For a team to be successful, leadership and development are essential. This essay will discuss a variety of leadership and management theories, providing guidance for effective teamwork. As well as referring clinical skills and knowledge, the essay will include descriptions of what teamwork means, effective communication, and how to develop personally. It will also include a review of the personal development I experienced during my new programme as a trainee nursing associate, and the importance of reflecting on your own practice.
When people are working as a team, they all have the same goal in mind. Effective, collaborative working requires communication within the team. It promotes teamwork and patient safety. It brings together the diverse ideas of the participants in a way that produces the best possible outcome. The therapeutic standard of care for patients is reached by having a high level communication, coordination, and collaboration (St Pierre 2011). There are different ways that people communicate and deal with issues within a team. Tacit communicators use non-verbal communication methods, as they assume the other person knows what’s being asked. The efficiency of a team could be affected by this alone. This assumption could lead to tension or friction within a group. Communication is essential for a team’s efficiency. It is essential to communicate clearly and confirm that you understand the service user’s needs. Team members can achieve their goals by working together. Closed loop communication is required for explicit methods. This helps to minimise risk and reduces error. This check ensures both that the message was sent to the right person and understood by their recipient. Communication in a closed loop is essential for teams to function smoothly.
To achieve the desired goal, team members need to share a common understanding (Endsley 2012). To reach this goal, employees must have the ability to take initiative while also being aware of collective efforts by other team members. (Gluyas & Morrison 2013, 2013) It may take some time to develop professional relationships which create a team-like dynamic. Tuckman’s models is one theory to support this. He observed that groups never reach their potential at first and need to grow through different stages. When observing team dynamics, he found two things that were similar: group and interpersonal structure and the activity of the tasks. Craig (2015) explains that this helped him to develop his theory of group evolution through four stages. Tuckman describes this model as the forming-storming-norming-performing model (Tuckman 1964). Tuckman understood that forming a team was not an easy task and that it would take time to get teams to a stage where they were functional. Belbin thought that for a team to be effective, it needed individuals that worked well together. Belbin created a nine-role list that was evident within teams, resulting in a well-balanced workforce. He believed that by categorizing people, tasks and schedules would be easier to allocate and complete. (Belbin 2010). These roles include: Plant, resource investigator, coordinator, shaper, monitor evaluator and specialist. Belbin appears to be a proponent of individuality. He acknowledged that everyone is not perfect but that a team would still succeed if they all understood their roles. Tuckmans team-working model is difficult to apply in large organizations such as NHS.
Tuckman argues that the team needs time to grow and become effective. Team members may leave the team before it reaches a high-performing status. This leaves a gap that needs to be filled. Belbins’ theory is a useful model for teamwork, especially in the NHS. It allows teams to be individual without having to assume roles that are not suitable. The behaviour of an individual in a conflict situation is usually categorised as either assertiveness, or cooperativeness. Thomas and Kilmann presented five conflict resolution strategies: Avoiding, Compromising, Collaborating, and Competing. Each approach contributes in its own way to conflict control. A person must be able and willing to deal with conflict. Conflicts usually lead to heated arguments and high emotions. Being socially and personally capable is therefore essential. It is important to be able to effectively communicate with your team and resolve conflicts. Teams that include meetings, like huddles or ad-hoc discussions, can solve problems and improve communication.
We hold weekly meetings with my service users in order to hear any complaints or compliments. The attendance is made up of staff from the unit, management and users. The maximum capacity of my unit is 13 service users, but we rarely have more than half the staff attend meetings. In addition to unit meetings, staff also provide one-on-one sessions with key workers to offer a more personal package of care. The meetings are often where the complaints get raised. So, a low participation rate was a concern. The low attendance was affecting resolutions. This caused agitation by service users. I was given the task of announcing that the meeting would begin and approached service users. After several rejections, i decided to contact service users once again to ask for their input. The level of cooperation I received from the service users was very pleasant. This small modification allowed service users the opportunity to voice their concerns safely without needing to address a large crowd. While I made this change, my concern was for the basic daily activities of service users. When service users did not inform staff about any problems, they were either left unassisted or received substandard care. When asked what issues they were facing, a customer complained that his bedroom tap didn’t work. In the absence of information, staff could not support a simple activity like washing. Service users who do not meet their needs will not be able to receive the health care they need (Care 2018). In addition, the mental health of service users was also a concern. In addition, his acute ill health could have affected the mental state of his client. The service user in question had a hard time being social. The need for him to remain in his room in order to avoid staff was not met. Many people with severe mental illness have a social dysfunction that can lead to the most distress. (Bellack and others, 2007).
Maslows Hierarchy of Needs is the best leadership theory I have found to date. Maslow stated that it was important for people to satisfy their basic needs before they can feel capable of achieving other needs like safety, love, and esteem. Abraham Maslow developed an order of needs that can be used by leaders to mould their style of working with a group. Maslow suggested a hierarchy of needs that could be used by leaders to customize their style according to the followers’ needs (Mack 2018.) Maslows motivation pyramid has five levels. These include physiological needs, safety and security needs, love and belongingness, self esteem, and finally, self actualisation. Leaders are less concerned with the motivations of their workers and can help them achieve optimum performance by assisting them to reach these bottom-up motivations. In acute mental health settings, where people have less choice and are restricted in their choices, the basic needs are crucial. It can be detrimental to a person’s social functioning or recovery if their needs aren’t met (SCIE 2014). As a leader in this activity, I had my own needs at the top. To have a team that is effective and service users who are satisfied, I needed to change my approach. As I support service users’ privacy rights and encourage them to bring up issues individually, a larger number of concerns or issues have been raised. I had to think about the needs of my clients in terms of safety, security and physiological requirements to ensure that this idea was successful. This allows staff to better attend to service users’ basic needs without impacting their recovery and wellbeing. John Adair’s Leadership Theory is another theory I would use in my clinical practice. He developed a diagram of three circles that highlighted the need for leadership. Adair stated that a good leader helps to achieve the task, create synergy, and respond to needs (Valuing-your-talent-framework.com, 2018). Adair’s leadership model is based on the belief that no matter what level of leadership one is exercising, it must always be mindful of individual, team, and task needs. The theory can be used to apply in any situation regardless of leadership level.
