This essay will examine the function and formation of teamwork; it will also explore why teams come together and what they do?
This essay will examine the function and formation of teamwork; it will also explore why teams come together and what they do? Problems that can arise between members will be discussed; it will also look at the multidisciplinary team in practice and its key features, including who is involved, how they work, and what their roles are. The link between theory and practice will be discussed. Guidelines and Policies will be explored, also what makes a good nurse in a hospital environment, and why good communication is an important part of nursing.
An article by Gustafson (1994) focuses on two different models for team work, looking at individual characteristics. The first model looks at the individual person, and is called the flow theory model. This model looks at the person's mental state during an experience they have had. There are "three realms, boredom, flow channel, and anxiety. The flow theory model refers more to the mental consciousness in relation to holistic life experiences. The second model is the forming, storming, norming, performing and transforming." Gustafson (1994) says this model looks at development and how a group functions.
Mears and Voehl (1994) describe how the stages work as follows:
Forming. This is when a team first form. It is at this stage, members feel comfortable, introduce themselves and leadership roles begin.
Storming. At this stage members have to perform a task which may be difficult so depend on their own skill to get them through it. At this stage members don't feel able to work with others, so cliques begin to happen. Some members become agitated on the progress of the team and the progress to the task given.
Norming. Members of the team start to help each other and start to get to know other peoples strengths and weaknesses. Everyone is friendly and there is no conflict. Individual member's strengths and weaknesses are discussed.
Performing. At this stage the team has grown, each member can acknowledge their strengths and weaknesses and are happy with the team and how it has progressed. Members can now become involved with tasks and deal with any conflict.
Transforming his is the last stage in which the group put new experiences into practice. It is up to the individual person to put these experiences into use for future projects/exercises, or they might not progress so hold back on progression.
According to Gustafson (1994) time is not put on when a group will progress from each stage, infact the group could regress back to a previous stage. Different groups have different attributes, and it is this reason why the group's development can be effected.
The Scottish Executive (2006) believes team work is about accepting and having an understanding of each person's role and relationship. Trust and support within a team is crucial. Working towards a high standard, to reach goals, and being able to accept other member's skill and personalities which all serve to bring about a ...
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According to Gustafson (1994) time is not put on when a group will progress from each stage, infact the group could regress back to a previous stage. Different groups have different attributes, and it is this reason why the group's development can be effected.
The Scottish Executive (2006) believes team work is about accepting and having an understanding of each person's role and relationship. Trust and support within a team is crucial. Working towards a high standard, to reach goals, and being able to accept other member's skill and personalities which all serve to bring about a more effective team. Problems can arise within a team if it is not structured properly no matter who works within it. A successful team is all about having clear roles, goals/ different skills and trust.
Within the team if it is managed without any authority it can lead to all kinds of problems such as; culture clashes, lack in resources, poor communication and a lack of communication (The Scottish Executive 2006).
The NMC code of professional conduct (2004) promotes the importance of teamwork, Stating that nurses should work well together in a team, give respect to each person and not to discriminate. Communication is important in a team. Shared skills and experience is important for the benefit of the patient cared for. The NMC go on to say that team meetings are a useful way to support and develop. Team members need to feel they can openly give an opinion. Effective communication with other members of the primary health care team is important and beneficial in the care for patients.
Webster (2002) tells us that as part of the multidisciplinary team, nurses will discuss information about clients accurately and to provide a high quality of care for this to be done they need to communicate well. Care plans should be in place and followed, they should be updated on a regular basis. Without a care plan for all to follow complications will occur resulting in a slower recovery for the patient.
The multidisciplinary team needs to communicate well when making decisions. Each person's individual qualities and opinions are important. In order for a team to work well it should not work as a hierarchical group, for example in psychiatry, psychiatrists traditionally took the lead role; nowadays it is more a shared role amongst the multidisciplinary team, where all members share their expertise and knowledge. Webster (2002) continues to say that clients are the main focus for telling their own story and share in their plan of care they also participate with the multidisciplinary team meetings. All relevant people in the client's life as well as other relevant professional disciplines should be involved, so the team is made up of those able to offer what the client wants and needs.
For the multidisciplinary team to work well together it needs to have shared goals and value base. A system should check the team are working well and effectively (Thomas and Mathias 1999).
