team building

Mulan · Aug 1, 2005

Wow, I'm glad I don't work there if they all can't stand one another. Too bad it wasn't elementary school, and you could have everyone come up with one positive thing or one thing that they like about another person, even if they had to look hard to find it, they'd have to come up with something.

:lol2:

I don't know. I guess the board would be a good idea if people would participate.

Do you have any social functions, potlucks, or the unit going out to dinner for special occasions?

chadash · Aug 1, 2005

It is great you want to affect change in this situation. How do you give a group of people a common vision for something bigger than their pettiness?

mydesygn · Aug 1, 2005

It is great you want to affect change in this situation. How do you give a group of people a common vision for something bigger than their pettiness?

What I have discovered in those situations are there are usually 4 things missing:

(1) the wrong indiviuals in leadership positions. Often nurses placed in "charge" don't have the organization or delegation skills necessary to allow unit to run smoothly. Are the nurses that are in charge able to anticipate and resolve problems before they occur or do they merely react to each problem? Are the nurses in charge able to asess the staff members needs on and ongoing basis and assign other nurses or ancillary staff to help? The most common complaint is that a nurse is overwhelmed and and no one helps. The best charge nurses can anticipate a bad assignment and begin delegating tasks such as vital signs, lab draws etc.. to others in order to help. On the best units, when an admit come, a second nurse always helps, usually without being asked. Having other nurses watch you struggle builds a lot of resentment.

(2) Lack of Organization. Assign someone to organize, count and stock supplies at night. Have nursing asst help empty trash, clean counters and stock. Set up lab bags already stocked with needed supplies for typical lab draws. Make admit paperwork packets ahead of time. There are some many things that can be prepared ahead of time in order to make the busy times run smoother. There is an incredible amount of frustration that comes form not having what you need when you need it and the mistake that happens is that because housekeeping is responsible, we allow trash to overflow --- Does not matter who does it - get it done and stop the frustration

(3) Stop the culture of blame and anonymous criticism. To often minor issues or errors are elevated . Nurses frequently run to the manager with every possible issue. The manager needs to ensure that staff are encouraged to address the problems with one another. As a manager, I have said that we will both talk to this indiviual together. After that statement, it is amazing how the issue was not as big a problem and it was clear to the indivual that I would not support pettiness. In order to stop pettiness, management needs to stop enabling it first.

(4) Support new staff. Ensure that new staff are treated fairly, encourage established staff to offer help, speak with them etc..

Remember you can't make people "like" one another but you can introduce structure that can ensure that indiviuals work effectively with one another. Social events (ie boards, dinners etc.. ) are nice but honestly they are merely placing a bandaid over a deeper issue which is typically an enviroment that is counter productive to teamwork. You will find that often the root of the pettiness and complaining can be resolved by ensuring the enviroment supports coopertion and teamwork. As leadership, we are obligated to introduce that structure.

chadash · Aug 1, 2005

mydesygn: Very helpful post!

purplemania, BSN, RN · Aug 1, 2005

My experience has shown we can boil down the "bad" influences to 1-2 people. Get rid of them. If you make team support and mutual respect (in words and deeds) part of your facility's mission, then it will be a part of the policy for that company. Failure to abide by policies should have penalties, regardless of the type of policy. I agree with Mydesygn: it starts at the top.

llg, PhD, RN · Aug 1, 2005

Don't be afraid to weed out the "bad apples." They may be in leadership positions ... but might not be. Sometimes, it can be a few people in staff nurse roles or support roles or in any role within the unit. They may have seniority and may know the technical aspects of their job very well. They think they are indispensible and that the place couldn't run without them. People have been putting up with their bad attitudes for years because they don't want to have to train someone else to do their job.

It may be a secretary ... or a tech ... or a staff nurse ... or whomever ....... but they make life miserable for those around them. You may have to simply tell them to either put a smile on their face and be nice or leave. It's a difficult thing to do, but it might be necessary.

llg

blufoxtrot · Aug 1, 2005

These are great ideas but I'm a staff nurse. Not a charge nurse and not the director. I have no power. A couple of other nurses and myself have named ourselves the cheerleaders of the department. We try to do things ourselves and come up with ideas and hope our example and positive attitude make the difference. We try to orient new people and be welcoming to float nurses. So unfortunately I need ideas on how to build a team from the bottom up.

mydesygn · Aug 3, 2005

These are great ideas but I'm a staff nurse. Not a charge nurse and not the director. I have no power. A couple of other nurses and myself have named ourselves the cheerleaders of the department. We try to do things ourselves and come up with ideas and hope our example and positive attitude make the difference. We try to orient new people and be welcoming to float nurses. So unfortunately I need ideas on how to build a team from the bottom up.

