Importance Of Effective Teamwork And Reflective Practice In Nursing

Group Activity Undertaken

Discuss about the Theory of Knowledge Emergence in Teams.

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Health care is a dynamic sector and nursing profession is an integral part of it. Nurses are the frontline carers of the patients and thus, team work is the crucial part of this business. Health care today involves multidisciplinary approach to care. Nurses do not work alone and collaborate with the specialists, fellow nurses and physicians to provide comprehensive care to the patients (Gausvik et al. 2015). This calls for effective team development skills and working collaboratively on the group projects. Thus, effective team working skills is important in nursing practice. In this reflective paper I would like to reflect on my experience of group activity undertaken as a part of my curriculum.   Reflection is considered to be an essential skill for students and nurses. It helps one realise their own thinking process and actions in a situation. Reflection is the assessment of the how and why of the learning or an event encountered. It helps determine strategies to be taken as a result (Nicol and Dosser 2016). According to Carter et al. (2017) Nursing and Midwifery council reflection and learning improve practice as it helps to make better sense of work situations. In my group project my team of five members focused on evidence based inquiry. It is because enquiry based learning is essential to empower nurses for future practice in health care setting. There are different models of refection and all most all form a basis for reflective thinking. In this reflective paper the Gibb’s model of reflection would be used to reflect on my experience and my team members performance in group project (Nicol and Dosser 2016).  I would evaluate my personal role in the group, strength and weakness and impact on my group and its outcomes.  The aim of the reflective paper is to demonstrate the theoretical understanding of team development and group process, new insights developed by the collaborative process and its application in future practice.

I have formed a group of 8members for practice development seminar. All the 8 members were to work together in specific task that is abstract for the seminar theme “Journey”, that is developed for the enhancing quality and safety of patient centered care by nurses. The group was supposed to present the power point presentation to share the findings from research. There was no specific protocol followed to form this group. It was a causal process of forming stage (Natvig and Stark 2016). The motto of the group was to work interdependently, avoid any miscommunication, share knowledge and responsibility. This aligns with the principle of the group dynamics mentioned by Hassell et al. (2016).  It was initially challenging to work in group as I was expert in making individual presentations. We have never worked before, so after the formation of group initial communication was through Blackboard discussion board.  To build rapport we signed to flock™ – a communication and collaboration platform It helped us communicate frequently while building significant relationship with each other.  It was versatile APP for mobile phones.

Reflection on Personal Role and Evaluation of Strengths and Weaknesses

In our first meeting regarding the seminar, we planned to meet and discuss roles.  I was selected as the team leader. We decided to work together on sequence of topics and task was allocated as per group guidelines. Later I had allocated each member to work on separate topic after they had confirmed to it.  I have given separate deadlines to each one of them based on their feasibility. The presentation theme was chosen based on individual’s feedback and opinion in second meeting. It was a joint agreement and everyone’s ideas were respected. The third meeting involves preparing of drafts and establishing deadlines followed by finalising of drafts in 4th meeting.  By 5th and 6th meeting all the tasks were done except the compiling of the documents and submission. My contribution to the group presentation was written speech, seminar plan and the first abstract. 

I was nervous and lacked confidence in team development. I had never worked before with group of eight members. I only perceived the group as task focused only. Later I decided to start the group with an open and positive communication system. According to Natvig and Stark (2016) the importance of team development lies in Tuckman’s process. The process of team development was described  by Tuckman through four stages. It includes forming stage, storming, norming performing and adjourning (Natvig and Stark 2016). Applying this theory or model helped me with successful team development in short span of time. It is considered an effective model in sustain team development through a systematic process. 

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 In the forming stage I was polite to the members and positive. My team members were anxious as they had no idea what to do. I am happy and satisfied that at this stage I could play a dominate role to explain the tea members roles and responsibilities and stay connected through social networking sites. In the storming stage I had delegated tasks to every member and they were pushing up their limits to give their best. At times they were uncomfortable with my ideas; however, it was sorted due to mutual understanding.  In the norming stage, out group started to resolve the individual differences occurring when the seminar was in finalising stage. It was tough time for me as there were some conflicts occurring. However, it was resolve as my team members respected my authority as unbiased leader. I had helped my fellow members to take responsibility.  The team then reached the performing stage to fulfil the team goals. At this stage it was easy for me to be part of the team. The guidelines I have used for team development helped to prevent the disturbance of performance. I was delegating the tasks and focusing on other goals.  It helped me better develop the team members. In the adjourning stage, we have achieved the team goals and celebrated the moment after successful presentation of seminar. At this stage I have developed close relationship with members and there was no moment of awkwardness.

