Concept Analysis: Team Work in Professional Nursing

1. Introduction

Although many nurses on the frontline in delivering high quality health care services may regard themselves as an army of one, they are still an integral part of an overall multidisciplinary team. Nevertheless, growing shortages of qualified nursing personnel have stretched existing resources to and beyond their limits in many health care organizations today, and the ongoing Covid-19 pandemic and its associated variants indicate the problem can be expected to worsen for the foreseeable future. Against this backdrop, it is clear that identifying opportunities to improve nurses understanding of the critical role they play as part of a multidisciplinary team represents a timely and important enterprise. The purpose of this paper is to provide a systematic review of the relevant literature to describe why and how teamwork in relevant to nursing in general and most especially with respect to staffing adequacy. In addition, a discussion concerning the specific uses of teamwork in the practice setting and a description of teamworks defining attributes, antecedents, and consequences are followed by an analysis of teamworks attributes, antecedents, and consequences to actual practice activities. Finally, a case example of teamwork in nursing and an assessment of its limitations are followed by a summary of the research and key findings concerning these issues in the conclusion.

2. Teamwork in nursing

One of the realities that nurses of all types must face in their professional practice is the need for teamwork in health care settings. In this regard, Anderson, Ross, Lim et al. (2019) emphasize, Teamwork is essential to delivering high quality care and is central to nursing (p. 119). Indeed, not only are the essentials of teamwork typically included as part of nurses curricular offerings, the need for effective teamwork is also consistently emphasized throughout their careers (Roper, Shulruf, Jorm et al., 2018).

Although effective teamwork is highly relevant to all types of nursing, the ability of nurses to participate fully in a team is constrained by the level of staffing adequacy that is available at any given point in time. For example, according to Bragadttir, Kalisch and Bergthra Tryggvadttir (2019), Teamwork and staffing adequacy are significant contributors to patient and staff safety in hospitals (p. 4298). This constraint just makes sense given that the availability of fewer health care staff dictates the composition of any team, but the importance of effective teamwork is not diminished irrespective of staffing levels.

Under optimal circumstances, a multidisciplinary health care team can be comprised of nurses as well as members of all of the specialty areas that are involved. As staffing adequacy levels decline due to the unavailability of interdisciplinary practitioners, however, the ability of health care organizations to field appropriate multidisciplinary teams declines. The implications of inadequate staffing levels for the quality of patient care that is delivered are therefore significant. While such staffing adequacy concerns may only adversely affect certain practice areas depending on which disciplines are in short supply, it is reasonable to posit that the overall ability of health care organizations to provide optimal levels of patient care is directly affected by staffing levels. Some relevant examples of the specific uses of teamwork in the practice setting are described below.

3. Specific uses of teamwork in the practice setting

Effective teamwork has been identified time and again as an essential part of providing high quality health care services in virtually every type of practice setting. The impact of effective teamwork has also been studied in depth and the findings that have emerged from the research to date confirms that teamwork provides a wide array of benefits for patients as well as health care...

…ancillary specialists to consider them as equals remains a salient limitation for close collaboration and effective teamwork. In addition, some team members may lack the requisite communication skills and demeanor that are essential for timely and effective teamwork (Carson, Laird, Reid et al., 2018). Likewise, some practitioners may have an inexplicable but visceral reaction to other team members which can derail close collaboration and effective teamwork.

Finally, perhaps an even more common limitation to effective teamwork in nursing practice is the issue of unresolved conflicts between team members. For instance, the results of a study by Payton (2019) showed that, Unresolved conflict can decrease staff productivity and teamwork, and potentially decrease the quality of patient care (p. 368). The potential for unresolved conflicts between team members also exists in any practice setting, making this an especially significant limitation to effective teamwork.

8. Conclusion

The research was consistent in showing that teamwork in highly relevant to nursing practice, but the level of staffing adequacy has a direct effect on the effectiveness of teams in health care settings. This constraint has been exacerbated in recent months by the loss of nurses due to relentless waves of new Covid-19 infections, and there is no clear end in sight. The research also showed that there is a fundamental need for teamwork in virtually all health care practice settings, but specific tam attributes and antecedents depend on the size and specialty areas of the health care organizations that are involved. Finally, despite the numerous benefits for nurses that accrue to effective teamwork, the research also showed that there are some significant limitations that are involved, including the perception of the importance of the role of nurses by other practitioners and a lack of effective communication skills among team members as well as unresolved conflicts and interpersonal issues between team…