The Challenge
We were approached to take a deeper look at the team dynamics in a hospital. Through interviews and observations, we discovered several teams marked by turbulence: leadership turnover, Covid pressure, and the complex integration of specialties. The preliminary findings showed wards where dedication was high, but so were exhaustion, mistrust, and feelings of insecurity.
Fieldwork
In daily practice, we saw commitment and professionalism alongside strong undercurrents of stress. Young nurses felt unprepared, while experienced colleagues carried hidden frustration. Pseudo-teams operated in silos, with gossip, ‘we vs. they’ dynamics, and unspoken conflicts undermining trust. Night shifts and responsibilities were pain points, and collaboration with doctors sometimes felt strained.
Analysis
We identified cultural patterns that kept several teams stuck:
- Safety & Trust: insecurity leading to gossip, hidden weaknesses, and exclusion.
- Us vs. Them: silos between subgroups, doctors vs. nurses, and even staff vs. leadership.
- Behavior & Involvement: complaints over collaboration instead of open conflict or feedback.
- Responsibility & Leadership: lack of consistent management presence, unclear agreements, and little space for dialogue.
Presentation
We presented findings with clarity: the teams needed healing before transformation. Issues included the absence of a safe culture, fragmented collaboration, role overload, and lack of recognition. Management heard directly how decisions affected staff wellbeing and patient safety.
Management Advice
We recommended:
- Restore safety by openly addressing gossip, exclusion, and conflicts.
- Establish structural support: more staff in night shifts, fair distribution of tasks, and structured onboarding.
- Anchor new agreements around collaboration, communication, and professional standards.
- Build a feedback culture with training for both staff and managers.
- Support managers with practical tools for difficult conversations and pattern recognition.
Boardroom Sessions
We facilitated sessions where board members confronted frontline realities. Executive coaching helped leaders reflect on their role, their visibility, and the patterns they unconsciously reinforced.
Campfire Conversations
We guided safe team dialogues where frustrations and fears could surface. Naming patterns such as ‘we vs. they’ and exclusion gave space for healing. From there, new agreements were co-created, supported by both staff and leadership.
Team Coaching
Through structured coaching, we helped several teams shift from collections of individuals into true teams: building trust, creating shared goals, practicing feedback, and celebrating small successes.
Executive Coaching
Parallel to team coaching, managers received coaching to build presence, consistency, and courage. They learned to intervene in gossip, facilitate open dialogue, and model the professional culture they want to see.
The Outcome
The hospital is now on the path from cultural healing to transformation. With restored trust, safer collaboration, and stronger management support, the teams have a renewed foundation for patient care — and for becoming real teams in the truest sense.