In considering the influence of this theory in my field, I discovered numerous points which were applicable to my leadership. Adair pointed out that there were eight functions of leadership which could help in leadership. The task was to define the following: Planning, Briefings, Controllings, Evaluatings, Motivatings, Organisings and Setting an example. (The British Library, 2018.) In preparation for the change in the practice area, I set the task, and ensured it was specific and measurable. It also had to be realistic, time-bound, and achievable. It appeared that my task was straightforward and simple to implement. I discussed the changes with my colleagues and explained how simple it was to make the change, as well as the potential benefits. I told the team about my idea and followed Adair’s three circle leadership model: Empower people, Build a team, and Complete the task. By delegating well and asking my colleagues for their opinions, I was able to control and evaluate the change. I encouraged my team to stay motivated by reminding them about the improvements we could achieve. I organised the change through a list that included tasks and resources. Notepads are a good example. They can be used by both staff and users to take notes during meetings. The service users will also feel empowered, as they’ll be a part the team.
I held the first meeting to introduce our new method of working with staff and clients. This practice area has been very successful in communicating with users, promoting their privacy rights and ensuring they are supported in their basic needs. My change has had a phenomenal impact. The mental health of service users has improved. Staff have become more aware of how to address each complaint in a unique way, adapting their service to suit the needs of clients. (Nottingham.ac.uk, 2018). In the past, I would support nurses physically who attempted to deescalate a difficult situation. The staff prefer de-escalation before any restrictive intervention (NHS Anonymous 2018,). If a user was physically or verbally aggressive, I could help with restraint if necessary. I wouldn’t communicate with a service user unless he or she asked a direct question to me. In order to avoid being perceived as stepping out of my team role, I would let the nurse de-escalate the situation. The service user started to threaten the nurses, and eventually rushed towards her and struck her cheek.
We both applied level 3 restraints during the movement. Following my AVERTS course (NHS Anonymous 2018,) we reacted to the situation by securing the user. Initially I thought if had I reacted sooner, there may have not been any injuries. I also thought I should’ve intervened when a service user verbally abused staff. During the debriefing, I shared my thoughts on the event. I also noticed that staff members reflected similar feelings. It was a feeling of disappointment that I had. I knew that the staff must be attentive to their patients, watch for changes in their behaviour and recognise signs of de-escalation. I felt like I didn’t react quickly enough to save my colleague. I began to doubt my abilities as a mental health worker. In the beginning, it affected my work performance and mood. In addition, I began to feel physically ill and emotionally uneasy. After reading that this is a common occurrence, it has a significant impact on those affected’s daily lives (Richards and al., 2006). There were some positives. I first realised that the way I approached conflict management had to change if I wanted to feel confident at work. This helped me use supervision from peers and managers more. I am more willing to engage with a client who is agitated and take the initiative in managing their aggression. This confidence can come with additional risks.
Due to my position as the leader, I’m more likely to experience increased verbal and even physical aggression. Also, I may be targeted in the future by service users who are still influenced by past events. By being assertive in my role and participating in the de-escalation process, I will be able to provide a much better service to my client as well as support my colleagues. While writing my piece of reflection, I realised that I had briefly utilised Kotters eight step plan (Kotter, 2018). I recognized that my performance needed to improve to help me recover and receive support. I developed a vision of how I wanted to behave in the future. I used reflective practice and removed barriers that prevented my success. When I initiated de-escalation, management would praise me. Afterwards, I met with management to receive updates on training material that could enhance my practice. I would then reinforce the change and improve communication skills. Kotters model builds upon Kurt Lewin’s Model of Unfreeze Change and Refreeze (Burns, 2004). This model of reflection has helped me to become more confident and engaged when I am dealing with challenging behaviour. My approach to strong emotions is another area that could be improved. I know that I get anxious when I see a client who is upset or crying. This course has broadened my knowledge and I think it will help me shape my approach. In order to improve my service, I need to have a solid foundation of knowledge. As a conclusion, management and leadership theories are important in the change process.
They improve service delivery, notably in the healthcare sector. Personal development is also aided by them. Teams can achieve a high level of efficiency and communication by using these theories. Communication is key to the success of any team. Therefore, a team that has a good standard of communication and unison will be successful. Maslow, Belbin and Tuckmans theory is crucial for effective teamwork. They can influence the performance of teams by their simplicity and efficiency. Kotter-Lewin’s theories assist teams in functioning at a therapeutically advantageous level. They also help team members reflect and develop. As a result of my reflections, i would strongly encourage the NHS’s use of these concepts to support the teams who struggle to work effectively together. If the team members and team leaders use these theories to guide their clinical practices, I think that this will help achieve effective teamwork.
