Chapter 18: Building Teams Through Communication and Partnerships


Chapter 18: Building Teams Through Communication and Partnerships
Yoder-Wise: Leading and Managing in Nursing, 6th Edition


1. A nurse manager is experiencing conflicts between herself and staff members. She had tried to develop a team by using a shared leadership model to empower the staff. Staff members are functioning:
a. As a team.
b. Independently.
c. Interdependently.
d. As a group.
A group is a collection of interconnected individuals working together, with a high degree of interdependence, for the same purpose. A team is a unified group that is committed to a common purpose, performance goals, and approach, for which they hold themselves mutually accountable. The conflict indicates that the staff may not be united in a common purpose.

REF: Page 322 TOP: AONE competency: Communication and Relationship-Building

2. The nurse manager used a mediator to help resolve conflicts on the unit. During the mediation process, the nurse manager saw signs of potential team-building. One key concept of an effective team is:
a. Conflict.
b. Task clarity.
c. Commitment.
d. A designated leader.
Team-building involves moving toward a common vision, which requires commitment. Conflict and clarification of tasks are components in the development of this commitment.

REF: Page 323 TOP: AONE competency: Communication and Relationship-Building

3. A mediator suggested that the nurse manager and staff members decide on a method to resolve conflicts. It is important to have agreements about how team members will work together because:
a. If there are no agreements, each member will make up rules about how to handle disagreements and relationships.
b. People are naturally difficult and will not work well together without such agreements.
c. People will naturally ask for agreements about how to be together.
d. A way to eliminate nonproductive team members must be available.
People must agree on the goals and mission with which they are involved. They have to reach some understanding of how they will exist together. Tenets or agreements such as “I will respectfully speak promptly with any team member with whom I have a problem” go a long way to avoid gossiping, backbiting, bickering, and misinterpreting others. Without agreement, people have implicit permission to behave in any manner they choose toward one another, including angry, hostile, hurtful, and acting-out behavior.

REF: Page 333 TOP: AONE competency: Communication and Relationship-Building

4. By following a shared leadership model, the nurse manager believes that staff members will learn to function synergistically. Some teams function synergistically because members:
a. Do not volunteer unwanted information.
b. Actively listen to each other.
c. Listen to the person who believes he or she is an expert.
d. Do not speak unless they are absolutely sure they are correct in their views.
Active listening in a group creates synergy in that team members really hear one another’s ideas and share in decision making.

REF: Page 335 TOP: AONE competency: Professionalism

5. The chief nursing officer decided that the nurse managers need a series of staff development programs on team-building through communication and partnerships. She understood that the nurse managers needed to build confidence in ways of handling various situations. The greatest deterrent to confidence is:
a. Lack of clarity in the mission.
b. Lack of control of the environment.
c. Fear that one can’t handle the consequences.
d. Fear that the boss will not like one’s work.
Fear of not being able to manage consequences undermines confidence and a sense of competency.

REF: Page 341 TOP: AONE competency: Professionalism

6. The mediator noticed that tension was still evident between the nurse manager and staff members. He informed the chief nursing officer that to begin team-building, it would be important that everyone:
a. Work together in a respectful, civil manner.
b. Use avoidance techniques when confronted with a conflict.
c. Develop a personal friendship with each other.
d. Socialize frequently outside of work.
For team-building to occur, team members need to be able to listen actively and respect one another’s opinions, while feeling comfortable in openly expressing their own.

REF: Page 338 TOP: AONE competency: Communication and Relationship-Building

7. The state of being emotionally impelled, demonstrated by a sense of passion and dedication to a project or event, describes:
a. Commitment.
b. Control.
c. Willingness to cooperate.
d. Communication.
Commitment is described as having a sense of passion and commitment to a project without necessarily having a need to control.

