Teamwork Concept in Nursing and Its Consequences

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Introduction

Working in teams is crucial for nurses, and the concept of teamwork becomes central to the nursing practice. It is difficult to underestimate the importance of effective teamwork in nursing and healthcare in general. First, nursing per se as professional conduct of continual health management and research depends on collaboration in mission and objectives achievement. Second, the research shows that successful collective work tends to decrease stress and increase productivity among the nurses involved (Dilig-Ruiz et al., 2018). Most importantly, effective cooperation and coordination are crucial for patient safety.

To avoid patient errors, it is vital to promote effective teamwork within the units and between them. Although there has been an increasing practical interest in teamwork, the concept as such calls for conceptual analysis in order to provide a more comprehensive theory of teamwork in nursing practice and ensure its coherent application.

Definitions and Uses of the Concept

According to the Merriam-Webster dictionary, teamwork is “work done by several associates with each doing a part but all subordinating personal prominence to the efficiency of the whole” (Merriam-Webster, n.d.). Cambridge Dictionary(n.d.) defines teamwork as “the activity of working together in a group with other people, especially when this is successful” and “the combined actions of a group of people working together effectively to achieve a goal.” Thus, all three definitions imply positive connotations of such type of goals and objectives achievement. Significant collocations supporting teamwork are efficient, successful, and working in a group.

Teamwork is especially emphasized in organizational contexts. “Teamwork skills” is an essential part of what employees seek in potential employers (Betta, 2016; Tripathy, 2018). There have been created a lot of applications, software, and web-platforms for businesses facilitating teamwork. These services outline setting and achieving mutual goals and objectives efficiently and timely (ProofHub, 2020). Such services structure inter-organizational communication and enhance productivity.

At the same time, in scholarly literature, there are three main streams of research dealing with teamwork: business, education, and healthcare. Apart from the efficient collective achievement of common goals and purposes, scholarly literature focuses on the process of deep mutual learning resulting from the interaction, dialogue, and cooperation (Tarricone & Luca, 2011; Hoegl & Gemuenden, 2001; Reeves et al., 2017).

Definitions of the discussed concept also emphasize the synergetic effect of teamwork. Consider, for example, this definition: “a cooperative process that allows ordinary people to achieve extraordinary results” (Scarnatti, 2011, p.5 as cited in Tarricone & Luca, 2011, p.641). Concerning the specific essence of teamwork in the nursing context, Tarricone & Luca (2011) focus on the nursing team itself, i.e., ” registered nurses (RNs), licensed practical nurses (LPNs), nursing assistants (NAs), and unit secretaries (USs) working together in the delivery of patient care, as opposed to interdisciplinary or other types of teams” (p.641). Thus, although this concept has been widely used in various contexts and in relation to different groups, there are several defining attributes that are common.

Defining Attributes

Generalizing various definitions of teamwork, it is possible to highlight their common features. It is constitutive features of a team: at least three individuals, a common purpose, the members’ interdependency, their specific roles linked to performing particular tasks, decision making, and mutual interaction in the process of achieving common objectives. Five elements can be distinguished for the teamwork to uphold the concept’s positive connotations.

First, an appropriate leadership style (i.e., how the leader directs the subordinates and supports them). Second, orientation towards collective achievements (as opposed to an individualistic approach to work and success). Third, the awareness of the team members of each one’s role and activities. Fourth, protecting behavior, i.e., team members are willing to help and support each other with their tasks and responsibilities. Finally, adaptability or the ability of individuals to adjust their activity most sufficiently.

Antecedents

Walker and Avant (2005, as cited in Brush et al., 2011) define antecedents as “the events or attributes that must arise prior to a concept’s occurrence.” First, in order for a team to emerge, there should be an appropriate organizational context. Teamwork in nursing practice presupposes clinical settings, adequate education level of the potential members, and the need to apply joint effort to achieve specific goals. When these criteria are met, three key antecedents should be present to call some collective activity teamwork. First, it is a shared understanding of the process, goals, and objectives, as well as the roles of each member. Second, an effective communication infrastructure, i.e., information exchange needs to be active and straightforward, verifiable, and efficient. Finally, the team members should trust each other.

Consequences

Walker and Avant (2005 as cited in Brush et al., 2011) define consequences as “those events or incidents that can occur as a result of the occurrence of a concept and that can often stimulate new ideas or avenues for research pertaining to certain concepts.” Possible and expected consequences of teamwork in nursing practice include increased members’ job satisfaction, more efficient and productive job performance and collective goals achievement, and the minimized amount of patient errors. The latter is of the utmost importance since a healthcare organization’s ultimate objective is patient care and cure. Teamwork is a positive concept, the occurrence of which results in desirable outcomes for all members and parties involved.

Model Case

Sarah M. works as a registered nurse in SM hospital. She is engaged in the nursing team consisting of a nurse manager (NM), three charge nurses (CN), ten other registered nurses (RN), and eight nursing assistants (NA). Sarah reports that the manager appreciates each member’s contribution, values efficient collaboration, and ensures that teamwork is possible through controlling the provision of adequate staff and resources every shift.

In her team, CNs are responsible for facilitating communication and lead the team members’ activities. According to what she experiences, the team divides patients not by their amount but by their needs and the respective work needed. The members support each other in crises and throughout shift routine activity. They are willing to help (unless they are not on top of their work, and it is physically impossible). CNs and NM make sure that the workload is fairly distributed. All nurses trust in each other’s job and are sure that it is done properly. At the same time, every time before the next shift starts, they meet up with each other to stay updated on the current objectives.

