of action-centred leadership."/>
Figure 4.2 Action‐centred leadership.
Source: Based on Adair (2010).
The Code (Nursing & Midwifery Council 2018b) discusses the importance of working cooperatively and of displaying leadership qualities in order to provide the best care possible at all times.
Green Flag
Working cooperatively is part of Practicing Effectively, and all registrants are required to:
1 8.1 Respect the skills, expertise and contributions of your colleagues, referring matters to them when appropriate
2 8.2 Maintain effective communication with colleagues
3 8.3 Keep colleagues informed when you are sharing the care of individuals with other health and care professionals and staff
4 8.4 Work with colleagues to evaluate the quality of your work and that of the team
5 8.5 Work with colleagues to preserve the safety of those receiving care
6 8.6 Share information to identify and reduce risk
7 8.7 Be supportive of colleagues who are encountering health or performance problems. However, this support must never compromise or be at the expense of patient or public safety
Source: based on Nursing & Midwifery Council (2018a)
Both the Code and the Proficiencies (Nursing & Midwifery Council 2018a, 2018b, respectively) share various elements of team working, including effective communication, supporting colleagues and respecting the scope of practice of colleagues and of yourself. These qualities are essential for good teamwork, and every nursing associate should consider them when delivering care.
All healthcare interventions have an interdisciplinary approach. In community care settings, the nursing team work together as a team of healthcare assistants, nursing associates, staff nurses and district nurses. They work utilising the strengths of each individual and their scope of practice. They work in collaboration with general practitioner (GP) services and community specialist nurses. There may also be involvement from specialist medical teams. Should a patient then need to go to hospital, they are cared for by the inpatient services including healthcare assistants, nursing associates, staff nurses, ward sisters, matrons, specialist nurses, the medical team and allied health professionals such as physiotherapists, occupational therapists, speech and language therapists, pharmacists and many others. The importance of effective team working cannot be overemphasised to ensure that the patient’s needs are met fully from all members of the team. The complications that can arise by having so many different professionals involved are high, and the more complex the needs of patients and service users, the more complex are the health services provided. This multi‐agency working means that effective team working is essential. In order to ensure that a patient is cared for effectively in every part of their journey, each individual team must work in collaboration with each other. This requires effective communication, candour, openness and having the common goal of good patient care. Adair’s model of 1973 clearly demonstrates how these elements work together to provide the highest quality and safest care.
Case Study
Jane, a 28‐year‐old lady struggles with lower abdominal pain for three days. As the pain is becoming increasingly worse, she goes to see her GP. The GP diagnoses appendicitis and recommends that Jane goes to Accident and Emergency (A&E) department. As Jane’s friend can drive her there, the GP does not call an ambulance but stresses the importance of attending that day and gives Jane a letter to present on arrival. The GP advises Jane to take an overnight bag with her should she be admitted.
Jane goes to A&E 2 hours later and is seen by a triage nurse who takes a history and does some clinical observations. The nurse associate takes the required blood tests, performs an electrocardiogram and cannulates Jane.
Jane is reviewed by the A&E specialist registrar and referred for surgery. In theatre, Jane is looked after by the theatre team of healthcare professionals, including the nurse associate, the associate practitioner, the nurse, the operating department practitioner, the anaesthetist, the surgeon and then the recovery team.
Post‐surgery, Jane is admitted to a surgical ward where she stays for one night. While there, she receives care from the ward nursing team consisting of the healthcare assistant, the nurse associate, the nurse and the ward sister. The pharmacology team reviews her medication. She is also reviewed by the surgical team consisting of the junior doctor, the specialist registrar and the consultant.
The next day, Jane is discharged home under the care of her GP. As she is mobile, she sees her practice nurse to monitor her wound the next day.
Consider
In the space of three days, Jane was under the care of eight different healthcare teams.
Where could errors in care provision have occurred?
What was important for ensuring no errors in care provision occurred?
How can a nurse associate act to ensure no errors in care provision occur?
Conclusion
This chapter has provided the reader with insight and understanding concerning the various elements of team working and the importance of effective leadership. A team is synergistic when there is a mixture of strengths and abilities working together. Nursing associates bring with them a range of skills, strengths and abilities, and no one team role is more important than any other. The nursing associate must understand their own skills and strengths to help find their place in a team. A team will not survive without a leader who motivates and inspires.
References
1 Adair, J. (2010) Develop your leadership skills, London: Kogan Page.
2 Barr, J. and Dowding, L. (2019) Leadership in health care (4th edn), London: Sage.
3 Belbin, R.M. (1981) Management teams, Oxford: Elsevier
4 Bonebright, D. (2010) 40 Years of storming: a historical review of Tuckman’s model of small group development, Human Resource Development International, 13(1): 111–120.
5 Ellis, P. and Bach, S. (2015) Leadership, management & team working in nursing (2nd edn), London: Sage.
6 Francis, R. (2013) Report of the mid Staffordshire NHS foundation trust public inquiry, London: The Stationery office.
7 Howatson‐Jones. (2004) The Servant leader, Nursing Management, 11(3): 20–24.
8 Jung, C. (1921) Psychological types, The collected works of CG Jung, Vol 6 Bollingen Series XX.
9 Lynas,