REF: Page 329 TOP: AONE competency: Professionalism

8. The mediator suggested to the unit staff that a group agreement needed to be made so meetings could become productive. For example, the group agreement, “We will speak supportively,” prevents:
a. Expression of opposing ideas.
b. Gossip and making negative comments about absent team members.
c. Efforts to ensure that everyone thinks alike.
d. Votes that oppose motions.
This is an example of a rule that a team can implement to prevent certain negative behaviors such as gossip, backbiting, and bickering that undermine the productivity and functioning of a group.

REF: Page 323 | Page 324 | Page 333 TOP: AONE competency: Professionalism

9. The mediator asked each staff member to reflect on his or her communication style. Which of the following best describes communication? Communication:
a. Is a reflection of self-analysis.
b. Is a result of thoughtful consideration.
c. Consists of thoughts, ideas, opinions, emotions, and feelings.
d. Focuses on the sender of the message.
Communication involves both senders and receivers and may or may not be a reflection of self-analysis and thoughtful consideration. It always, however, involves thoughts, ideas, opinions, emotions, and feelings.

REF: Page 325 TOP: AONE competency: Communication and Relationship-Building

10. The staff development educator developed strategies to help nurse managers actively listen. Guidelines for active listening include which of the following?
a. Speed up your internal processes so that you can process more data.
b. Realize that the first words of the sender are the most important.
c. Be prepared to make an effective judgment of the communication sender.
d. Cultivate a desire to learn about the other person.
Active listening means suspending judgment about what is about to be said and listening to all that is said (and not just the first or last words). It is motivated by a genuine desire to learn about the other person.

REF: Page 335 | Page 336
TOP: AONE competency: Communication and Relationship-Building

11. The nurse manager was upset with the staff nurse and said, “You did not understand what I said.” Which element in the communication process was she referring to?
a. Feedback between receiver and sender
b. A message channel
c. A receiver who decodes the message
d. A set of barriers that may occur between sender and receiver
Problems can occur at any point in communication and result in miscommunication. In this instance, it can be assumed that there was a sender, a receiver, a channel, and feedback. In this scenario, barriers such as distractions, inadequate knowledge, differences in perceptions, and emotions and personality may have resulted in misunderstanding between the manager and the staff nurse.

REF: Page 326 | Page 327
TOP: AONE competency: Communication and Relationship-Building

12. As the nurse manager on a rehab unit, you are asked to come to the tub room immediately because two nursing assistants are having a loud disagreement in front of a patient. You ask the nursing assistants to meet you outside and after ensuring that a third nursing assistant is able to care for the patient, you speak with the two nursing assistants. Which of the following would you ask first?
a. “How long have you two been working together?”
b. “Have you experienced disagreements like this before?”
c. “How do you think this patient’s perception of her care has been changed?”
d. “What happened to bring on this disagreement today?”
Conflicts are usually based on attempts to protect a person’s self-esteem or to alter perceived inequities in power. When a nurse recognizes upset and reaction, the following steps can be helpful (Sportsman, 2005):
Identify the triggering event (“What happened to bring on this disagreement today?”).
Discover the historical context for each person.
Assess how interdependent each person is on the other.
Identify the issues, goals, and resources involved in the situation.

REF: Page 328 | Page 329
TOP: AONE competency: Communication and Relationship-Building

13. Sally (RN) and Melissa (RN) have shared an ongoing conflict since the first day that Melissa worked on the unit. Sally has confided to another colleague that she doesn’t even know why the conflict started or what it was about. This is an example of:
a. How expectations and objectives need to be made clear in team situations.
b. The need to encourage open discussion of disagreements in opinions.
c. The importance of involving all staff in discussions in group settings.
d. The enduring nature of first impressions.
First impressions are lasting and, as Sally indicates to her colleagues, are often an unconscious response.

