Working with care –

improving working
relationships in health
and social care:
self-assessment tools for health
and social care teams

Healthy workplace, healthy you

Dignity at work
Acknowledgements
This document was originally prepared in 2005 The RCN would like to reiterate their thanks to the
by Dr Diane Beale and Dr Phil Leather from the organisations who took place in the original focus
Institute of Work, Health and Organisations at the groups and pilot studies:
University of Nottingham.
• Queen’s Medical Centre, Nottingham
The RCN has updated the introduction to this
guidance to reflect up to date research. The self- • RCN Clinical Leadership Group
assessment tools remain the same. A number of • University of Nottingham School of Nursing
research papers cited in the original document
remain the same as they are still valid. • C
 helsea and Westminster Healthcare NHS
Trust, Thomas Macauley Ward
• Marie Curie Nursing Service, Tiverton.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 3

Contents
1. Introduction 4 4. Appendices:
Aims of the initiative 5 documents for participants 13
Structure of the tools 6
A. Individual assessment tool 13
2. Facilitator’s notes 7 Introduction to the self-assessment tools 13

Using the tools 7 Completing the individual assessment tool 14

Requirements for facilitators 7 Section 1: common positive behaviours 15

Role of the team manager 7 Section 2: common negative behaviours 17

Preparation 8 Section 3: friendly behaviours open to

misinterpretation 22
Procedure 8
Section 4: retrieval behaviours 23
Follow-up 10
Section 5: reflection 24
Safeguards 11

B. Team assessment tool 25

3. References 12
Introduction 25
Section 1: team supportiveness 25
Section 2: problem scenarios 28
Section 3: suggestions for team action plan 28

C. Agreed team action plan 29

D. Follow-up progress form 30

E. Monitoring form 1 31

F. Monitoring form 2 33
4 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Introduction The terms bullying and harassment are used

to describe behaviour that clearly causes
humiliation, offence or distress, and that may
interfere with job performance and/or cause an
Through our working life we interact with many unpleasant working environment.
other people. The quality of these interactions
can have a profound effect on our health and Bullying behaviour has been classified into five
wellbeing, and our enjoyment of work. There broad types:
is also a direct link between staff health and
wellbeing and the quality of care. For example, • threat to professional status
research by Maben et al (2012) shows that patient • threat to personal standing
experiences are generally better when staff feel
they have a good local team and group • isolation
work-group climate; co-worker support;
supervisor support as well as job satisfaction; • overwork
a positive organisational culture; organisational • destabilisation.
support and low emotional exhaustion.
Harassment involves negative behaviour
Ideally, we enjoy good working relationships concerning a colleague’s gender, sexual
in supportive teams. However, most people orientation, race, religion, age or disability. More
encounter a mixture of positive and negative detail is provided in the explanatory notes for
experiences in their relationships with colleagues. the individual assessment tool. Work-related
Working with care is a set of tools designed to bullying and harassment should be seen not
encourage health and social care staff to examine just as problems for the individuals involved, but
their interactions with colleagues, to enhance the also for the employing organisations. They are
positive interactions and to increase awareness often caused by the interaction of organisational
of negative interactions, some of which can structures and systems with the individuals
amount to bullying and harassment. The RCN has working in them. Consequently, there is no one
identified bullying and harassment as problems remedy that will solve these problems. It is
that a significant proportion members encounter only by constant vigilance and a combination of
at work. Indeed, a number of studies have measures integrated into the structures and the
demonstrated that bullying and harassment are systems of work, and absorbed into the culture,
widespread in health care (RCN, 2012; Illing that these problems can be tackled. Attention
et al, 2013). has to be paid to prevention of problems in the
first place, to reaction or response when potential
problems occur, and to rehabilitation of staff
and organisational learning after a problem has
occurred. Measures to reduce the occurrence and
the effect of such problems have to involve staff at
all levels of an organisation, and are implemented
by the organisation centrally, by work teams
and by individual workers. Such an integrated
organisational approach examines policies,
systems, procedures, practice and behaviour to
ensure that they encourage a supportive culture.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 5

