Enhancing nursing team resilience to manage continuous change in practice: A qualitative descriptive study.

Abstract

Aim: The study explored nurses' perceptions of team resilience in coping with continuous changes and in developing nursing practices. Additionally, it sought to identify what nurses need to strengthen their team's resilience in adapting to change and how clinical nurse specialists can support these efforts.

Background: Persistent changes in healthcare require nursing teams to continuously adapt and develop their practices. However, development and implementation processes are often challenging, stressful, or unsuccessful. This can lead to change fatigue and, when combined with daily workload pressures, high job turnover. Currently, individual resilience is regarded as a key factor in coping with workplace stressors and burdens. Yet, growing critical perspectives emphasise the importance of team resilience, which differs from individual resilience. Despite practice development being mainly a team effort, nursing team resilience remains underexplored in the literature.

Study design and methods: This qualitative descriptive study involved 29 registered nurses from two nursing teams at a Swiss paraplegic rehabilitation clinic. Data were collected through eight semi-structured group discussions, and the analysis was conducted using structured qualitative content analysis.

Results: The nurses identified four key areas as crucial factors for team resilience in managing change: 1. A lack of knowledge about team resilience and interest in integrating the concept as fundamental resource. 2. Psychological safety within the nurse team and the desire to enhance interprofessional psychological safety, recognised as key factor in team resilience. 3. Readiness to learn. 4. Anticipated burdens. Furthermore, they expressed a need for support from clinical nurse specialists to strengthen team resilience.

Conclusion: Team resilience was identified as an unrecognised and neglected concept, yet it was acknowledged as being significant both intra- and interprofessionally for coping with challenges; weak team resilience was considered disadvantageous. Clinical nurse specialists should play a key role in supporting team resilience.

Recommendations for research and practice: Team resilience should be promoted among nurses across all education levels and fostered within nursing teams. Models for interprofessional collaboration and implementation could enhance team resilience factors that are essential for managing change. Additionally, the perspectives of other professionals on collaboration with nursing teams should be explored further.

What is already known?

• Nursing teams must continuously adapt their practices due to persistent changes in healthcare. This process is often challenging and stressful, increasing daily workloads and potentially leading to change fatigue and job turnover.


• The level of resilience in individuals, teams and organisations becomes evident when challenges and stresses arise. Currently, individual resilience is regarded as a key factor in coping with workplace challenges and burdens.


• Hospital nursing relies on a strong team-based approach, and nurses face numerous challenges, including those arising from ongoing change.

What this study contributes:

• This study highlights the importance of team resilience. A knowledge gap regarding this concept was identified and addressing it could enhance teams’ ability to cope with change.


• Nurses recognised team resilience as an essential resource for managing persistent change and fostering future development. Consequently, they expressed a desire to gain knowledge about team resilience and to strengthen key factors such as psychological safety in interprofessional collaboration, readiness to learn, and the anticipation of burdens associated with change.


• Integrating and strengthening team resilience in change implementation may facilitate more successful and sustainable development.


• Clinical nurse specialists should play a key role in enhancing team resilience.