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Flashcards in Chapter 11 Deck (25):

A team is a:
a. small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they are mutually accountable.
b. group of people who wear the same T-shirt and have the same goals.
c. small number of people who share common goals and like to get things done in an organized and timely manner.
d. group of people who work together to accomplish stated goals over the long run.

A: While it may be nice to share T-shirts and common goals (short- or long-term), teams are generally established for a certain period of time to accomplish set goals. Their members have skills that complement each other. They share a common purpose and approach and are all mutually accountable for the outcomes of their actions (or inactions). DEFINITION OF A TEAM


A new graduate complains to the charge nurse, “I don’t see why we have to work in teams.” The best response by the charge nurse regarding advantages of teamwork would include:
a. increased interpersonal skills, communication, and delegation of responsibility.
b. collaboration, communication, and job satisfaction.
c. innovation, collaboration, and socialization.
d. increased interprofessional communication, collaboration, and job satisfaction.

D: Teamwork has a number of advantages and can contribute to safe and efficient patient care delivery. Some advantages to this group process are job satisfaction, interprofessional team communication, and collaboration. ADVANTAGES OF TEAMWORK


After a class discussion on teamwork, the instructor asked the participants if they could identify some of the disadvantages of teamwork. Which of the following responses would indicate that further teaching is needed?
a. Teams may take longer to accomplish a task or achieve a goal.
b. Teams equalize power through shared governance.
c. Team process takes time, effort, and resources.
d. Team members may disagree on the best course of action to take for a specific situation.

B: A positive advantage of teamwork is that it equalizes power through shared governance. If the participant in the class gave this response, he would be incorrect and further teaching would be indicated. There are several disadvantages to teamwork. It may take longer to accomplish a task or achieve a goal due to the size and diversity of disciplines involved. Members may not agree with ways to accomplish goals, or they may disagree with group process or solutions. The team process takes time, effort, and resources. Some members may lack motivation, ability, or skills to adequately participate in the team process. This may be due to differences in personality, work ethics, language, or different perceptions of what needs to be accomplished. DISADVANTAGES OF TEAMWORK


Which comment by a staff nurse would indicate to the nurse manager that further clarification regarding the concept of shared governance is needed? Shared governance:
a. formalizes and insists upon collaboration among the health care team members.
b. affirms that the patient is the center of care.
c. distributes power more evenly among nursing staff and leaders.
d. provides an outlet for the recognition of inappropriate processes.

D: Shared governance is the process that formalizes and insists upon collaboration among the members of the health care team and confirms that the patient is the center of care. It is also a means by which power can be equalized because it is more evenly distributed among the team members. It is not a means by which inappropriate behaviors or processes are confronted, criticized, or affirmed. ADVANTAGES OF TEAMWORK


A nurse manager states to the staff nurses, “This group has such synergy!” One of the new nurses asks, “What does that mean?” The most appropriate response by the nurse manager is that synergy is:
a. a stage of team development.
b. when luck and circumstance work together.
c. a bonus when things work together harmoniously.
d. a philosophical term relating to sharing of visions and goals.

C: Synergy has been defined as the bonus that occurs when things work together harmoniously and that the whole is greater than the sum of its parts (Covey, 1989). Hence, synergistic nursing models such as those espoused by the American Association of Critical-Care Nurses provide nurses with a model in which the needs and characteristics of the patient, clinical unit, or system are matched to a nurse’s competencies (Hardin, 2005). ANATOMY OF A WINNING TEAM


A nurse manager compliments one of the staff nurses on demonstrating the skills that an effective team leader must possess. On which qualities of the staff nurse is the nurse manager most likely focusing?
a. Conflict resolution, communication, and interpersonal skills
b. Leadership, communication, and control
c. Control, communication, and conflict resolution
d. Communication, conflict resolution, and leadership skills

Skills that good team leaders should have to be effective are good communication skills, knowledge of and techniques of conflict resolution, and leadership skills. Honest and open communication is vital in any group or team activities, and a good leader is versed in how to maintain respectful negotiations, when to utilize conflict resolution techniques, and which type of leadership style should be used in a given situation. QUALITIES OF THE EFFECTIVE TEAM LEADER


A nursing instructor has just completed teaching a class on activities that promote effective communication among team members. When grading the post-test the instructor recognizes that further teaching is needed if the students chose which of the following as an activity to promote effective team communication?
a. Scout activities c. Ambassador activities
b. Task-coordinator activities d. Coordinator activities

D: Anacona and Caldwell (1992) noted three types of communication behaviors used by the team in their internal (team members) and external (outside the team) communications: ambassador activities (frequent communication with those above themselves in the organizational hierarchy to help gain support and resources and to protect the team from outside pressures), task-coordinator activities (frequent communication laterally with other groups), and scout activities (general scanning and exploration of the external environment for information and ideas). CONDUCIVE ENVIRONMENT FOR TEAMWORK


You have been appointed team leader for one of your organization’s marketing teams. You recognize that a key to success for effective teams is:
a. political environment. c. timeliness of goal setting.
b. diversity of members. d. status distribution of team members.

