Unit managers' role in improving nursing teamwork in a mental health care facility
Oosthuizen–Van Tonder, Mariska Elizabeth
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The nursing team in a mental health care facility is a known dynamic at every hospital, rehabilitation centre and out-patient unit which enables these units to be functional. Currently nursing teams function in a challenged environment in mental health care facilities. The National Department of Health in South Africa states that one of the priority areas in the core standards of health care is to improve values and attitudes of health care professionals. One of the ways to accomplish this is that leaders at all levels should be positive role models to staff to encourage a culture of caring and positive attitudes that supports service delivery. However, mental health care in practice is in contradiction to this ideology of how mental health should function. In reality, regular involuntary treatment, minimal patient contact with therapists, negative attitudes, pressure of beds not being available as well as regular seclusions due to unmanageable situations are experienced in practice. The aim of this study is to explore and describe the role of the nursing unit manager to improve nursing teamwork in a mental health care facility in Gauteng in order to improve the quality of health care. A qualitative, explorative, interpretive descriptive and contextual design was selected to address the research question at hand. Non-probability, purposive sampling was used. A focus group discussion was held (n=8) and graphic team sculptings were done with each participant (n=9). The state of the current nursing team was described and explored as well as the practical intervention aimed at improving nursing teamwork. Data of the focus group was analysed using content analysis. Graphic team sculptings were analysed by interpretation analysis. The results of this research study indicated that nursing teamwork is influenced by various factors that can be categorized as organisational-, unit specific- and unit manager specific factors. There might be a negative organisational culture and negative attitudes of team members. There is uncertainty in the hierarchy structures, below the unit manager that causes power struggles, this has an effect on the responsibility and accountability in the absence of the unit manager. Individual team member’s needs constant supervision and direction to complete their daily tasks. The unit managers feel like there is poor support from top management. The general ward assistants and administrative clerks is seen as part of the team, although they are not directly involved with patient care, they contribute to the teams functioning. Mental health care facilities are overcrowded and this increases the workload of the nursing team. Trust and cohesion within the teams is low with poor communication between team members due to clique formation. The unit manager plays a vital role through leadership, collaboration, fair delegation and guidance. Individualism and diversity should be embraced. The unit managers acts as a role model and leader that bring the teams together and solve problems, facilitates effective communication and involves all the team members in decision making.
- Health Sciences