building teamwork

[debRN10]

Does anybody have any ideas on how to build teamwork and a feeling of belonging to a team in the hospice setting? Right now I have taken over managing at a hospice and no one feels appreciated or a sense that we are in this together. Thanks for any input.

[MJ Marx]

Deb, It takes time. I know that is probably what you don't want to hear, but it is true. I do have some ideas that I myself have been using the past few months in my new position with Home Health/Hospice. Listen. Listen for tidbits about each ones personal life that you can either ask a question about later or give a positive remark too. Listen for their ideas and give encouragement where you can. Try a new idea one of them brings up to encourage them to bring ideas to you. Look for processes where you can bring them together and lead them into teamwork without them knowing they are doing it. For example, we have a brief meeting every morning where assignments are given out, I ask for a mini report during that time, or share a mini-report that I ascertained the day before when everyone was taking off for the day. Now that works only if everyone comes in to the office before making their visits for the day. If your staff don't all come to the office but maybe work from home, a conference call at a specific time every day may be helpful. For our Hospice IDT meetings we invite all staff to attend if they are able, to promote the team. I hope some of this is useful.:)

[MJ Marx]

Deb, In regards to appreciation. Observe them and give thank you cards, notes, giving them specifically what you are thanking them for. Does your agency have the capabilities of doing small dollar amount gift cards to a local coffee shop or eatery to go with that thank you note? Little things go a long way with a team who feels underappreciated. Hope there is something you can use.

[AtlantaRN, RN]

coffee at the office, encourage staff to talk about their homelife.....and food at idt or monday morning meetings is always appreciated.....i work with a good team now and we support each other.

[caliotter3]

For one thing, I would nip tale bearing in the bud. When a nurse calls or comes in to "report" on another nurse and I discern professional jealousy rather than a valid complaint, I would tell this person right off that I don't want to hear this type of talk from her/him. I would not use this drivel in order to hurt the nurse being talked about. When established employees do this to any new employee, it is not hard to see why it is difficult to keep good employees at any particular agency.

[ErinS, BSN, RN]

We just went through a huge change in our office of nurses. Here are a few recommendations.

1. Get every one on the bus (this is what my manager calls it). For us this meant that the only team members that would be tolerated were those providing excellent care, with good attitudes and willingness to change. This meant we lost nearly all of our nurses, and had to hire a whole new team.

2. Encourage socialization. We often go out to breakfast or lunch, and we have barbeques after work where we hang out.

3. Be proactive. In my experience, nothing diminishes moral more than a manager who listens to all your complaints, makes promises, and then nothing gets done. This really undermines staff. If something is not working, but you can not fix it, explain why.

I think this is a slow process, and you have to be willing to have some turnover for things to really change. Staff generally feels mistreated because they have been mistreated.

[debRN10]

Thanks guys. You gave me some really good ideas and I really appreciate it!

[tewdles, RN]

The foundation of a team MUST be trust. The staff must trust you and you must be able to trust them. The staff is important, get to know them, what is important to them, what is hard for them, and what they feel their individual strengths are.

Teams must be safe places for the staff. You cannot problem solve if there is a hostility to the ideas and opinions of the members of the team.

As others have said, feedback is crucial. "Good" feedback is regular and routine and NOT directly related only to incidents or issues. Meet with individual team members and with the entire team on regular intervals. Treat all team members with respect and demand that all team members treat one another with respect. There is no gossip and back stabbing in a healthy team.

If a team member is struggling with a performance issue, use that as an opportunity to nurture and grow that person whenever possible. Your success will be measured by their success in many ways. It is generally easier to fix a bad performer who is an otherwise good and competent professional than it is to find an equally competent replacement and fit them into the existing team. Of course, sometimes you just have to counsel people into another career path.

Jean Watson encourages us to have unconditional esteem for our patients. I find that a good measure of this philosophy is helpful when managing professional staff...holding them in high esteem as the foundation for your relationships.

Good luck.