5 Ways to Move Nurse and Staff Teamwork Forward

A culture of strong teamwork benefits both patients and staff, acclaimed chief nurse says.

Inadequate nurse-physician interaction and communication is one of the risk points affecting patient safety, according to one study, but healthcare is evolving to create more of a teamwork approach, says Jeanette Ives Erickson, chief nurse emerita of Massachusetts General Hospital in Boston.

"As nurses, we are connected to the patient's life, whether it's in illness or through times of great joy, or times of personal tragedy, including illness and death. Physicians are more, if you will, disease- and illness-driven," Ives Erickson says. "Over the course of time, both of those roles have started to merge where patients are benefiting from physicians and nurses coming together to develop this sense of team around the patient."

Collaboration and teamwork can provide more than patient safety; they also lead to happier employees, she says.

"Working in a healthy work environment and in a greater understanding of the importance of well-being on each team member leads to satisfaction," she says. "People are working very hard … so caring for and about each other is an important factor today."

Ives Erickson offered five ways for a hospital or health system to bolster staff teamwork and collaboration in its ultimate mission to keep patients safe:

1. Create a strong team that includes the patient

"If you think about the team surrounding the patient, no matter where the practice setting is, if everyone is on the same page, then the plan of care is developed within the team. When I talk about the team, I personally believe the patient needs to be a member of that team," she says. "And so, if everyone is hearing the same thing, and planning the same thing, and acknowledging what each member of the team needs to do to get to the goal that has been set, then the patient is much safer."

2. Make teamwork part of the hiring process

"The whole mission of that organization needs to be based on interprofessional teamwork that's very patient- and family-driven. When members of the team are not valued by [another] member of the team, organizations need to have a mechanism where they talk to the member of the team that [they] might not value. The importance of teamwork needs to be very clear upfront upon hiring, within the team huddles, etc.," she says.

"With the current workload, the teams are working in some instances under-resourced or are working with a lot of new members of the team. So how are we really coming together? It all comes back to those huddles, so that no matter what, the goals for the day are known to the entire team and what the team together can achieve."

3. Embrace handheld technology

"Technology can be a wonderful facilitator if we think about all of the handheld devices that people are using to communicate within the team. Our physician colleagues might not be within the inpatient care environment when the nurse needs to communicate with them. Back in the day, we used to have to call or page them to find them, and now people are using their handheld devices to send each other text messages. It's instantaneous communication that really is a facilitator," she says.

"The days of calling on a telephone would be like breaking the silence when people were trying to do other things and the phone is ringing and ringing. And now you can just look at this text message and respond by either sending the text or calling back."

4. Incorporate teamwork into nursing school curricula

"It first begins in the schools. We used to go in our silos being educated and now there's the recognition of the level of importance of really being educated together. With lots of schools like the one I’m affiliated with, the Mass General Institute of Health Professions, their clinical practicums are with student nurses and students in the therapy programs, and the medical residents or interns are all training at the bedside together. That builds the value in the understanding of what contributions each role group makes," she says.

5. Be an influential role model

"The role modeling that happens between the chief nursing officer and the chief medical officer is of value. Rounding together, holding town hall meetings together, sending out memos together, co-chairing important committees together—that is one of the most important relationships in any organization," she says.

"We also, of course, know that the relationship between the chief nurse and president or chief executive of the organization is very important. The chief nurse really influences how that CEO looks at the importance of nursing—the contributions of the team—and builds that relationship with the CEO that's built on the integrity of the relationships that the team has with each other and with the patient."

"The chief nurse role is so important, and the level of influence that a chief nurse has within shaping an organization becomes more and more important each day and building the support by other leaders within that organization is incredibly important."