This model case represents all five defining attributes of the concept. The members have a set of common goals and objectives; they are interdependent and have their particular roles throughout the shift. NM exhibits a desirable leadership style, and all nurses are oriented towards collective achievements, each of them is aware of their role and the roles and tasks of others. The members behave in a supportive way showing a high level of protective behavior. They ensure adjustability as well through the adequate resource usage and supply. Besides, the teamwork here is ensured by the presence of vital antecedents such as trust.

Borderline Case

Patricia B. works as a CN in PB hospital. The nursing team she works with also includes a NM, six RNs, and eight NAs. Patricia tends to be proud of her team and the work they do. She communicates with all the nurses, and three of the RNs are her close friends. She ensures that every nurse has a fair workload and tries to redistribute tasks if necessary. In crises, she makes sure collective efforts are deployed most efficiently. If there is a mistake during her shift, Patricia wants to know who exactly is responsible. In doing so, she tries to minimize patient errors and enhance nurses’ responsibility and accuracy. In the process of such investigations, she learned that some nurses make mistakes slightly more often than others. In order to increase their performance, she tries to watch them.

This case shows a borderline situation since, in this team, not all the attributes and antecedents are met. Patricia established mostly close and friendly relationships with her subordinates, values their work, and focuses on collective achievements. Although she promotes team orientation and aims at adjustability, some of her leadership style patterns lead to the absence of supportive behavior among subordinates (the necessity to point at another person) and decreased trust. The latter is observed among subordinates to each other and Patricia’s lack of trust in some particular team members.

Contrary Case

Olivia J. works as a RN in OJ hospital. The team she works in includes a NM, two CNs, fifteen RNs, and fifteen NAs. The nurses do not receive after-shift updates and their current tasks until nine-ten in the morning. Because of that, it is difficult for them to catch up. The CNs tend to emphasize individual drawbacks and mistakes. NM usually distributes workload based on patients number, and it results in uneven workload distribution. NM and CNs do not reassign patients. If there is a unit crisis, the team uses help from nurses from other units instead. It often leads to misunderstandings since the latter have their own nursing practice patterns established in their primary teams. Olivia is not sure that her colleagues will have her back because everyone is stressed and under pressure from dismissal possibility.

This case represents a situation contrary to efficient collaboration, which could be called teamwork. First, the leadership style of NM and CNs is discouraging and promotes an individualistic approach to work. Thus, nurses do not exhibit collective orientation in their practice. It negatively affects trust among team members and supportive behavior. Every nurse seems to be on their own. Intergroup communication infrastructure is flawed. At the same time, the team does not share a mutual understanding of the way collective activity and individual tasks should be performed. Because the workload is not distributed properly, the team lacks adjustability, and the members cannot be aware of each members’ agenda.

Implications for Nursing Practice

Understanding of each distinct core constituent, attributes, antecedents, and consequences of teamwork has implications for nursing practice on several levels. First, improving conceptual awareness of the concept helps enable nurses to design initiatives to enhance patient quality and safety. Ultimately, teamwork is intended at more efficient job performance and objectives achievement, which has patient well-being as imperative. Second, teamwork leads to better design and performance of clinical interventions because it implies intergroup communication enhancement. Third, it promotes a satisfying working climate for all members of the team. This, in turn, leads to better job performance among staff (Olsen et al., 2017). Teamwork is crucial for nursing practice and the hospital’s operation in general.

Conclusion: Influence of Nursing Theory on My Practice

Nursing theory has become a criterion for the practice of nursing. There is an understanding that the practice should be approached systematically. The main criteria in practice are the following: objectivity, empirical reliability, the possibility of using quantitative indicators, reliability, clinical suitability, as well as publicity, and collegiality.

The theory helps to answer key questions for a nurse. What factors affect life processes, function, and human well-being; what are the types of human behavior in relation to others in critical situations; what factors can have a positive impact on health.

References

Betta, M. (2016). Self and others in team-based learning: Acquiring teamwork skills for business. Journal of Education for Business, 91(2), 69-74.

Brush, B. L., Kirk, K., Gultekin, L., & Baiardi, J. M. (2011). Overcoming: a concept analysis. Nursing forum, 46(3), 160–168.

Cambridge Dictionary, (n.d.). TEAMWORK: meaning in the Cambridge English Dictionary. Web.

Dilig-Ruiz, A., MacDonald, I., Varin, M. D., Vandyk, A., Graham, I. D., & Squires, J. E. (2018). Job satisfaction among critical care nurses: A systematic review. International journal of nursing studies, 88, 123-134.

Hoegl, M., & Gemuenden, H. G. (2001). Teamwork Quality and the Success of Innovative Projects: A Theoretical Concept and Empirical Evidence. Organization Science, 12(4), 435–449.

Kalisch, B. J., Lee, H., & Rochmann, M. (2010). Nursing staff teamwork and job satisfaction. Journal of Nursing Management, 18(8), 938–947.

Merriam-Webster (n.d.). Teamwork. Merriam-Webster. Web.

Olsen, E., Bjaalid, G., & Mikkelsen, A. (2017). Work climate and the mediating role of workplace bullying related to job performance, job satisfaction, and work ability: A study among hospital nurses. Journal of advanced nursing, 73(11), 2709-2719.

ProofHub. (2020). 52 Best Online Collaboration Tools & Software for Teams [2020]. ProofHub. Web.

Reeves S., Xyrichis A. & Zwarenstein Merric (2018) Teamwork, collaboration, coordination, and networking: Why we need to distinguish between different types of interprofessional practice, Journal of Interprofessional Care, 32 (1), 1-3.

Tarricone, P., & Luca, J. (2002). Successful teamwork: A case study. Web.

Tripathy, M. (2018). Building quality teamwork to achieve excellence in business organizations. International research journal of management, IT and social sciences, 5(3), 1-7.

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