Many health care organisations now have policies Aims of the initiative
and procedures designed to address problems
when they have occurred. However, little is in place These tools are intended to:
to promote a change in culture so that bullying
• a
 ct as a means for individuals and teams to
and harassment are less likely to occur in the first
examine, and reflect on, their own behaviour
place. The RCN endorses a proactive approach
to reducing bullying and harassment, with the • encourage positive behaviour
aim of encouraging “a workplace culture in which
everybody treats their colleagues with dignity and • discourage negative behaviour
respect, and where all steps are taken to minimise
• increase understanding of behaviour that may
the occurrence of bullying and harassment”
be perceived to be bullying or harassment
(RCN, 2015). The establishment of such a culture
(whether intended or not)
requires action at organisational, work team and
individual level. For example, the organisation • increase awareness of behaviour that might
should ensure that all its policies and systems contribute to a climate in which antisocial
regarding, for example, management structures, behaviour is tolerated
performance targets, appraisals and complaints
procedures, are fair and do not implicitly • increase acceptance of strategies that might be
encourage bullying or harassment. In addition, used to retrieve a problem situation
it should publicise its opposition to bullying and
• h
 elp to produce a supportive culture or team
harassment by appointing advisers and devising
climate where bullying and harassment are
equitable complaints procedures. The work team
unlikely to occur.
similarly can examine its procedures and practices
to ensure that there is no inherent bullying, for
These tools are not designed to solve major
instance of students, support staff or junior
bullying, harassment or other interpersonal
members of the team. In addition, for culture to
problems between individuals at work. They
change, individuals need to examine and change
should not be used with teams where such major
their own behaviour. Incremental improvements
problems are suspected.
in individual’s behaviour then influence other
people’s behaviour, reversing the downward spiral
of incivility (Andersson and Pearson, 1999). If such The tools focus on the interplay between individual
a change took place in a significant proportion behaviour and team climate, and are designed
of the workforce simultaneously, then real to be relevant for teams at all levels of an
improvement in the culture might result. organisation. Some fundamental principles for the
approach taken are that:
Working with care is a suite of tools for use in work
teams at any level of an organisation. If the tools • improvement in individual behaviour, team
were endorsed for use throughout an organisation, climate and organisational culture includes
they could assist in changing the culture to be increasing positive behaviour as well as
more caring of staff and less accepting of bullying decreasing negative behaviour
behaviour. These tools are only one part of an • p
 eople may be more willing to think about
integrated approach to tackling bullying and negative behaviour when considered alongside
harassment. Health and social care organisations positive behaviour
should examine their policies, procedures,
systems and practice to ensure fairness in normal • individual behaviour and interactions in work
working, to discourage a culture of bullying and teams need to be considered together for
harassment, and to guarantee fair and rigorous effective learning and improvement in team
investigation of complaints. climate
6 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

• ideally, team exercises should be carried out

by overlapping teams covering all levels of an
organisation, including senior management,
in order for the tools to be effective as a
vehicle for improvement of overall
organisational culture.

Note: Overlapping teams are teams that have

one or more members in common. For example,
a ward manager would not only be a member of
a ward team but also a member of at least one
management team.

Work teams might include, for example:

• p
 eople who work on a particular ward (nurses,
health care assistants, clerical and other
support staff, other clinical staff such as
doctors, physiotherapists.
• staff of a community clinic
• the management board
• managers for a department or division
• a theatre team.

Structure of the tools

The tools consist of:
• individual assessment tool (IAT) to be
completed by individuals in private before the
group session (see Appendix A, page 13)
• t eam assessment tool (TAT) to be completed
during a group session (see Appendix B,
page 25)
• a
 greed team action plan (ATAP) to be completed
at the end of the group session (see Appendix
C, page 29)
• f ollow-up progress form (FPF) to encourage
implementation of agreed action (see Appendix
D, page 30).
You will need to download and/or photocopy
these tools from this publication and supply the
appropriate number of copies to the work team.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 7

2. Facilitator’s notes
Using the tools • h
 ave some experience of work and
circumstances similar to those of the team or,
These tools are intended for use in the majority of at the least, have some knowledge about such a
health and social care teams, where interactions work setting
between team members are within the normal
range of positive and negative behaviour, or where • b
 e independent from the team and should not
relatively minor problems are suspected. Raising know any members of the team well
awareness of interpersonal behaviour and team • n
 ot have had any problematic encounters with
supportiveness should help to prevent future any members of the team in the past
problems and improve existing minor problems,
for example where people are unaware that some • n
 ot be in a position where they could be
of their behaviour could be perceived by others as suspected of having a political reason, or
bullying or harassment. ulterior motives, for wanting to find out about
working relationships in the team.
This tool is not designed to solve major bullying,
harassment or other interpersonal problems
between individuals at work. It should not be used Role of the team manager
with teams where such major problems are known Team managers or leaders should not facilitate
or suspected. the team session(s), but should normally be
included in the exercise as any other member of
Where major problems do exist, bullying and the team attending one of the group sessions.
harassment advisers should work with the However, team managers will obviously be
persons involved on an individual basis according important in organising the whole exercise. They
to the policy of the relevant organisation. If only will need to:
a small number of people are directly involved in
the major problem, it might be appropriate to use • sanction use of the tools with the work team
the tools with the rest of the team. However, this
• a
 rrange for staff to be able to attend a group
should only be done after careful consideration of
session, including adjusting duty rosters
the particular circumstances.
where necessary
This tool is not designed to solve major bullying,
• e
 nsure that all members of the work team
harassment or other interpersonal problems
receive all the information
between individuals at work. It should not be
used with teams where such major problems • r eassure staff about the confidential nature of
are suspected. the exercise
• s et the example of using the exercise
Requirements for facilitators constructively, not as an excuse to gossip or
scapegoat individuals
Facilitators using this exercise with a work team
should: • a
 ct on the agreed team action plan(s) following
the exercise.
• b
 e skilled and experienced at handling sensitive
issues in group sessions
8 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Preparation individuals who have unusual patterns

of work)
Facilitators must take time to familiarise
themselves with the tools and the procedures – distribute the individual assessment tool
before embarking on this exercise to ensure (IAT) beforehand, if possible allowing
that they are fully prepared to conduct the group individuals some time (30-45 minutes) and
sessions. privacy to complete it while on duty

