Teamwork in nursing requires each nurse to input their strengths, skills and weaknesses to
improve quality of care and enhance positive health outcomes for patients (David, 2017).
According to West (2012), teamwork is coordinating different organizational levels to achieve a
certain objective. The action plan in Appendix one was created for the ward manager on an
intensive care ward to deal with ineffective teamwork noticed while on placement. The four
development needs were observed that may have resulted in ineffective team working. The
development needs are unstable and unsupportive team, lack of respect and trust among team
members, ineffective communication and inadequate reflective feedback. The identified areas
of need are discussed to show how team work may be improved. (Dietz, et al, 2014 and Curran,
et al, 2005)
The intensive care teams were made up of unstable teams that could not support each other.
The staff members were not engaged and would not boost each others’ morale. A supportive
team that backs up each other and staff that show care for each other relieves pressure of
workload and builds a good working environment (Weaver, 2008). Although some members
were able to show support for others, their effort was not acknowledged and this de-motivated
them. Teams could not relate to each other experiences as there was no personal interaction
and they could not share their experiences. Supportive teams increases dedication to work and
morale. Improvement of stability and supportive teams promotes strong work relationships and
open team culture. (Henderson, et al,2006)
In addition, staff would not show respect for each other by using negative comments and false
information and not listening to one another. Staff exercised extreme attachment to their
hierarchy not allowing assistants to share ideas or be part of a conversation. Patients’ requests
given to assistants were not acknowledged. This disrupted the smooth flow of carer in the
ward. Respect among staff automatically leads to trust among staff members (Kwadwo and
D’Egidio, 2015). Lack of trust meant that staff were not able to air out their ideas or be honest
to each other. Trust helps teams achieve their objectives and goals thus must be promoted by
encouraging staff to share their opinions and ideas (Assbeihat, 2016). Work relations may be
enhanced by treating staff equally regardless of hierarchy.(Bourgault and Goforth, 2021)
Furthermore, intensive care team ineffectively communicated with each other, with doctors
and with patients. Reasons behind this would be that nurses concentrated on their workload
and personal issues other than others. Misunderstandings were very frequent and the ward
manger was always fixing communication glitches thus the need for the action plan. Poor
communication between nurses may result in poor care o patients and dangerous
consequences (Delves-Yates, 2018). Communication tools such as SBAR (Situation, Background,
Assessment, and Recommendation) can be used to remove breaks in communication (Park,
2010). It is a technique used to pass information in critical scenarios. Another evidence based
technique is the closed loop communication tool. This tool allows acknowledgement by
recipient and checking with the sender that the information has been received as it was
intended to be received. (Park, 2010 and Delves-Yates, 2018)
Another area of need is poor reflection and lack of feedback by team. The team were not
assessing their progress and performance, thus were not giving feedback to each other whether
positive or negative. Feedback is essential in assessing staff members and all, team
performance and helps staff learn from their mistakes ( David, 2017). Engagement through
team meetings would allow team members to critically reflect on their objectives, processes
and strategies and provide feedback and make decisions about how they may improve in the
future. (Schumtz, 2019)
Team work; coordination and collaboration are important in managing the intensive care ward.
The ward manager needs to work on the developed action plan by creating stable and
supportive teams that can boost each others’ morale and openly engage, encouraging staff to
respect and trust ideas of each other regardless o hierarchy or ranks, using tools such as SBAR
for effective communication, providing reflective feedback, positive or negative, to improve
future performance. Implementation of the action plan will ensure a coordinated team working
together as one is achieved and thus improve the standards of patient care in the intensive care
ward. (Curran, et al, 2005)
REFERENCES
Assbeihat, J. M. (2016) The Impact Of Collaboration Among Members On Team's Performance.
Management And Administrative Science Review, 5.
Bourgault, A. N. And Goforth G. (2021) Embrace Teamwork To Create And Maintain A Positive
Workplace Culture. Critical Care Nurse, 41, 8–10.
Curran, V. R., Deacon, D. R., And Fleet, L. (2005) Academic Administrators' Attitudes Towards
Interprofessional Education In Canadian Schools Of Health Professional Education. Journal Of
Interprofessional Care, 1,76-86.
