Professional Organization

January-February 2021 • Vol. 30/No. 1 5

I spend more time indoors this time of year because of the colder weather and lack of outdoor activities. Therefore, I usually end up watching more sports than I do during the more seasonal months of the year. I have always enjoyed watching sports, and my two favorite sports to watch are basketball and soccer. I love a fancy dunk after a fast break, and I love to see the soc- cer ball go into the net for a goal. In both sports, there can be 10 or more passes between teammates to create a goal or a basket. Passes that lead to points take skill, coordination, and trust among the players. Those attrib- utes combined create teamwork and, in my experience, teamwork creates the best and most high-functioning teams on a court, field, or rink, as well as on a medical- surgical unit.

When considering skill and how it relates to team- work, I think of roles and responsibilities. No matter how good athletes are at a particular sport, they have a role to play. Similar to a nursing unit, we all have a role to play in caring for patients and supporting our team. Some nurses have a talent for starting IVs and always get the laboratory draw on the first try; some nurses can help difficult patients become calm and coopera- tive, and some nurses are drawn to leadership and cre- ate a safe and supportive environment during the shift. Assigning roles and responsibilities to align with our nursing colleagues’ unique skills or talents pro- motes the best individual performing that skill among the team. When the right people are in the right roles, the team flourishes.

Coordination Coordination of patient care is a hallmark of nurs-

ing. Nurses spend most of their shift coordinating patients’ care from admission to discharge, ensuring patients receive the correct medications, participate in therapies, and get enough nutrition to heal. Running a medical-surgical unit from shift to shift also takes coor- dination and planning. Nurse leaders build a schedule, adjust staffing as the nursing workload changes, and ensure those on the schedule have balanced compe- tencies so high-quality, safe patient care always is pro- vided. Knowing the skills of individual nurses and unlicensed staff is essential in building a schedule that allows for the highest functioning team to be used every shift.

When I was at the bedside, I was often the charge RN. I worked hard to coordinate the activities on the unit during my shift to achieve one goal: everyone working that shift with me clocked out and left at the same time. Nothing gave me more satisfaction at the end of my shift than achieving that goal. I knew we had all worked together to ensure everyone completed their tasks but, more importantly, all the patients received great care. For all of us to leave on time and together, we had to have each other’s backs and care for each other as we did for our patients.

Trust Trust is imperative when talking about teamwork.

As an athlete has to trust a teammate will make the pass to complete the play, nurses must trust a task will be completed when they delegate it to a coworker. Nurses must trust their charge RN and nurse manager are making decisions that prioritize the best interests of patients and caregivers. Nurses must trust their teammates are performing their roles and are ready to help any coworker when needed. Some ways to culti- vate trust among team members include keeping your promises (do what you say you are going to do) and completing a task for a coworker without being asked. Even getting to work on time and being ready to care for patients establishes trust because your coworkers know they can depend on you to relieve them when they are ready to hand off their patient assignments.

I spent 12 years as a nurse manager of a medical-sur- gical unit. The unit specialized in the care of trauma and general-surgery patients. Trauma patients often have complex injuries affecting many body systems. In addition to injuries and any comorbidities, some trau- ma patients also have a traumatic brain injury (TBI). Patients with TBI could be exceptionally challenging, requiring multiple highly skilled caregivers and critical coordination. The teamwork I saw in caring for these patients humbled me every day. Nurses anticipated patients’ needs and worked together to prevent out- bursts from the patient with a head injury, and they performed care in groups of two or three, so they had the manpower needed to address safety issues. Other team members not in the room covered these staff members’ assigned patients without being asked. Teamwork became an expectation on this unit, and

AMSN President’s Message

The Medical-Surgical Unit: A High-Performing Team

Summer Bryant, DNP, RN, CMSRN®

President, AMSN

January-February 2021 • Vol. 30/No. 16

AMSN President’s Message

new staff members were trained to value and perform as a team from the first day. This team had skill, coor- dination, and trust.

Coaching Teams also have coaches, and coaches are every-

where in nursing. They may be your more experienced colleagues, a nurse manager or educator, nursing instructors, or they may even be the new nurse who brings a new skill or knowledge to the unit. To have a successful and fulfilling career in nursing, we need mentors and coaches throughout our professional life. Importantly, we need to be mentors and coaches to others. One of the greatest joys of my career has been to see those I have coached and mentored grow profes- sionally. Early in my career, I oriented new staff mem- bers to the unit. As I served as a preceptor, I always learned something new; more notably, seeing them become highly functional team members was the ulti- mate reward. Later, when I was a nurse manager, I mentored staff who moved into advanced practice roles and became nurse leaders.

Team Building In the same way a team playing a sport has skill,

coordination, and trust, nursing and healthcare teams need these attributes to be a highly functioning team. Team building is a process, and there are ways to pro- mote and improve teamwork on all units. One strategy is to incorporate team building exercises into daily huddles or staff meetings. These exercises can be quick

and easy, and even fun. They assist teammates in knowing more about one another and building rela- tionships outside their patient care. Another technique to improve teamwork is to use simulation. Any sce- nario can be developed and used, allowing teams to practice their roles and learn how to anticipate next steps. Athletes practice with their teammates almost every day, rehearsing game scenarios over and over so they can trust their teammates will be there to execute the designed play. Simulation also can be used to improve communication and delegation among team members.

Working Together The best teams seem to have the best teamwork

even if they don’t have all the best athletes. However, when individuals perform well in their roles, great things happen. I equate this concept to nursing teams on a unit, where nurses and unlicensed staff have a variety of skills, experience levels, and competencies. When a team is working together, a spectator can see and feel the energy produced. It’s a great day on a med- ical-surgical unit when the team is performing at a high level. Everyone smiles more and there are more jokes than complaints at the nurses’ station. There are often fewer call lights because everybody is engaged in meeting patient needs; it doesn’t matter who is assigned to a patient because everyone is caring for that patient. I always wanted to belong to these teams. I hope you can create these team-centered environ- ments on your medical-surgical units.

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