Teamworking in nursing homes

Background. Nursing homes have an important role in the care of frail older people, but concerns have been raised about the quality of care. High standards of care appear to be facilitated when nurses work in effective teams. Greater understanding of teamworking in nursing homes could have implications for training and policy-making. Aim. The aim of the study was to explore the experiences and perceptions of teamworking with qualified nurses working in nursing homes. Method. This was a small, exploratory focus group study. The sample was 12 qualified nurses working in nursing homes in the south of England. Transcriptions of the focus groups were coded by the research team and agreement was achieved by discussion. Findings. Teams described were constructed in 'vertical', hierarchical terms rather than as 'flat', collaborative structures. The achievement of good teamworking was hindered by inadequate communication, particularly as many staff worked part-time and on shifts. Management was perceived as remote, and lines of authority were ambiguous and unfocused. Conclusions. This group of nurses were aware of the difficulties of working in a hierarchical, profit-making culture. Individually, they tried to provide good quality care for patients and aspired to teamworking, but seldom succeeded to their satisfaction. There may be considerable potential to improve the working lives of staff and quality of patient care by effective teamworking. However, significant barriers, particularly concerning organizational culture, need to be overcome.