Group Performance and Outcomes

I was really nervous about the group process as I was new to such big group. However, I was wrong as everything worked properly. Although there were conflicts,  it was easy to handle and our group did perform well at the seminar. It will help me develop effective nurse’s group in future in multidisciplinary setting to give high quality patient care.  More than the size of group, it is important to have the group cohesion. According to Engleberg and Wynn (2014) a group of less than ten members are productive. Our group comprised of 8 members and there was a good collaboration.  The reason for successful seminar was a good level of team bonding, encouraging each other, committed to common goal, trust and respect for each other.  During conflicts and disagreement over ideas I felt distress. However, I realised that it would hamper the team performance due to poor dynamics (Ahmed 2018). Overcoming conflicts with positive attitude eliminated negative interactions and uncertainty.

It was easy for me to communicate in small groups but in group of 8, I was uncertain about communicating effectively. I was worried about rising of miscommunications and poor bonding as all the members were from nursing background and schedule was hectic. However, communication right from the forming stage was effective. I believed in the positive and negative criticism and therefore, I was encouraging my team members about sharing of ideas and opinions. Our group made its sure that we were respecting each other’s viewpoints and demonstrated sensitivity. It was supported by Streeton et al. (2016) who argued that positive collaboration could be enhanced   by ensuring both verbal and nonverbal communication. It is essential for nurses for multidisciplinary collaboration. The name of the theme as “Journey” was based on mutual agreement. According to Lee et al. (2015) in the early phase of the group process it is effective to establish the standards and expectations of the collegiality. Working mutually eliminates conflicts among team members ensuring better outcomes for the group project. Therefore, I had established a strong communication element right from the forming stage. Being aware of consequences of poor communication helped me detect potential problems at an early stage as also supported by Hassell, Talbert and Fisher (2016).  This factor enhanced the collaboration and harmonious decision making an element that is a challenge in group dynamics

I could connect with my group respectfully right from the first teleconference meeting.  It was a connection similar to having a family life. There was a commonality and it allowed to have sense of respect and shared understanding that is also brought about by studying and working.  I was proactive in reorganising roles with my team mates whenever there was a crisis. It was a positive change inside me as I had difficulty in trusting people who are not closely bonded to me.  With the help of Flow App it was easy to build trust and sense of confidence, even when at times it was difficult have team meetings. I believed in being transparent with my views and team goals.  It enhanced the mutual trust and respect. It gave my group members the confidence to openly criticise my views as well.  The qualitative study by Choi (2018) argued that positive results could be achieved in group project by establishing trust and respectful environment.

Importance of Effective Communication and Positive Collaboration

On reflecting on my coordination skills, I was initially bad at coordinating things as I used to mess up.  For this group project I decided with my group to start with the blackboard discussion before proceeding with Flock and teleconference sessions. The whole process flowed smoothly because of the prewritten agenda. It was something different from my usual approach where I was disorganised and always changed plan at last moment. My decision to set up guidelines and work through framework was successful. I was overwhelmed with my positive decision. Else it would have affected the efforts of all the members in the group. The idea is in alignment with the viewpoint of Gagnon and Roberge’s (2012) that emphasised on preplanning the peer engagement process and having the team goals and agenda of team meetings structured.     It prevented the messing up of work and saved huge time for us to delegate tasks and be comfortable with individual roles.  It enhanced the coordination element of the group process an important aspect of group dynamics (Forsyth 2018). 

I was quite anxious about how to ensure cooperation from my group members. As each member was willingly sharing their insights from their expertise, it helped me move near to our aims.  It was my own willingness to seek information and share knowledge enabled the group members’ commitment.  I ensured that each member submitted his or her own research and contributions to seminar to Flock. It allowed the other members to also participate proactively. This step to promote cooperation aligns with the   viewpoint of Grand et al. (2016) that emphasised that unco-operative group members limits the documented benefits of group work.

It was difficult for me to decide the way to assign roles to the individual members in the group work. This was the vital process to complete the assignment. I approached to this process sequentially by making best use of the each team member’s skills. In each meeting I have discussed the responsibilities and roles of each member. In the meeting minutes the delegation was reiterated. To strengthen the accountability and responsibility factors of the group work I have not created any specific agenda or theory. It delayed the process of allocating specific roles in the beginning of the project. I realise I should have used more of my imagination and creativity in recognising the skills and talents of individual group member. It would have served as support for new ideas as each member was different in thinking. However, with little effort of mine my team members did play their individual roles well.   They questioned the task required of each of them and together we discussed and documented the responsibilities of each member. It ensured the accountability of our actions. According to Forehand et al. (2016) a group work can be successful only if the initial planning stages established the sense of responsibility and accountability. Further, balancing the intertwined responsibilities is essential for nurses in intensive care practice (Bjurling-Sjöberg et al. 2017).