A: Having adequate support (political environment) and buy-in from administration is vital to the success or failure of team activities. Administrative and political support can provide financial support staff, time allotted, and empowerment and may allow for creativity and self-governance. Having a diverse group of people with various status levels and the timeliness of setting the group’s goals can be beneficial to teams; they are not a requirement for success. CONDUCIVE ENVIRONMENT FOR TEAMWORK


The Institute of Medicine’s report Keeping Patients Safe: Transforming the Work Environment of Nurses determined that which of the following factors in nurses’ work environments may have a significant negative impact on patient outcomes?
a. Education level c. Status
b. Experience d. Culture

C: One of the contributors to medical errors discussed by the Institute of Medicine’s 2003 report is “counterproductive hierarchical communication patterns that derive from status difference.” Some medical practitioners, often perceived by others as having a higher status due to their education and profession, tended to ignore valuable information from nurses or others they perceived as being lower status members of the health care team, which contributed to an increased tendency toward medical errors. In addition, nurses also have been found to withhold pertinent information needed for diagnosis and treatment from medical practitioners. STATUS DIFFERENCES


The Tuckman and Jensen Conceptual Model of team process development includes:
a. six stages. c. four stages.
b. five stages. d. three stages.

B: The Tuckman and Jensen model is comprised of five stages of team development: forming, storming, norming, performing, and adjourning. TABLE 11-1TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS


A staff development trainer evaluates a group of nurse interns’ knowledge and understanding regarding the quality of effective team members. Which response by an intern would indicate that further training is needed?
a. Critical thinking c. Time management skills
b. Being proactive d. Self-esteem

D: Effective teams are comprised of individuals who possess certain characteristics conducive to good team function: time management skills (enhance the ability to effectively manage their time and tasks), critical thinking skills, and motivation and the tendency to be proactive (take charge of their personal and professional lives and tend to be proactive rather than reactive to situations and events). QUALITIES OF EFFECTIVE TEAM MEMBERS


A group of professionals has joined together in a team to address the issue of low morale among employees. During which stage of team formation would interpersonal issues come into play?
a. Norming c. Performing
b. Adjourning d. Storming

D: During the storming stage of team development, opposing opinions or interpersonal agendas or issues can surface, increasing the potential for conflict or uneasiness. This is a natural part of team formation and should be expected whenever people from a variety of disciplines, specialties, and experiences work together. STORMING STAGE


With regard to teams and team function, a person’s perceptions about the potential results of taking interpersonal risks and a climate where productive discussion is possible is called:
a. groupthink. c. synergy.
b. psychological safety. d. group cohesiveness.

B: Psychological safety in groups or teamwork concerns the perception of safety when taking a risk such as asking a question or proposing a new idea. Psychological safety is created by mutual respect and trust among team members as well as the belief that they will not be criticized or belittled in front of their colleagues. This perception is largely taken for granted in most teams. CREW RESOURCE MANAGEMENT


A group of nurses work together on a team; however, they are unwilling to challenge each other or disagree. The situation is most likely the result of which of the following?
a. Cohesiveness c. Psychological safety
b. Groupthink d. Synergy

B: Groupthink occurs when the team’s desire for harmony and consensus overcomes rational desires to effectively analyze and assess a given situation. Maintaining a pleasant atmosphere and reducing or eliminating the potential for conflict or the introduction of new ideas are some of the prime results of this behavior. It is counterproductive to effective teamwork because it tends to stifle creativity, inhibit innovative solutions, and reduce the potential for a psychologically safe environment. AVOIDING GROUPTHINK


Which of the following is not characteristic of groupthink?
a. Stereotyping others c. Use of mindguards
b. Collective rationalism d. Illusion of vulnerability

D: Three of the characteristics of groupthink as noted by Janis (1972) are stereotyping of others (biased, highly negative views of competing teams or those who are not members of their own team), collective rationalism (tendency to overlook conflicting information), and the use of mindguards (these are used by team members who withhold conflicting or disharmonious information that is in direct opposition to the teams’ views and thoughts). Another characteristic of groupthink is the illusion of invulnerability, where team members believe that they are impervious and invincible, not vulnerable.