REF: Page 325 TOP: AONE competency: Communication and Relationship-Building

14. After staff meetings lately, Sharon, the head nurse, observes her staff in small groups, having animated discussions that end abruptly when she approaches. Sharon reflects on this observation and realizes that:
a. Two very outspoken members tend to dominate discussions in meetings.
b. This behavior is indicative of a high level of communication among her staff.
c. Staff members are very committed to the team and have strong opinions.
d. Ongoing discussion outside of meetings is conducive to creativity.
When team communication is dominated by a few members, leaving others uninvolved or bored, disagreement is not expressed openly. As a result, team members “stuff” their feelings and wait until after meetings to voice their opinions.

REF: Page 323 | Page 324
TOP: AONE competency: Communication and Relationship-Building

15. You are charged with developing a new nursing curriculum and are committed to developing a curriculum that reflects the needs of the profession and of the workplace. To address deficits that may already be present in nursing curricula related to the workplace, you include more content and skills development related to:
a. Therapeutic communication with patients.
b. Effective communication in the workplace.
c. Increased emphasis on sender-receiver dyads.
d. Generational differences in communication.
Nursing programs teach therapeutic communications with patients and their families. Little focus, however, is placed on effective communication in the workplace, although communication is essential to building and maintaining smoothly functioning teams.

REF: Page 325 TOP: AONE competency: Communication and Relationship-Building

16. The SBAR system of communications is one of the most used communication systems in health care because:
a. It deals with all aspects of communications in patient care except communication with the physician.
b. The nurse is on the same communication level as administration.
c. It honors a familiar, structured transfer of information among health professionals.
d. It honors an unstructured transfer of information.
The SBAR system was developed by professionals in the California Kaiser Permanente System and involves direct, respectful communication skills among professionals with the aim of quality patient care.

REF: Page 328 TOP: AONE competency: Communication and Relationship-Building

17. In the cardiac intensive care unit, there has been simmering discontent about the new nurse manager, who avoids any discussion about her scheduling and practice decisions. The staff have begun to sort into “different camps” depending on how they feel about the manager or the decisions. Which of the following statements MOST accurately describes this situation?
a. The tension that has been generated will result in creative solutions.
b. Staff will become a cohesive group that takes a stand against the manager.
c. The conflict will result in increased dialogue about practice and scheduling options.
d. Patient care may suffer because attention and energy is being diverted toward the unit relationships.
Destructive conflict polarizes groups, saps group morale, deepens differences in values, and diverts energy from more important activities, such as patient care. Constructive conflict opens up issues of importance, results in solutions to problems, and enables authentic communication.

REF: Page 337 TOP: AONE competency: Communication and Relationship-Building

18. From the information presented in this chapter, which of the following statements best defines an accomplished team? Effective teams:
a. Can create a form of synergism in which the outcome is greater than the sum of the individual performances.
b. Do not necessarily need goals, objectives, vision, and a clearly stated purpose.
c. Do not always have effective communication patterns.
d. May or may not have a clear plan that is followed and revisited and has an ongoing evaluation scheme.
Research on team-building over many years has established that high-functioning teams are characterized by synergy that takes the team from a collection of individuals to an outcome that is greater than the sum of the parts.

REF: Page 335 TOP: AONE competency: Communication and Relationship-Building

19. “I really wish that my supervisor would realize and acknowledge all the things I do well.” In nursing, this has been identified as a problem. Which statement is part of the solution? Focus on:
a. New staff.
b. Care assignments with which the individual is not familiar.
c. Making corrections.
d. The strengths of the individual rather than the weaknesses.
The research of Rath (2007) included many recommendations, one of which was that focusing on mediocre behaviors and on a person’s weaknesses will not lead to excellence. Focusing on weaknesses tends to decrease the appreciation, and thus the acknowledgements.

REF: Page 335 | Page 336
TOP: AONE competency: Communication and Relationship-Building

20. Trust is an important aspect of helping relationships, therapeutic communications, and the positive communications model. Which statement does not involve or define trust? Trust:
a. Involves decisions to manipulate situations to gain advantage over another.
b. Is the basis by which leaders facilitate the activities and progress of a team.
c. Is low among members and leaders in poorly performing teams.
d. Involves what we say and not necessarily what we do.
Trust is high in high-performing teams and involves not consciously taking advantage of others and behaving in a way that inspires trust. It is the basis by which leaders facilitate the activities and progress of a team.

