For the most part my floor has been a cohesive team. There was a sense of togetherness and mutual support that was very comforting. You knew, based on who was on, if someone had your back when the shit hit the fan. While there were a few times where that was suspect, for the most part you knew you had support. Usually there was someone around to ask questions of, if nothing more, bounce and idea at, just to see if you were thinking correctly or if you were way off base. It was a family of sorts, dysfunctional at times, but a family.
We underwent a split this last summer, with some core staff on each new unit and the rest of us floating between the two units based on census and need. Because of this, there began to be fissures in the feeling of security. While you knew for the most part that if really needed, there was someone to back you, but that feeling of family seemed to be fading. Attitudes emerged which further added to the division. On the less acute unit, an influx of new grads made that feeling of being alone even worse. Not only did you have your issues, but if you were a “seasoned” nurse, you inherited their issues as well. There have been nights where it was me and one other seasoned nurse and the other 4 or 5 were new grads. And it wasn’t an issue of them being bad nurses, but it was the lack of experience, that acquired knowledge and comfort zone that comes with working with the kinds of folks we do for them to be self-sufficient. Many nights I felt like the Oracle at Delphi, answering questions non-stop thru the night.
That sense of team was pretty loose. We all worked together, but it wasn’t as tight as it may have been before. In the last month however our manager decided to make a permanent staff split. The floaters would be gone and each unit would have a set core staff. There might be a little floating, if needed, but the staff would be set. We knew it was coming, it was only a matter of time. It had to happen to allow a set staff to develop that necessary bond of a team. If you constantly have different people flitting in and out, getting to know your fellows, their strengths and weaknesses was difficult. But when you start working with the same folks night after night those imperceptible bonds begin to emerge.
A new energy has begun to settle onto the unit. That mild sense of uneasiness and doubt is beginning to fade as the staff are slowly getting to know each other. It’s nothing that you can point your finger at, but a general sense of a team starting to emerge. When things start to go south people are stepping in to ask if the nurse needs help, offering to do what is needed. When we have an admit dropping into our laps at 0705, they get 2 nurses working to get them settled in, without the admitting nurse asking. When I was trying to admit a patient at 0430, the busiest time for me as a charge nurse, one jumped in to finish a long and complex medication reconciliation, despite my protestations. It’s starting to gel and form into a cohesive group of professionals. Sure I get asked questions non-stop, but it becoming more of a “Am I thinking about this correctly?” more than the “Uh…what do I need to do now?”
And I know I’m not crazy, others see it too. Several of us went out for breakfast the other morning a we all commented on this fact, that it’s starting to feel like a team. I wish I had a company card so I could have expensed the breakfast to the unit under “team building”, but alas that doen’t happen. But becoming a team is.