In previous articles we identified self-care is important because it enables the manager to operate at their best both inside and outside of work. We also saw that a stressed manager will impact on the behaviours and culture within the team and how this in turn will affect patient care. While identifying how health and social care managers need to practice self-care first, we acknowledged the manager has an important role to play in supporting and caring for the team and one of the key areas related to self-care for the manager is how they manage their relationships with people within their team.

In this paper we will consider why managers should consider it part of their role to support their team as well as some of the strategies that may be used to achieve this.

Why team care is important

Some managers think that because it is not their role to come to work to make friends with their team members (which is arguably true), that they do not have a role to play in supporting and caring for them either. Of course this is a very unrefined version of the truth and is often used by leaders who lack emotional intelligence, or who are burnt out. 

The real issue when considering friendship and leadership here lies in defining what we mean by friend and friendly, or perhaps more pertinently caring. One study of the workplace preferences of millennials identified how respondents want their boss to be friendly, but tended towards not wanting them as a friend (Hall, 2016). This suggests that, while people crave a workplace that is not negative and indeed one which is nurturing, they understand the boundaries between nurturing leadership and friendship and indeed value these. 

Positive workplace cultures, which are friendly and enabling, tend to be more productive and have a lower turnover of staff especially as the friendliness at work is there to provide support in times of stress (Khaleel et al, 2016). This underpins the notion that leaders and managers should foster friendliness and positivity. 

In a previous paper in this series (Ellis, 2015), we saw how Scholtes (1988) identified that the development of trust in the workplace is linked not only to employees believing their manager is capable of doing the job they are employed for, but that the manager cares about them as an individual. We saw how trust is linked to reduced staff turnover and improved job performance and therefore how caring works in favour of the manager and the organisation as well as the individual employees. 

It appears therefore that staff like a manager who cares about them, because they feel this is a person they can trust and when they trust them, they regard work as a good place to be and work more productively. 

Strategies for team care 

There are many things a manager can do to demonstrate they care about the people in their team without going over the top or overstepping any boundaries, real or perceived, and gain some of the benefits this brings. As with so many issues management related much of this is about exercising emotional intelligence, that is the ability to understand one’s own emotions and those of other and use these to communicate in a meaningful way (Ellis, 2017). 

In their study of nurses in an acute hospital, Polis et al (2017) identified how good communication with leaders, as well as between nurses, were the most important predictors of teamwork. These suggest an important role for the manager in maintaining open channels of communication. Such observations resonate with other studies that suggest good communication from managers who are readily available to share expectations, correct errors and provide feedback cause nurses to perceive they are providing care in a positive patient safety culture (Ammouri et al, 2015).

In a study by Bridges et al (2018), nurses and healthcare assistants identified how they found a benefit to having a mid-shift meeting to check on each other’s wellbeing as part of a broader study looking at the impact of communication, reflection and mutual support in developing sustainable team working practices. Similarly, managers who promote reflective spaces for teams, such as those found in Schwartz rounds, will see a reduction in team stress and enhancements in connectedness and compassion for self, other staff and ultimately patients (Maben et al, 2018). 

Within all this, the role of the leader or manager is that of communicator who is visible and known to the team. There is nothing team members dislike more than managers who are not known to them, who seagull in, especially at times of perceived crisis as they both display and cause distrust and defensiveness (Cooke, 2016). Such ephemeral relationships are not built on trust nor often good communication and are perhaps well described by Bradberry (2009) who says: 

“[a] seagull manager deposits steaming piles of formulaic advice and then abruptly takes off, leaving everyone else behind to clean up the mess”. 

One simple to implement manifestation of managers who know their teams is regular clinical supervision. Supervision is linked to personal and professional development (Hussein et al, 2019), wellbeing (Oates, 2018) and nursing intentions to stay working in a particular team and is never the waste of time many think it to be. Empowering team members to achieve their role tasks, including the use of supervision, and involving them in shared decision-making is an important strategy for developing contentment in the team (Halter et al, 2017). 

Kaiser (2016) makes an interesting point about the behaviours of nurse managers with those who are uncivil (rude), and those who fail to empower their team members, breeding cultures where incivility between staff is commonplace. This suggests one of the roles of the manager in caring for their team, and creating the culture, lies in role modelling civility, e.g. asking not telling. Another behaviour that managers need to role model to their teams is that of self-care. Managers who fail to care for themselves set a low benchmark for staff to copy, for example through failing to take breaks. This creates a precedent for staff to follow. Prolonged poor self-care practices will give rise to fatigue, ill health and unhealthy workplace cultures. 

Simple acts of kindness like deserved praise and recognition are fundamental to making staff feel appreciated (Cowden et al, 2011). Deserved praise should not be mistaken for robotic chanting of thanks to staff at the end of each shift as this quickly turns from appreciated praise to something to ridicule. 

Conclusion

In this paper we have seen that there are significant benefits to the team, and to patient care, to be had when managers pay attention to staff wellbeing. Caring for staff also helps the team and wider organisation in that it tends to improve staff retention and encourages team members to be more team focussed and productive.

We have identified managers need to role model self-care to their teams and how communication is fundamental to the manager — team relationship. We have identified that managers who seagull into teams when they perceive there as being something happening often have the opposite effect to that they desired. Instead, to attain team cohesion, staff satisfaction and the best patient care, healthcare managers need to ensure that they are known to their team and in turn, in order to gain trust, know and demonstrate care for their team members. 

Empowerment of the team and involvement in shared decision making as well as regular supervision are important in developing the morale of the team as is giving praise when it is due. 

What we have seen here is that taking care of the team and team morale is not about gimmicks, away days and expensive reviews, it is about everyday behaviours, relationship building and recognition of ability. So while we have discovered nothing to suggest that managers need to be the friend of the members of their team, we have seen how there is a place for friendly, civil behaviour and emotionally intelligent communication.