You have all the power. For example, when I was a staff nurse, the oncoming charge nurse would make assignments for her shift. The oncoming charge nurse may have been off work for several days before this shift and would have to rely on the report from the previous charge nurse in regards to assignment. There were 2 common occurences: (1) the oncoming charge would be late and the entire next shift was delayed waiting on assignments to be made or (2) due to unfamiliarity with the patients, assignments were not adequately balanced. The second week I began doing charge (on nights), I did the assignments for the day charge, she walked in the door I told her I did assignments for her, she could change them if she wanted and asked her if she would do assignments for me when I came back that night. Within a month, the entire procedured had changed, shift change ran smoothly, assignments were more balanced. Only had one diehard nurse who refused but we continued the change despite her.

The bottom line is you are the instrument of change and very small things can make a big difference and you need to realize that it does not take a commitee or permission from someone in leadership to make a change - Just do it, if people complain change it back but take the initiative. It does not require leadership involvment, only indivuals who have pride in their work and willingness to participate - seek out those idiviuals on the unit and you would be susprised what you can accomplish. Many of the ideas I expressed i.e. chart packs, lab bags, helping with an admit don't require any endorsement by someone in leadership, nursing staff can do that.

I try to keep in mind a sentiment expressed by Colin Powell:

"You don't know what you can get away with until you try."

You know the expression, "it's easier to get forgiveness than permission." Well,it's true. Good leaders don't wait for official blessing to try things out. They're prudent, not reckless. But they also realize a fact of life in most organizations:if you ask enough people for permission, you'll inevitably come up against someone who believes his job is to say "no." So the moral is, don't ask. Less effective middle managers endorsed the sentiment, "If I haven't explicitly been told 'yes,' I can't do it," whereas the good ones believed, "If I haven't explicitly been told 'no,' I can." There's a world of difference between these two points of view.

grinnurse, RN · Aug 3, 2005

Don't be afraid to weed out the "bad apples." They may be in leadership positions ... but might not be. Sometimes, it can be a few people in staff nurse roles or support roles or in any role within the unit. They may have seniority and may know the technical aspects of their job very well. They think they are indispensible and that the place couldn't run without them. People have been putting up with their bad attitudes for years because they don't want to have to train someone else to do their job.
It may be a secretary ... or a tech ... or a staff nurse ... or whomever ....... but they make life miserable for those around them. You may have to simply tell them to either put a smile on their face and be nice or leave. It's a difficult thing to do, but it might be necessary.
llg

Oh how I wish they would do this where I work. It is truly amazing how one "bad apple" can spoil the whole bunch. We have one person who hates doing charge (why does she keep saying yes??? Beyond me!!). This person makes everyone miserable with her attitude including the pts.

safewaygreenbox · Aug 4, 2005

What about ward nights out with lots of alcohol :chuckle :chuckle :chuckle

Perhaps just lead by example and it may have spin off effects. Although you may always have a couple that won't change. In real life I think it is very difficult to get rid of the 'bad apple' but the person in charge should confront them.

Do you have regular news letters? Social evenings? Ward meetings ...... mind you it is my experience that ward meetings can end in disagreement!!!

A bulliten board with thank you notices on it wouldn't work for me. I would find it patronising and if I did a 'good thing' but the nurse forgot to thank me it would annoy me or i would feel unappreciated.

Also have a chat with other nurses who are more friendly, see if you can start a trend off.

Ummm OK thats all my suggestions... good luck ..... if all else fails you could follow suit and work somewhere nicer!!! ..... come and work with me :)

grimmy, RN · Aug 4, 2005

when i was a pct, i often did night shift in the ed, and we would plan a bbq night every week. one of the rns would bring a portable bbq and set it up under the heliport, and cook up hotdogs, veggie burgers, etc. everyone else would provide fixings, drinks, salads, etc. we couldn't always eat together, but it got people talking about things other than work. during the winter, we'd have a crockpot meal every so often.

speaking of teams, i just joined a newly forming team in our or, and so far so good - we had our first real meeting yesterday and talked about our group vision for the team. seems hokey, but it is important. even if its simply to state that our focus is "the patient," speaking the words re-emphasizes the goal, reminding us that its not about "us." we do have commonality.