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AACN Clinical Issues: Advanced Practice in Acute & Critical Care:

Troubled Units: Creating Change

Hawkins, Anne LaVoice RN, MS; Kratsch, Lucinda Stephens RN, BSN

Section Editor(s): Thornby, Denise C. RN, MS; Pettrey, Lisa J. RN, MS

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Your unit may be in trouble. Are conversations among team members authentic or do real conversations happen in the hallways after the meeting? Are staff afraid of voicing their disagreements for fear of being labeled, while other team members complacently agree to a consensus, then go off and work from their own agenda? Some units have fallen into the habit of disrespectful communication and uncaring behaviors toward team members. The impact this has on staff, units, and organizations can be deleterious. More importantly, these behaviors impact the quality of patient care a unit is able to provide. Fostering teamwork must be a top priority for leaders. In a healthy team, differences and conflict exist, but they are acknowledged and dealt with openly. Creating change in a troubled unit is not a fast fix, but rather needs a well-devised plan. This article describes how leaders can seek out appropriate resources, develop strategies, and intervene to create a healthy, professional work environment.

© Copyright 2004 American Association of Critical-Care Nurses


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