A team leader evaluates whether the team members understand the stages of team development. Which response by a team member would indicate that further teaching is necessary?
a. Norming, storming, and reforming c. Adjourning, forming, and performing
b. Storming, performing, and norming d. Performing, storming, and forming

A: The stages of team development are forming, storming, norming, performing, and adjourning. There is no reforming stage. TABLE 11-1 TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS


Which of the following have well-defined roles and organized processes, are outcome-oriented, and have open interpersonal relationships?
a. Teams c. Committees
b. Groups d. Organizations

A: These are all characteristics of highly effective teams. These types of teams are able to assess and analyze specified concerns and situations to provide viable results due to their use of clear goals; offer well-defined role delineation and organized processes that are outcome-oriented; and encourage honest and open communication and interpersonal relationships. KEY CONCEPTS


Setting a time frame, reviewing progress, establishing ground rules, and encouraging equitable participation and discussion are all characteristics of:
a. ad hoc committees. c. meetings.
b. standing committees. d. interdisciplinary teams.

C: It is advisable for leaders to have a set of guidelines for effective meeting management. Some guidelines that should be considered are setting a time frame (time for current and future meetings), reviewing the progress made (generally done at the beginning of each meeting), establishing ground rules up front (concerning individual and group discussions), and encouraging equitable participation (managing the discussions to allow everyone to participate). By setting guidelines and instructions up front, leaders can help avoid disruptive group practices such as discussion monopolization or a lack of understanding of when the meeting will be held.


Which descriptor is vital to effective team function?
a. Desired c. Accepted
b. Known d. Clear

D: Being clear in the processes, duties, roles, responsibilities, opportunities, and communication is a vital part of effective and successful teams. A clear understanding of what is to be expected, the processes used, and the desired outcomes can enhance trust among team members. CONDUCIVE ENVIRONMENT FOR TEAMWORK


Three requirements for successful teams are:
a. conducive physical, social, and political environment.
b. compatible members, environment, and goals.
c. creative environment, like disciplines, and socialization.
d. compliant administration, political environment, and status.

A: Successful teams work best when there is a supportive and conducive environment consisting of physical (good space, noise control, privacy, and adequate seating), social (trust, mutual respect can lead to improved interpersonal relationships), and political factors (support from administration and potential external stakeholders). CONDUCIVE ENVIRONMENT FOR TEAMWORK


The members of a team have achieved their goals and begin to review their activities and evaluate their progress and outcomes. The team is most likely in which stage of the team process?
a. Norming c. Forming
b. Adjourning d. Storming

B: During the adjourning stage of the team process, the team is involved in termination. Team goals and activities are met, leading to closure, evaluation, and outcome review. This may also lead to reforming, when the need for improvement or further goal development is identified. TABLE 11-1TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS


Several nurses have been assigned to a new team. They come to the first meeting with a sense of curiosity, adventure, and a little apprehension. The team is most likely in which stage of the team process?
a. Forming c. Norming
b. Storming d. Adjourning

A: During the forming stage of team development, relationships are developed. Team orientation, identification of role expectations, beginning team interactions, explorations, and boundary setting occur. TABLE 11-1 TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS


One of the nurses on your team states, “I enjoy working with you and the other team members. We support each other and are willing to share resources. If there are any problems, we work together to solve them. It’s good to work with a team where there is trust and it’s easy to work together to complete our tasks.” Your team is most likely in which stage of Tuckman Jensen’s team process?
a. Forming c. Performing
b. Storming d. Adjourning

C: According to Tuckman and Jensen’s team process, the team is most likely in the performing stage. During this stage, team roles become more functional and flexible, and structural issues are resolved, leading to supportive task performance through group-directed collaboration and resources sharing. TABLE 11-1 TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS


You are conducting a meeting with a group of nurses. Today, you plan to discuss role expectations and the purpose of the team. You ask each individual to introduce themselves and share a little about their background in nursing. Your group is most likely in which stage of Tuckman and Jensen’s team process?
a. Forming c. Norming
b. Storming d. Performing

A: The group is most likely in the forming stage of the team process. During this stage, relationships begin developing. There is team orientation, identification of role expectations, beginning team interactions, explorations, and boundary setting. TABLE 11-1 TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS


You have been working with a group of nurses to update the job description for nursing assistive personnel (NAP). The team has completed its assigned task, and it decides to submit a recommendation for possible in-service education presentations for the NAPs on such topics as safety and effective communication. According to Tuckman and Jensen, your team is most likely in which stage of the team process?
a. Forming c. Norming
b. Storming d. Adjourning

D: Your team is most likely in the adjourning stage of the team process. The task for this stage includes termination and consolidation. Team goals and activities are met, leading to closure, evaluation, and outcome review. This may also lead to reforming when the need for improvement or further goal development is identified. In this situation, a team may need to develop an in-service program. TABLE 11-1 TUCKMAN AND JENSEN'S STAGES OF TEAM PROCESS