As a manager you may have the opportunity to manage a nursing unit or department where all the work is accomplished by your team! Your team building role provides a unique opportunity to develop staff, problem solve and meet the patient’s needs. The team leader determines the style of the team while the most important role of the manager is one of communicator and role model.

            Managers can be advocates for the team in the building stages. They can assist in undoing the structure that is a barrier to success for the team and provide resources for the best possible care and problem solving. A positive mindset and communicate and express confidence in the team’s capabilities.

            The following can be useful tips in managing your team, as outlined by Margaret Sharp Woodward: 

·        Role model in a way that demonstrates respect to staff, peers, and others.  

·        Remind the team of the task at hand.  

·        Respect the team for their professional knowledge and skills.  

·        Project self-confidence.  

·        Show enthusiasm.  

·        Listen and problem solve.  

·        Be flexible.  

·        Provide support.  

·        Be organized.  

·        Continually use your human relation skills.  

·        Create an atmosphere of cooperation and collaboration.  

·        Keep the team on track and focused.  

·        Recognize and reward team members.  

·        Give feedback as necessary.  

·        Share common goals.  

·        Give the team members accountability and responsibility.  

·        Manage with a clear vision and share it often.  

·        Allow the team members to take risks.  

·        Provide encouragement and feedback.  

·        Clarify assignments when needed.  

·        Foster a cooperative environment.  

·        Write about the team and their accomplishments in memos, newsletters and professional journals.  

[Margaret Sharp Woodward. Communication for Managers (New York: Harper and Rowe, 1994), 297.  

What to do if a Team is not Performing Well  

          One if the major reasons why a team might not perform well are that there is no clearly defined goal to work toward. This deficit isn’t always obvious to staff members on a team. If situations are not going well, the team members may be more likely to lay the blame on a single tea member, considered a weak link, rather than to ask management to clarify the team’s objective.

            Without a mission or vision, staff members may tend to continue working individually, unsure of how to function as a group. The manager, then, has to make sure that the team gets together on a regular basis so that everyone can bring up questions or concerns and redefine common goals. Once there is clarity and commitment to a common goal, it’s easier to spell out each staff member’s roles and responsibilities and get important feedback.

            There is magic to teamwork that is often summed up by the statement, "the whole is greater than its parts.” But because teams comprise staff members with different expectations and temperaments, the magic can easily turn into a nightmare!

            The problem may stem from the fact that all the staff members did not fully understand the concept of teams. Some may think “great, no I’ll no longer have a boss or a supervisor and I’ll be self directed.” This thought may even be reinforced because the manager have adopted a less directive attitude.

            In addition, many on the team may be unwilling to share. There may be a lot of personal investment and sense of ownership about their work. It takes a great deal of maturity to deal with the openness that teams often require.

            No matter what the team’s task, one way to build a long term, intact team is to pay a lot of attention to relationship building. If each member of the team feels valued and respected, then he or she will be a motivated team player. A few suggestions listed below may help team members get along: 

Trust is essential  

            Trust is essential in sharing information and planning for patient care activities. It is also critical for team members to discuss, in a constructive way, behaviors that erode trust. Building trust requires respect, belief in the competence of others, taking risks and open, direct communication.  

Resolve conflicts  

Conflict is inevitable within teams and a natural part of team building. Confronting problems and resolving conflict will make the team grow stronger.  

Empower team members to influence decisions and outcomes  

            This concept requires team members to listen to each other. Too often, ideas are cut off, either by the team leader or members. An example would be a team member putting out a suggestion or idea and the response being, “great, but.” When the word “but” is used, it may imply that the other person has a better idea and someone is not listening. This results in enthusiasm and creativity being stifled. 

Encourage and help team members solve their own problems.

    The increased ownership and commitment that results can payoff in terms of improved team performance and satisfaction. 

Give teams a wide range of roles and functions.

            If teams are provided with training, information, equipment, materials and especially the opportunity, they can accomplish significant work. 

The removal of self-constraints.

    Skill deficiencies and low self esteem among team members is important to enhance team self-management. Providing role models and training and learning opportunities are also important for equipping staff members to be effectively self-managing. 

Incentives provided by the organization and management team.

    If encouragement, rewards and incentives are provided to team members, they will feel more of a commitment to contribute constructively to their team’s performance and team effectiveness. This is turn will benefit the organization’s mission, philosophy, goals and objectives.

Become patient (customer) focused.

    High quality, patient satisfaction and a service orientation are good business practices in any organization. Team members should also be empowered to solve patient car problems and concerns.             