"Care planning includes the patient, his or her carer(s) and appropriate service providers in the identification and assessment of patient needs, from which a care plan is developed, that includes goals and actions aimed at achieving desired/optimal outcomes" (Care Coordination 2005).
The Scottish Executive Health Department (2004) emphasised why a team-based approach is relevant for improving patient care. Good communication is important within the multidisciplinary team. Team working should include each person giving input when decision making, sharing objectives in order to make use of appropriate skills, which will help with health needs within the practice.
According to Crawford and Brown (2005) nursing is about good clear communication and written interactions with all members of the team, including the client and family. "This might take place in such activities such as counselling and building a therapeutic relationship, assessment and care planning, information giving, teaching and health promotion, record keeping and dealing with communication difficulties."
Johnson (1997) states that in practice, pathways of care are written and developed by health care professionals; all disciplines should be involved, making up a complete multidisciplinary team. Where they discuss and review care processes and practices. Inter-disciplinary barriers are melted; staff gets to know the roles of other disciplines and what skills they have. For example doctors find out what an occupational therapist does, nurses learn the role of the speech therapist, dieticians have an understanding of the surgical consultants role and all have an understanding of what part each play within the team and what they can offer. Johnson (1997) believes that having an understanding of the inter-disciplinary builds a team. For patients to receive the best care, skills are required from all members of the team and for the team to work well, for the highest quality in patient care.
The Scottish Executive (2006) states that the main function for mental health nurses and the multidisciplinary team, is to give good care and have an understanding of a patients spiritual, psychological, emotional and social needs, also to work with patients to assess, plan, implement and evaluate in their care. Being aware of assessing any risk, and implementing the management of any risks. The Scottish Executive (2006) continues to say that "mental health nurses practice within multidisciplinary, multi-agency care environments in full engagement with the joint future agenda. This is focused on promoting joint working primarily between health and local authorities to deliver better services to all people in the community.
Ashby (2006) explains that in practice critical reflection is important for nurses, as it provides a more patient centred care and helps to be a better patient advocate. Being able to reflect helps, when situations or performances are not as good as they could be. Reflection helps us by understanding what went wrong? Why you behaved in a certain way and what went wrong? Ashby (2006) says reflection is to know how to do something differently next time, which can lead to improving practice and team work. Being honest and open about limitations is important in patient care and for good team work and provides respect in the workplace.
Wigens (2003) states that within the multidisciplinary team "research needs to be relevant to the clinical situation, acceptable to the professional and the patient, comprehensive, accurate, and easily accessible as well as understandable if nurses and other health care professionals are to implement the findings. Evidence based practice is about giving the best care for patients based on individual care plans, research, policies and other external evidence".
Hinchliff et al (2003) says that patient's notes should be constantly updated and referred to. These should be audited regularly to ensure the patient receives the best care. Nursing staff receive yearly objectives, these objectives are essential, such as attending fire lectures, moving and handling updates, infection control training, as well as regular meetings with the multidisciplinary team.
Wilkinson (2007) believes nursing is about the person as a whole, ill or well. Nurses as well as other members of the multidisciplinary team help the ill patient either by helping to solve or reduce their health problems, by helping a patient to understand or accept illnesses that are terminal, and give support and help to patients to achieve a peaceful death. In well patients nurses need to promote wellness and prevent illness. This can be done by involving activities which include problem solving, making decisions, being an advocate, and aiming for a healthier lifestyle. Wilkinson (2007) goes on to describe the nursing process as a promoting collaboration, this is when team members have an organised approach, communication is good, and patient problems are prevented. Collaborative work involves policy making and decision making.
In conclusion, there are many reasons why a team should function and communicate well together. Good team work results in good quality of care for patients. Team meetings with the multidisciplinary team should also include the patient as well as all other relevant people to the patient.
To be able to reflect on practice is important for a nurse, being aware of areas in which to improve upon, and areas in which through experience can be built on. The theory of nursing is about how we experience and observe outcomes and situations. Being able to reflect, on how we work and deal with new experiences and how we give evidence of our understanding on how we reflect on our actions.
A good nurse is one who does not judge another person and can work well with anyone in a non-judgemental way, is empathetic to others and interacts well within the team, in view of giving the highest standard of care.
