I have been nursing for 33 years this November and over those years I have experienced a variety of good and not so good team working. Those experiences have influenced me greatly to form the nurse and team leader I am today.
My job as Senior Charge Nurse in Ward 12 is to provide a high standard of effective care in an environment that patients feel safe in and by a team that feel confident and supported to do so , and everything else that falls within the patient / relative experience. Working in a team can be challenging but also fulfilling when the job is done well. We couldn’t do what we do every day without good team work .
WHAT IS A TEAM?
A group of people that share a common purpose, are committed and empowered to set goals and problem solve. Without these traits they are not a team but a group of people who work together, a work group.
“Together Everyone Achieves More”
Together = we have a common purpose = giving excellent care.
Everyone = all who work in Ward 12= everyone has a voice.
Achieves = how we deliver our care = evidence based, safe and effective.
My role as team leader is to make clear the team goals, identify the issues that stop the team from achieving their goals and solve those issues with the help of the team .We would do this by doing tests of change , getting feedback and auditing improvement . My job is to create an environment where team members are supported and valued in the work place .By keeping the team motivated, developing and maintaining skills, being aware of individual strengths and weaknesses and attitudes and behaviours I can enhance the staff experience. I was encouraged and guided by work done by Julie Booth, Senior Charge Nurse in Ward 3. Julie and her team developed Values and Standards for the ward. All our staff had input in developing the ward standards and all staff agree to work by them. The basis for the Values and Standards is respect, being non judgemental, and being respectfully open and honest in giving and receiving feedback.
As well as the patient wellbeing, the wellbeing of my staff has equal standing. I believe you can’t enhance or improve the patients experience unless you value and enhance your staff experience. I have encouraged staff to attend the National Person Centred Health and Care Programme, and our local Patient experience events. The staff come back to the ward enthused with ideas for change, they share them with colleagues and then as a team we plan how best to introduce those changes to the benefit of patients and staff.
One such idea was after a local Patient Experience event. Team members returned to the ward and wanted to introduce reflection for staff. The team felt that after a busy shift there was no opportunity for them to say how that shift was for them. Staff felt they took their thoughts home and returned on their next shift with heavy minds and frustrations from the previous shift.
We have a definition of reflection, an aim and a process for reflection. The purpose of the reflection session was to be able to speak freely about their experience of that shift , any challenges and to discuss what could have worked better, or to say what was good about that shift and how that could be embedded. It is time limited to 10 minutes at a convenient time, it involves all nurses on the shift, there is a lead person for the session (not necessarily the Senior Charge Nurse, or person in charge), and ground rules were established = confidential- no notes taken – what was said in the room stayed in the room, discussions are relaxed and non confrontational, open and honest. Any “bigger” issues arising would be discussed with the staff member and myself out with the reflection session. The sessions were greeted with apprehension by some staff who found it difficult to speak about their experiences, but after a few sessions everyone soon got into the swing of it. These sessions were soon generating ideas for improvement and themes of frustrations in the work place. We added 2 boxes , one where staff could write down their good ideas =Golden Nuggets box, and one where they could write what was annoying on their shift = The Bug box.( replacing what you had used and tidying up were the top 2 ). We then discuss what is in the boxes each week and plan how to improve or change our practice. We have a questionnaire for staff for feedback and we use the safety cross check chart per month to record our consistency. We saw very quickly that staff felt they had the chance to reflect on the challenges and the successes of their shift and by giving everyone the chance to talk about it freely the staff felt they no longer left work feeling burdened by “work stuff”. This has improved our communication within the team and improved staff morale .It takes commitment by all staff to maintain these sessions, when we are extremely busy some sessions do not happen and the staff comment that they miss them. It is my job to raise the focus again and encourage the staff to keep it going.
Dale Stewart and Wendy Langan who facilitated the reflection development.
Another idea introduced by the Health Care Support Workers in the ward was to have a welcome and information leaflet for all staff coming to help in the ward. It starts with thank you for coming to help in the ward today, you will be working with….. , the ward routine is…. , your break is… . We have feedback sheets which we review monthly and encourage suggestions to improve staff’s short term experience whilst in ward12. We have had a lot of positive feedback from staff helping in the ward and they look forward to coming again.
By encouraging staff to develop their ideas and improve the team performance they take ownership of change and enthuse others to do the same. This makes my job easier it enhances the patient care and journey which we measure with our patient questionnaires; What did we do well? What could we have done better?
Being part of a good team gives you a sense of pride in achievement and celebrating success, and camaraderie in supporting the team. In Ward 12 a wicked sense of humour and a liking for sarcasm will also enhance your experience!
Celebrating success , Susan ,Drew and Mary.
I would like to dedicate this blog to Charge Nurse Heather Renwick who retires this week after an outstanding 37 year nursing career, one of my excellent experiences in my nursing career.
Jackie Nicholson is the Senior Charge Nurse on Ward 12 at Dumfries and Galloway Royal Infirmary