REF: Page 333 | Page 334
TOP: AONE competency: Communication and Relationship-Building

21. Team Member A and Team Member B engage in heated disagreements on a frequent basis in team meetings. Their behavior is characterized by insistence on their points of view and refusal to back down or to negotiate alternative solutions once their ideas have been expressed. This behavior is characteristic of:
a. Autocratic leadership.
b. Constructive conflict.
c. Dualism.
d. Creativity.
Our society tends to be dualistic in nature. Dualism means that most situations are viewed as right or wrong, black or white. Answers to questions are often reduced to “yes” or “no.” As a result, we sometimes forget a broad spectrum of possibilities actually exists. Exercising creativity and exploring numerous possibilities are important. This allows the team to operate at its optimal level.

REF: Page 337 TOP: AONE competency: Communication and Relationship-Building

22. The unit manager was addressing nursing students in the lounge area and was discussing team leadership and team effectiveness. She stated, “One can agree to disagree with another team member’s perspective even when one doesn’t necessarily see that perspective as being the correct one.” In being creative, what did she mean?
a. Championing one’s own opinion.
b. Being compassionate
c. Being flexible
d. Committing to resolution
Caregivers must listen to the other person’s perspective, listen to the message accurately, identify differences, and creatively seek resolutions.

REF: Page 336 TOP: AONE competency: Leadership

23. Which of the following would not be a characteristic of an effective team nurse leader?
a. An autocratic perspective
b. Excellent communication skills
c. Awareness of everyone’s abilities
d. A genuine interest in team members
In ineffective teams, leadership tends to be autocratic and rigid, and the team’s communication style may be overly stiff and formal. Members tend to be uncomfortable with conflict or disagreement, avoiding and suppressing it rather than using it as a catalyst for change. When criticism is offered, it may be destructive, personal, and hurtful rather than constructive and problem-centered. Team members may begin to hide their feelings of resentment or disagreement, sensing that they are “dangerous.” This creates the potential for later eruptions and discord.

REF: Page 323 TOP: AONE competency: Communication and Relationship-Building

24. As a nurse manager, you notice that one of your new nurses has provided exceptional care for a patient with especially complex needs. What would be the MOST effective way of recognizing the nurse’s performance?
a. At the next performance review, note specifically what the nurse did to make the patient comfortable.
b. To avoid embarrassing the nurse in front of others, find a way to compliment the nurse in private.
c. When the nurse comes out of the room, tell the nurse specifically what you appreciated about the care that was provided.
d. Encourage the patient to note the care on the patient feedback form so that the institution can recognize the nurse’s efforts.
Acknowledgement is most effective when it is specific, timely, given in public, sincere, and on an eye-to-eye basis. The more time that elapses between the event and acknowledgement, the less effective it becomes.

REF: Page 336 TOP: AONE competency: Communication and Relationship-Building

25. What is not a key concept in a well-functioning team?
a. Absence of disagreement or conflict
b. Special work that is understood and supported by all
c. Willingness to work together respectfully
d. Dedication to a mission
The challenge in teams is not to eliminate disagreement or conflict but to recognize when a breakdown in communication occurs. Singleness of mission, willingness to cooperate, and commitment are all key concepts in a well-functioning team.

REF: Page 328 | Page 333
TOP: AONE competency: Communication and Relationship-Building


1. Mobilizing others to accomplish extraordinary things requires what leadership behaviors? (Select all that apply.)
a. Celebrating the successes of others
b. Demonstrating exceptional technical skills
c. Imagining possibilities
d. Establishing a sense of “being in this together”
ANS: A, C, D
Leaders who inspire teams to accomplish extraordinary things or to display synergy model the way, inspire shared vision, challenge the status quo, and encourage the heart by celebration of success.

REF: Page 324 | Page 325 TOP: AONE competency: Leadership