Collaborative relationship and team work

A team is a collection of individuals who are interdependent in their tasks, who share responsibilities for outcomes, who see themselves and who are seen by others as an intake social entity embedded in one or more larger social systems, and who manage their relationships across organisational boundaries. Work teams are continuing work units like operation theatre, wards, critical care units and other important areas responsible for producing goods or providing services. Work teams are directed by superiors who make most of the decisions about what is done, how it is done and who does it.

Healthcare services are expanding their reach in different directions due to various aspects like specialties, research and development and other complexities. These aspects demand more understanding, participation and interaction and cordial relationships. It would be possible to achieve the desired output (better patient care) only by effective interaction, collaborative relationships and effective communication among the various professionals and non-professionals working in the hospital. The situation is such that healthcare cannot be provided by a single individual. In a large sized hospital several persons are a part of the patient care delivery system. The team work and collaborative relationships complement each other.

Team work reflects on how the people working together in an organised setup have opportunities to participate in the team process. Similarly, the collaborative relationship reflects the existence of good communication, faith among the members and respect for each other. These aspects are discussed in Table 2.12.

Table 2.12

Working together in collaborative manner to achieve the team effectiveness Work team relations Grading Staff Nurse Sister

incharges Total Doctors, nursing staff,

class IV employees and administrative staff work together as a team Not at all 6 (2.3) 0 (0.0) 6 (1.9) To some extent 155 (58.7) 23 (43.4) 178 (56.2) To a large extent 103 (39.0) 30 (56.6) 133 (42.0) There is an opportunity to participate in meetings, discussions, sharing information related to nursing work

Not at all 27 (10.2) 2 (3.8) 29 (9.1) To some extent 124 (47.0) 21 (39.6) 145 (45.7) To a large

extent

113 (42.8) 30 (56.6) 143 (45.1) The team members

communicate freely with one another

Not at all 12 (4.5) 1 (1.9) 13 (4.1) To some extent 132 (50.0) 20 (37.7) 152 (47.9) To a large

extent 120 (45.5) 32 (60.4) 152 (47.9) The work load shared

equally among us Not at all To some extent 110 (41.7)23 (8.7) 15 (28.3) 6 (11.3) 125 (39.4)29 (9.1) To a large

extent 131 (49.6) 32 (60.4) 163 (51.4) Staff expertise is

respected by the team members Not at all 20 (7.6) 2 (3.8) 22 (6.9) To some extent 135 (51.1) 23 (43.4) 158 (49.8) To a large extent 109 (41.3) 28 (52.8) 137 (43.2) To a large extent 122 (46.2 ) 32 (60.4) 154 (48.6 ) Total 264 (100.0) 53 (100.0) 317 (100.0 ) (Figures in brackets indicate the percentage of nursing staff) N=317

A nursing staff is involved in collaborative relationships, acting as mentor, student, coach, and support for professional growth of others as per the needs of the patients. She is ethically informative, is good at decision making and practices values she and her hospital subscribe to. She communicates, critically thinks and follows ethical guidelines concerning clinical and professional practices. Only 40 per cent of the staff nurses and 57 per cent of the sister incharges feel that they are working together with doctors, class IV staff, and other administrative staff in an organized manner. However, the degree of cooperativeness depends on the cases, such as emergency, routine and non routine patient care services. It is to be noted that the quality of healthcare services could be achieved mostly by the means of team work. It is reported by 43 per cent of staff nurse, 57 per cent of the sister incharges and 45 per cent across both categories that there is an opportunity to participate in meetings, discussions and sharing the information with the team regarding the

assignment carried out by the team. This statistic reflects that only half of the staff is comfortable with the existing situation and there is a high scope for improving participation through team discussions on the matters related to teamwork. Hence there are greater opportunities for the team members to get an opportunity in planning and executing work in their field. This shows that there is inadequate attention focussed on the autonomy of the staff working as a team. This also has bearing on the team members’ communication with each other. Nearly 46 per cent of the staff nurse and 60 per cent of the sister incharges feel that they communicate freely with one another. Regarding the other important aspects like sharing work load it has been reported that 50 per cent of the staff nurse, 60 per cent of the sister incharges feel that the work is distributed equally among them. Similarly, 46 per cent of the sister incharges and 60 per cent of the sister incharges feel that their expertise is effectively used and is respected. The nurse staff are part of the team but they do not have adequate opportunities to participate in the team processes. This can be understood from the Table 2.13. The overall score of the five dimensions of team work clearly reflects that the team effectiveness marginally high at 53 per cent.

Table 2.13

Nursing staff opinion on team effectiveness score

Collaborative Relationship for Team Effectiveness

Present designation

Total Staff Nurse Sister

incharges

Low (50.0)132 (33.9)18 (47.3)150

High (50.0)132 (66.0)35 (52.6)167

Total (100)264 (100)53 (100)317

(Figures in brackets indicate the Percentage of nursing staff) N=317 On a positive note nearly 66 per cent of the sister incharges say that they have many opportunities to take decisions, as they are given opportunities at various levels and on various occasions. Whereas the nursing staff are seen participating in their team only at the routine team activities like work in the operation theatre, ICU, and other some areas and not mainly at the administrative level of team management.