Nurse as a Team Member: Communication & Group Process

Group activity

Teamwork and engagement enhancement intervention

Type of group

Work group. The group is authorized to complete a certain task. In this case, the task element is the focus.

Group participants

  1. 32 registered nurses (RN)
  2. 2 licensed practical nurses
  3. 15 certified nursing assistants
  4. 6 unit secretaries

Goals/purpose of the group

The goal and the purpose of the group concerns evaluation of the nature and the level of teamwork and the educational needs of the teamwork.

Example(s) of Member Commitment and Cohesiveness

Commitment and Cohesiveness of the group improved the members’ relationships and increased staff communications as well as job satisfaction. Britton (1984) greater cohesion and understanding of work roles and its clarity can be used to show how nurse managers executed a team development program. Similarly, DiMeglio et al (2005) revealed that through team-building intervention, group cohesion can improve turnover rates and nurse satisfaction. The commitment of the staff members was essential element of the teamwork as it ensured that the goals were attained. The staff members were required to be actively committed in:

Teamwork training needs assessment; training in teamwork knowledge, skills, and attitudes customized to the unit; the appointment of a guiding team made up of unit staff and managers who engaged in creative idea generation, testing, and implementation of ideas for change; a comprehensive communication strategy to keep the entire unit staff informed and involved in the project; and follow-up after training by managers and guiding team members to reinforce the new behaviors and ultimately change the culture of the unit to one that supports and expects teamwork (Kalisch, 2005, p.78).

The groups’ leadership style

To improve the staff relationships, two guiding teams were created. Essentially, the aim of the two teams was to improve the relationships between CNAs and the nurses as well as facilitating the teamwork’s quality of care. The leadership and membership of the teamwork followed Kottler’s directions which included “managers, representatives from the different job categories so that all viewpoints would be represented, credible staff with good reputations on the unit so that their ideas would be taken seriously by other employees, and staff with leadership capabilities (1996, p57). All the guiding team members were allocated 5 to 6 unit staff members and were entitled to inform them of the team’s proceedings as well as getting feedbacks from them.

The leadership style was aimed at enhancing the group relationships so as to facilitate the overall accomplishment of the tasks (Homans, 1950). The leaders mainly exercised democratic style of leadership. Team members seemed to get motivated as a result of being recognized as decision makers and being given opportunity to participate fully in the teamwork. Generally, good leadership helped to eliminate team obstacles that could have made the group task unsuccessful (Tjosvold & Wang, 1998).

Type of decision making

To facilitate the decision making process, specific protocols were stipulated prior to the commencement of the project; however, they were open to adjustments in order to suit specific needs of the members. For example, the decision as to which changes to make upon the unit foster team was mandated on the unit staff. The decision regarding what is to be reported to the constituent staff members was made at the end of every meeting. In addition, the feedback for the subsequent meeting was decided at the closing of any meeting. To achieve a better outcome, the team applied participatory decision making process which is based on four co-values that includes: mutual understanding, full participation, shared responsibility and inclusive solutions.

Members’ behavior and participation in the group

The role of each individual depended on the person’s preferences and capabilities. The task roles are played by the team leaders while the maintenance and self- serving roles were shared by the rest of the members. The teamwork engagement was based on principles of teamwork which include staff engagement, change management and training (Mickan, 2000).

Group interaction pattern

The interaction in the teamwork was as shown in Figure 1. From the illustration, it is clear how anybody could communicate with anybody at any time. In other words, the interaction was absolutely participatory.

Group interaction
Figure 1. Group interaction

Power in the group

Power was vested in the managers who represented different job categories. They were selected to ensure that viewpoints from all the categories were adequately represented. In addition, the staff with good reputation were chosen and accorded some authority to ensure that their actions were taken seriously by the members. Any other staff member who possessed leadership capability was given some degree of authority over the team members. Though power was vested on some selected individuals, democracy was highly encouraged and viewpoints from all members were given weight.

Group effectiveness

The group can be considered to be very effective as the relationships of all the participants were well harmonized and managed. This was particularly enhanced by effective system of information transfer and leadership structure. Essentially, the group was guided by a clear set of performance goals and shared values. The working approach was also well defined with all the members having mutual accountability.

Improving group process

A group process that encourages participation of all members in the decision making process usually achieves better results. Different views from different members should be given adequate consideration to enhance the group relationships (Gastil, 1994). A group should work towards achievement of common goal. All the members should actively contribute in the teamwork tasks. In addition, good leadership is essential as it significantly determines success or failure of a team. The team leaders must work towards developing courses of action to overcome barriers that impact on teamwork. The leaders should also ensure that commitments are instilled in every member if the team is to achieve its goals (Tjosvold & Wang, 1998).


Gastil, J. (1994). A Definition and Illustration of Democratic Leadership. Human Relations, 47(8), 953-975.

DiMeglio K, Padula C, Korber S, et al. (2005). Group cohesion and nurse satisfaction: examination of a team-building approach. JONA, 35(3):110-120.

Homans, G. (1950). The Human Group. New York: Harcourt Brace.

Kalisch B, Begeny S. (2005). Improving nursing unit team work. JONA, 35(12): 550-556.

Kotter J. (1996). Leading Change. Boston: Harvard

Mickan S, Rodger S. (2000). Characteristics of effective teams: a literature review. Aust Health Rev, 23(3): 201-208.

Tjosvold, D., & Wang, Z.M. (1998). Cooperative goals and constructive controversy in work teams in China: antecedents for performance, paper, Academy of Management Meetings, August. San Diego, CA: Jossey-Bass.

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