Teambuilding: A Critical Step in Creating a Healthy Work Environment in Schools of Nursing

Saturday, 23 February 2019: 8:30 AM

Linda C. Comer, PhD, RN, CNE
Carrie Riley Risher, DNP, MA (Ed), CMSRN
School of Nursing and Health Sciences, Florida Southern College, Lakeland, FL, USA

This presentation will discuss the transformation of the culture of a school of nursing in a small private liberal arts college to create a positive work environment that fosters the physical and emotional health of faculty, staff and students. The health of the environment within a school of nursing is critical to the retention of faculty and students, ultimately impacting the long-term viability of the academic unit (Clay-Robinson & Ruth-Sahd, 2017).

One of the first actions taken by a new dean was an assessment of the faculty work environment. It was discovered that there had been much faculty and administrative turnover since the addition of programs and a change to the school vs. department structure. Faculty members with longevity expressed residual feelings of mistrust and recounted instances of bullying. New faculty members were optimistic and eager to work to create a positive environment. The dean and nursing leadership (program directors and coordinators) decided to prioritize healthy work environment as a pillar of faculty retention, a marker of effective shared governance, and in line with the ANA 2017 Year of the Healthy Nurse initiative. A social ecological model provided a multi-level and multi-pronged approach, impacting the structures, culture, and inter- and intra- personal relationships (Pacers Civility Toolkit).

The leadership team adapted the American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Tool (2016) for use with faculty. Despite overall positive results on the survey, the team decided to develop and implement a plan to enhance faculty health. Components of the plan included: teambuilding activities, a civility workshop, a movement and exercise focus, opportunities for socialization, health and self-care support group, and shared governance structures. Exemplars from other schools of nursing (Fontaine, Koh, and Carroll, 2012) provided a starting point for the team’s planning. Faculty self-reflection and insight were overarching values of the leadership team, as they are key to promoting a healthy work environment (Bolton, 2018).

An early faculty retreat included team-building activities by an outside facilitator, allowing the faculty to get to know each other’s interactions styles in a nonthreatening manner. Teambuilding activities were included in subsequent faculty meetings. A second appreciative inquiry retreat was held where faculty members identified aspects of their work that were extremely satisfying. Faculty members were provided individual copies of books promoting individual and team ownership of the work culture (Tye, 2014). A civility workshop based on the PACERS Stop Bullying Toolkit was provided at an all-day faculty retreat. One nurse leader began a “stop, drop, and walk” initiative which provided an opportunity to move and socialize during the workday. Other opportunities for faculty socialization were potlucks, social events, and group activities. A faculty member organized healthy nurse support meetings where faculty selected goals, tracked progress, made vision boards, and held discussions about self-care and healthy lifestyle habits. Faculty meetings included continuing education in emotional intelligence and its importance for faculty and for nurses in general. The dean created opportunities for participation in shared governance structure within the school, increased transparency, and promoted the free exchange of ideas.

The implementation of this initiative faced some interesting challenges, beginning with resistance among some program directors to the civility survey. Honest discussion of feelings and concerns resolved the issue. Another challenge was perception by a few faculty members of shared governance as “extra work” to serve on committees and take ownership of faculty responsibilities. Fortunately, the majority of the faculty was eager to be a part of creating a school they could be proud of, one that functioned in a healthier manner. There were also many successes during implementation, including increased collaboration and enhanced scholarly productivity. When faculty understood the priority that was being placed on their well-being, they spontaneously created activities to enhance the work environment that added to the planned strategies.

The outcome of the initiatives included a work environment where faculty report feeling that their input is valuable and valued, where they have the freedom to speak up and to be creative in their teaching and scholarship. The faculty members are very generous with each other as they collaborate and better understand each other’s work styles. Faculty members have developed collaborations for scholarship, and scholarly productivity has increased each year. There have been no complaints of bullying or exclusionary behavior in over a year. Faculty turnover has dramatically decreased (from 40% in 2016 to 0 in 2018. Plans are in place to reassess the work environment using the adapted AACN tool this fall. Faculty perceptions of the work environment will also be qualitatively assessed during dean meetings with individual faculty this fall.

An unanticipated positive effect was infusion of the concepts of healthy work environment into the student experience within the school. Faculty brought content about self-care and wellness into the classroom, planned activities to enhance the collaborative relationships among students, and developed a mentoring program for incoming students. This spontaneous faculty effort demonstrated their value for the types of activities created to enhance the work environment and their desire to extend this to the future nurses as a part of the social and academic curriculum.

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