Improvement of Coordination and Team Development Skills

During the initial stages of group work, I have felt less assertive or confident. Even different members of the group had different levels of assertiveness. It was an effective decision to stay connected with Facebook and Whatsapp as it helped members to discuss grievances with roles.   It was something not possible during team meetings or teleconferences. It was easy to contribute ideas to flock even when was less assertive. It had positively impacted the team dynamics. Using multiple forms of communication prevented our group dynamics to shift to autocratic process (Levi 2015). However, being les assertive was my negative factor to be overcome as it sometimes hampered delegation. 

I was more than happy to work autonomously being a part of this group while not compromising on the group goals. I always had strong preference for autonomy. At the same time I had made intense efforts to balance the autonomy and collaboration. It was facilitated by the mutual trust and respect among group members. It fostered group involvement where each member’s autonomy was acknowledged. Such balance is considered to be important in strengthening in group process as per Grand et al. (2016).

On researching about the effective leadership style, the literature was found to have bulk of information about the positive implications of transformational leadership style.  Reflecting on my leadership style, I could well implement the transformational leadership style though at time I did resort to autocratic leadership style. It was mainly due to lack of confidence and lack of good observational skills. I could not perceive the individual’s talents and skills and I had faced difficulty while allocating roles to them.  Some of the team members were very participative and possessed the quality of the democratic leadership. It compensated for my lack of assertiveness and poor coordination skills during initial phase of group work. According to Vaismoradi et al. (2016) democratic and transformational leadership style both has more benefits than demerits, in leading a team successfully. However, as per my team feedback I need to improve on my transformational leadership skills and avoid being autocratic to facilitate cooperation among group members as well as coordination. Transformational leadership style is essential in nursing practice for mentoring fellow nurses and juniors as well as personal development (Woolnough and Fielden, 2017, Cunningham et al. 2015).

Reflection helped me realise my strengths and weakness based on the group project.  The major issue was lack of confidence and low assertiveness. It was through effective and open communication from my peers in the team, that I could overcome the problems. My active listening skills were an added advantage. Secondly, I was poor at identifying the skills and strengths of each member in my team. It was challenging to assigning roles to individual member.  It was because the group was proactive and we had multiple communication channels like Flock, Whatsapp and others that it was easy to sort out grievances about roles and resolve the confusion. I could make a good decision to use multiple communication channels. Though I was autocratic at times, I could better compensate it by adopting transformational leadership style. It helped me encourage honest feedback and sharing of knowledge and ideas. It clarified thoughts and helped to find the right solution.  It positively contributed to the group dynamics. By documenting each step towards the group project through Flock I could ensure responsibility and accountability of each member, which was essential for harmonious group work process. In short I think I am good but not excellent at organising, controlling, and delegating task which are an important skills for nurse leaders and managers. I am grateful to get an opportunity to reflect on my experience as it helped me realise my areas of improvements.

Conclusion

Conclusion

I think I should practice being more confident in  my work as at times my ideas were not accepted even though it was worth it. I should work on being more assertive and improve my negotiating skills. I need to improve my innovation and imagination to better able to allocate tasks to members of my team by assessing their individual strengths and weakness.  It is needed as I have to deal with nurses in multidisciplinary setting with different strengths. I need to further improve my transformational leadership traits for being effective nurse leader in multidisciplinary setting as well learn situational leadership style so that I could implement the best leadership style depending on the situation. I must learn excellent organising, controlling and conflict resolving skills.

In future, I plan to overcome my weaknesses by participating in more workshops and seminars to gain confidence. I would engage myself in community volunteering activities to deal with people from different cultural backgrounds. It will help me develop awareness of self and others which will guide to assess individual strengths and weaknesses. It will enhance my delegation and controlling skills. I will be more confident in delegating and negotiating in future projects   to come up with best possible ideas. I can be more assertive and confidence during personal interactions and feedback on other’s performance.  In future, my plan is to implement evidence based framework for resolving conflicts and improve team dynamics for success of team goals.

In conclusion, the reflection on my group assignment has improved my self-awareness.  I am grateful for this opportunity as I could identify my areas of strength and weakness. Gibb’s reflective model is an important tool that contributes to continuous personal development. It is systematic process of reflecting on a particular event so as to evaluate all the aspects related to it. It has helped me realise what to do in similar situations in future.  In nursing practice team work is inevitable. With the help of this group assignment I could enrich my Knowledge of planning, organising, task delegation and controlling skills. I have learned the concepts of effective communication in team development. For future practice I must learn better strategies to act more confidently and negotiate. Using some of the strategies based on evidence helped build team cohesion such as respecting each other’s opinions, maintaining responsibility and accountability of actions and sharing honest feedback. I need to learn more strategies to solve conflicts when working with diverse group. The key learning from the reflection will be implemented in future nursing practice for professional development.

References

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Woolnough, H.M. and Fielden, S.L., 2017. Mentoring in Nursing and Healthcare: Supporting career and personal development. John Wiley & Sons.