Ways of Working (WoW) resource package
The WoW resource package is now available and will assist you in your efforts to implement a collaborative nursing model (CNM) on your ward or unit.
The WoW resource package:
- introduces the evidence for considering a CNM in your ward/unit
- provides guidelines for implementing a CNM in your ward/unit
- provides an audiovisual representation of nurses working collaboratively
- provides tools that can be used to support and evaluate a CNM
What is the WoW project?
Nurses today need to support and grow the workforce of the future by ensuring that not only the ‘science’ but also the ‘art’ of nursing is supported through the way that work is organised.
The Nursing and Midwifery Office commenced the WoW project in mid 2010 to explore the ways in which nurses organise their clinical work.
What do we hope to achieve?
It is anticipated that outcomes from this project in NSW will include:
- more efficient use of nursing resources
- improved communication between staff
- improved patient outcomes
- improved support for staff new to an area of practice
- improved capacity to effectively utilise all skills within the nursing team
What is happening now?
The WoW project manager has conducted site visits and discussions with a number of nurses and other key stakeholders across NSW to gain an understanding of the variety of ways that work is organised at the ward/unit level.
A number of ways of working across NSW have been identified. These include patient allocation, task allocation, case management and team models.
The more collaborative approaches will help to build future nurse skills and capabilities.
When nurses work collaboratively in teams, team members need to have an understanding of the individual team member’s roles. To this end, a project to examine the EN and AIN role across the NSW public health sector has commenced.
There are a variety of skills and knowledge that underpin a collaborative nursing model and the next step of the project will be to identify opportunities to assist staff in improving their work environment and organisation, collaboration and communication.
- Making it real
A short film which showcases a nursing team working collaboratively over the course of a morning shift.
- WoW Presentation
Building nursing teams for the future contains information supporting a collaborative nursing model.
- Short summary
The different ways that nurses use to organise their clinical work.
- Sample schemata for team assignment
When allocating teams for a collaborative nursing model it is important to be flexible in the way the team is composed to allow for patient acuity, changes to skill mix and to cover untoward situations such as sick leave replacement. Some sample schemas for shift staffing are available here.
- Benner’s stages of clinical competence
When preparing the rosters for a collaborative nursing model it is important to divide the roster into levels of expertise. One good way to determine the level of expertise is to use the framework proposed by Patricia Benner (1984) – “Novice to Expert”. This framework is used widely and is acknowledged as an effective way to classify nurse skill acquisition. Patricia Benner’s framework is based on the Dreyfus brother's 1980 work, "A Five-Stage Model of the Mental Activities Involved in Directed Skill Acquisition", also known as the "Dreyfus model of skill acquisition”.
- Conflict resolution flowchart
It is not unusual to have conflict in the workplace. In the event that conflict occurs in teams there should be a standard mechanism for dealing with it. Here is a sample conflict resolution flow chart which you might consider using.
- Conduct a values clarification exercise
All nurses should be given the opportunity to contribute to a shared vision for the wards/unit. Follow these instructions for conducting a values clarification exercise.
- Conduct a claims, concerns and issues exercise
As part of the discussions about the WoW on the ward/unit it might be useful to conduct a claims concerns and issues exercise to address any issues the staff might have about modifying or changing their current WoW.
Nurse satisfaction with the model of care is pivotal to the success of the collaborative nursing model. The Nursing Workplace Satisfaction Questionnaire was developed specifically to evaluate job satisfaction with a new model of team nursing (Fairbrother, Jones & Rivas, 2009). The tool is available to use for the project with the support from the authors. The Nursing Workplace Satisfaction Questionnaire will be useful in evaluating the level of nurse satisfaction before and after introducing a new WoW.
The Nursing Teamwork Survey measures the level of nursing teamwork in acute care settings. The Nursing Teamwork Survey was developed and validated for use in the United States (Kalisch, Lee & Salas, 2010). Minor demographic changes were required for the Australian context. The Nursing Teamwork Survey will be useful in evaluating the level of teamwork before and after introducing a new WoW.