility ■■ Respect for each team member and the role he or she plays in the team ■■ Appreciation of each individual team member’s needs ■■ Opportunities to de-stress ■■ An acknowledgment that the organisation that you are working for appreciates the part you are playing. Poor teamwork is often the absence or confusion of those positive components: ■■ The focus or purpose of the team will often appear unclear. Is it patient care, filling in paperwork, discharging patients, admitting patients, meeting deadlines? All of these can be important, but may in themselves cause a conflict of focus. For instance, you can’t admit a patient if you haven’t got an empty bed, and you can’t get an empty bed without discharging a patient. But are they physically or psychologically ready and is the support in place in the community? ■■ The last group of 25 health care assistants (HCAs) I talked to (with only a few exceptions) felt that none of the registered nurses respected them as carers or people. Yet HCAs deliver a substantive proportion of direct patient care and are key team members ■■ A team needs time together to relax and have

a little fun; this can be coffee and toast or an evening out. It’s about taking time to recharge batteries and prevent burnout. This is not about working less hard—it is simply taking a little time to allow physical and psychological energy to return ■■ It is difficult for managers of large healthcare organisations to keep in touch with the people involved in direct patient care. I’m sure you’ve seen those TV programmes where the chief executive of an organisation goes undercover and ‘back to the shop floor’. They are always so amazed at the difficulties their staff work under and how simple changes can make production and customer service so much more efficient. A team works most efficiently when it knows that people at the senior end of the organisation understand what its workers do, the pressures they are under, and the resources they need to do the job well. I hope I’ve stimulated your thoughts on teamwork. My challenge to you is to take this short article and use it as a focus of discussion in your own team. Theory, textbooks and journals are worth nothing in nursing if they don’t influence practice. So take these ideas to a team meeting or organise a couple of coffee sessions where staff have the opportunity to reflect on BJN some of the issues raised in this article.

Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books

© 2015 MA Healthcare Ltd

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his is the third article in the new staff nurse to nurse consultant series, which is exploring ‘relationships’. Over the next 10 issues, the series will be examining relationships with junior staff, and medical and allied health care members. It will look at relationships with terminally ill patients, people with mental health problems and relatives, and will offer some tips on how to handle personality clashes.This article examines teamwork. There are times when I find that working in a team is rewarding and enjoyable, and allows me to be part of something that is far greater than I would be if I were working alone. There are other times when I find that working in a team is frustrating and stressful, and prevents me achieving something useful. Some teams can give you energy; others can sap it. Think about some of the teams you have worked in. Which ones stand out as examples of good teamwork and which ones as poor teamwork? In your example of good teamwork, try to identify why you think it worked so well. Take a couple of minutes to jot down a few reasons. When I was a junior staff nurse, I worked on what was then called a ‘psycho geriatric’ ward, caring for 30 patients with severe dementia and associated behavioural problems. It was the hardest I have ever worked, both physically and emotionally, but one of the most enjoyable and rewarding experiences I have had of working within a team. This is why I think it worked so well: ■■ There was one ward sister in charge who had a clear vision of what she wanted for that ward. These were high standards of care and respect for each patient ■■ The ward sister communicated those standards by her actions, working on the ward with patients, spending very little time in the office ■■ Paperwork was kept to a minimum; the focus was on direct patient care ■■ After the patients were got up, washed, breakfasted and toileted, the staff (including the ward cleaner) sat down in the centre of the ward and we had tea and toast. If any

British Journal of Nursing, 2015, Vol 24, No 7

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Relationships: from staff nurse to nurse consultant: Part 3: teamwork.

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