1. MCCloskey, Annette RN, BSN, MEd

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Staff or team: What does it mean?

When nurses are selected to lead because of their years of experience, the transference of clinical knowledge to leadership knowledge isn't equal. Consequently, the dynamics of productive teams often elude leaders.


Using the Integrative Model of Group Development, nurse leaders can gain insight into team development. 1


Working with a Stage I team (dependency/inclusion) feels like being a mother. The team looks to the leader for all manner of guidance and support. For example, unit nurses sometimes page the unit leader with questions about decisions they're capable of making themselves.


During Stage II (counterdependency and fight), members find their voices and strike out to express their differences. Conflict can arise over assigned roles or differing ideas on the group's goals. Instead of "leaderspeak," it's now "groupspeak," with slow forward progress.


In Stage III (trust/structure), trust is established between members. As a result, they may change roles to those that better suit their skills, abilities, or interests. Members agree on a goal and spend time creating a structure that leads to goal accomplishment.


In Stage IV (work), synergy is high. Team members are clear about the goals and the roles of the group's members. Team members delegate appropriately. A strong collegial relationship exists between nurses, physicians, and other department members. Nurses find time in their day to address issues that go beyond direct care.


Structure and guidance for Stage I members require a directive and confident manner. 2 In Stage II, allowing the members to feel a sense of empowerment leads them through the counterdependency/conflicts and onto Stage III. Leadership in Stage III should be that of a facilitator or coach, while the Stage IV leader's role is one of expert member. 3




1. Wheelan, S.:Group Processes: A Developmental Perspective. Allyn and Bacon, Boston, Mass., 1994. [Context Link]


2. Wheelan, S.:Creating Effective Teams. Sage Publishers, Thousand Oaks, Calif., 1999. [Context Link]


3. Ibid. [Context Link]