Positive Management Report    

            Coaching, counseling, and mentoring can be extremely rewarding. Rewards come from the small, but consistent successes of the person or team with whom the manager is working. The reward is the celebration of what an individual staff member or team has achieved and the part that the manager plays behind the scenes.     

            Margaret Minor defines coaching as a “directive process by a manager to train ad orient a staff member or team to the realities of the workplace or process and help the staff member or team remove barriers to optimum work performance.” Coaching is useful to assist the team to identify standards of performance, assess the current performance and develop a plan for improvement with a timetable and follow-up dates.

            She further defines counseling as “a supportive process by managing a staff member or team define and work through personal or work related problems that affect job performance.” Career counseling insists on staff member or team accountability, with an expectation of success. 

[Margaret Minor. Coaching and Counseling: A Practical Guide for Managers (Los Altos, California: Crisp Publications Inc., 1989), 2].  

            A mentor is described by Mary Jane Balzar as “an individual with experience in a particular area who offers to share that expertise with a staff member or team who is still learning and guide that individual or team to greater awareness or ability.” It involves not only teaching specific skills for doing a job, but also survival skills such as handling the politics, negotiating with others and communicating effectively.

            Mentors usually have similar goals, values and personalities. The mentor can also be a nurturer who can listen and guide the staff member or team through a dilemma or crisis. It can even be considered a tool to be used in professional career development and effective team building.

            Role modeling for another or a team can often be described as the most important method used by the mentor. Mentoring can also be considered a “growth process” when someone is observing the staff member or team in action.  

[Mary Jane Balzar, “The OR Manager as a Mentor: Paving the Way for the Future,” OR Focus (1989); 5 (4): 5]. 

            Whether the situation requires a coach, counselor or mentor, the effective manager should use the technique of increased listening to provide feedback regarding what they heard to ensure that they heard it correctly.

            The skilled manager will generally use questions to further identify and clarify what is being discussed. Both parties must be prepared for the discussion, whether they are formal or impromptu. In fact, there is probably more “quality” in the coaching and mentoring in an informal arena.  

Managers and Decisions 

            Manager’s may ask, “What decisions are left for me to make now that the staff members of the new team are supposedly empowered?” This way of asking may lead to more confusion because it assumes that “getting to” make decisions is a goal in itself. It is far better to focus on how the get the team goals accomplished, then on whether the manager, staff members, or the whole team ends up making the decision.

            Who makes the decision may depend on expertise, how many staff members will be implement the project, and who is closest to the situation requiring a decision. Managers and staff members working together can optimize their time, talents, and learning curve as the team benefits from the empowered approach.

            Even though the manager’s behavior may not look like the boss of the old organization, the work may be getting done far more effectively and the patient’s needs being met more responsively. It takes enormous self-confidence as a manager to let go of the old ways, remove barriers, and ensure that the vision of the future involves empowering staff members.

            The staff member’s behavior may look more like leadership than the subordinate mind-set of the past. This is progress! Even though it may at first feel uncomfortable, everyone (team members and managers) stand to benefit from empowerment.

            In the past, managers managed the workers. Now, more than ever, all of the staff members will manage themselves and the managers will manage the environment in which the staff members work. Ultimately, managers who effectively led the empowerment effort and let teams make the decisions realize a great deal of personal growth and satisfaction. They also find that the power available to empowering managers actually increases the more it is channeled to others.

            So, how does an empowered manager let go of the decision making process and let the team handle the decisions? Robert Crawford has suggested the following challenges for managers is assisting teams make decisions: 

·        Alignment 

Managers should spend a lot of time clarifying goals and strategies that integrate them horizontally with peers in other functions or units. Coordinating vertically can give staff member’s knowledge of the organization’s goals via a big picture and what measures it is using for productivity standards.  

·        Resources  

Managers should provide the best tools and expertise needed for team success. This may include budgetary information, systems, technical support or the actual addition of staff members.  

·        Coaching  

The manager is responsible for coaching members to make decisions by guiding the improvement process with team members. This is accomplished by role modeling, providing feedback, facilitation and mentoring.  

·        Training  

Managers can identify and find ways to develop knowledge and skills in the areas of current and future needs as well as cross-training and continuous quality improvement activities.  

·        Information  

Team members need all the information they can get! Information is power! Managers can provide the needed information in a user-friendly format in order for the teams to provide better patient satisfaction.  

·        Climate  

Showing respect to team members and encouraging the same from team members are the pillars of an empowered work setting. The climate should include trust, respect, confidence and a true working partnership.  

·        Rewards and Recognition  

Team members should be rewarded for providing excellence in patient service and satisfaction. Necessary policies should be patient driven, not management driven. This results in managers and team members focusing outward rather than continually thinking about internal matters.