David, C. (2017) Teamwork And The Patient Care Experience. Nursing Made Incredibly Easy! ,15.
Delves-Yates, C., (2018) Poor Communication: Essentials Of Nursing Practice.
Dietz, A. S., Pronovost, P. J., Mendez-Tellez, P. A., Wyskiel, R., Marsteller, J. A., Thompson, D.
A., Rosen, M. A. (2014) A Systematic Review Of Teamwork In The Intensive Care Unit: What Do
We Know About Teamwork, Team Tasks, And Improvement Strategies?. Journal Of Critical
Care,29.
Hall, P. (2005) Interprofessional Teamwork: Professional Cultures As Barriers, Journal Of
Interprofessional Care, 5.
Henderson, A., Winch, S., Heel, A. (2006) Partner, Learn, Progress: A Conceptual Model For
Continuous Clinical Education. Nurse Education Today, 26.
Kwadwo, K. And D'Egidio, G. (2015) Guide To Strategic Planning In Critical Care Medicine.
Journal Of Hospital Administration, 4.
Park, L., J. (2020) SBAR TOOL IN: Using The SBAR Handover Tool. British Journal Of Nursing, 29,
812-813.
Richardson, J. West M. A. And Cuthbertson, C. Team Working In Intensive Care: Current
Evidence And Future Endeavors
Robson, W. (2017) Debriefs And Catch-Up Huddles: Tools And Techniques To Improve
Teamwork And Avoid Patient Harm. Nursing Times, 24-27.
Schmutz, J.B., L. L. Meier & T. Manser. (2019) Feedback Boosts The Team Morale: How Effective
Is Teamwork Really? The Relationship Between Teamwork And Performance In Healthcare
Teams: A Systematic Review And Meta-Analysis.British Medical Journal Open.
Weaver, T. E. (2008) Enhancing Multiple Disciplinary Teamwork. Nursing Outlook, 56.
West, M., A (2012) Teamwork Is Collaborating With Different Organisational Systems: Effective
Teamwork. Practical Lessons From Organisational Research. Wiley-Blackwell
APPENDIX 1: ACTION PLAN
DEVELOPMENT ACTION IMPLEMENTATION RATIONALE OUTCOMES
NEEDS
1. Stable and 1.1 Appreciate the Acknowledging Boosts staff
Supportive Acknowledge team during the whole dedication to
teams the work meetings team. team leads to their work
duties done better team and increase
by the team. cooperation staff morale
(Robson,
2017).
1.2 Make Ask staff about Knowing staff Promotes
personal their personal on personal strong work
connections achievements and basis and relationships
with your their life after appreciating and build
team work. what is team culture.
members. important to
them builds
strong work
relationship.
(Hall, 2005)
1.3 Share Allow staff to This action will Open team
with team on openly share their enhance culture; Staff
their experiences. engagement will assess
workload by staff what they
and possible (Robson, have done or
challenges 2017). what they
could have
done
2. Respect and 2.1 Provide a platform Exercising Staff
trust among Encourage for staff to openly respect for confidence
staff. everyone to air out their others builds will be
openly share concerns trust and boosted.
ideas allows team to
operate
openly. (West,
2012)
2.2 Raise Deal with staff Work relations Staff will feel
levels of members equally may be valued or
interaction regardless o improved by their work
among staff hierarchy. close and input,
in different collaboration. including the
hierarchy (West, 2012) least staff
member.
3. Effective 3.1 Use Confirm with staff SBAR Team
communication communicati that information technique coherence
among staff and on tools such had been passed improves team will be
with patients. as SBAR and effectively and that culture. Closed improved and
closed loop the recipient has loop work
communicati received the communicatio together.
on information well. n removes
errors in
passing
information.
(Park, 2020)
3.2 Orient Have Debriefs Staff will
team on debriefs after shifts remove reflect on
their misunderstand what they
workload. ings and have done.
enhances
engagement of
team
members.
(Robson, 2017)
4. Reflective 4.1 Provide Have meetings Allows staff to Feedback
feedback. negative and during which team assess their helps improve
positive may weigh their performance future
feedback. achievement to and suggest performance.
Assess work team goals. ways and
done. provide room
for
improvement.
(Schmutz, et
al, 2019)