Facilitators and team managers should work – encourage, but not pressurise, all members
together to: of the work team to complete the IAT and to
attend the group session
• a
 rrange suitable time(s) and venue(s) for the
group session(s): – try to ensure that any members of the work
team who find each other difficult to work
– in many health and social care settings with attend different group sessions
it will be logistically impossible for all
members of a work team to come together – ensure that staff counsellors and bullying/
for a single session. In this case, it will harassment advisers are aware that the
be necessary to hold several sessions in exercise is occurring.
as short a time period as possible so that
everyone in the team is focused on the
issues simultaneously. Sessions should be
Procedure
arranged to allow the maximum number of • T
 he tools are designed for use by all members
people to attend a session. The total number of a work team (ideally by overlapping work
of sessions required will depend on the teams throughout a health care organisation).
size of the team and the nature of the work
carried out. Group sessions should normally • The exercise consists of two stages.
involve six to 12 people. • T
 hese may be completed consecutively at a
– if practical, the venue should be chosen to halfday workshop, or stage 1 may be carried
ensure that the session is not interrupted out more informally by distributing the IAT a few
by work demands. Ideally, it should provide days before the stage 2 group session.
comfortable, informal surroundings that
allow privacy, and it should be readily Stage 1 (minimum 30-45 minutes)
accessible to all members of the team. All team members complete the IAT, and read the
accompanying explanatory notes, to help them
• give appropriate information to all staff:
think about their own attitudes and behaviour
– a letter should be given to all members of towards other team members, both positive and
the work team explaining why the exercise negative. The IAT is the heart of the suite of tools
is being carried out and what is involved in and staff need to be given the chance to consider
terms of time and personal involvement it carefully. The IAT may be distributed and
completed before the main session, and is best
– practical information about times and completed in private. Facilitators should:
venues should be given to all staff well in
advance of the session. If arrangements • m
 ake clear to all members of staff that
have to be altered at the last minute, it is individuals are not required to show their
important that everyone due to attend the completed IAT to anyone else
session gets the new information. It can be
• e
 mphasise that the issues raised in the IAT are
very counterproductive if some individuals
essential background for the group session
are missed (check part-time staff and any
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 9

• if the IAT is completed as part of a workshop, 2. complete the team assessment tool
allow at least 30-45 minutes so that members Section 1: team supportiveness (20-25
of staff do not feel rushed but have time to think minutes)
about their behaviour.
• D
 istribute the team assessment tool (TAT)
Stage 2 (minimum one-and-a-half to and ask participants to read through the
two hours) introduction and to complete Section 1: team
supportiveness individually (allow 10 to 15
Stage 2 consists of a group session, which uses minutes). This section examines and affirms
the team assessment tool and the agreed team positive team behaviour, and uses questions
action plan. During the session, facilitators should: similar to those used in section 1 of the IAT.
Again emphasise that individuals are not
1. introduce the session (10-15 minutes) required to show their individual responses to
• D
 eal with housekeeping for the session such as anyone else.
practicalities and safety issues.
• Invite discussion about positive ways in which
• E
 xplain the purpose and structure of the the team works together.
session.
• If you judge that it would be appropriate and
safe to do so, ask whether participants were
1a. emphasise its constructive nature
surprised by anything that was included in
• E
 stablish confidentiality by agreeing that the IAT.
what is said in the session remains absolutely
confidential to the people present, and that any 3. complete the team assessment tool
information gained will not be used to harm Section 2: problem scenarios (30-40
any other member of the group in any way. minutes)
Explain that the group will produce an agreed
team action plan, which will be shared with • A
 sk the group to discuss how the team would/
other members of the work team, and passed should manage the problem scenarios given in
to the operational team leader. Explain that Section 2. If there is insufficient time to discuss
participants take away their own assessment all the scenarios, select those that are most
tools to dispose of how they wish. appropriate to the particular team.

• A
 sk participants whether they have all had the • Allow more general discussion, if appropriate.
opportunity to complete the IAT. Provide spare
copies in case some have not seen it.
• E
 nsure that participants have information about
further support such as staff counsellors and
bullying/harassment advisers.
• Invite and answer queries that participants have
concerning the exercise.
• A
 sk participants to introduce themselves
very briefly to ensure they are all known to
each other.
10 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

4. complete the agreed team action plan Following each group session, facilitators should
(25-30 minutes) take a copy of the ATAP for their own records.
After the final session for the work team, they
• A
 sk the group to write in their own TAT
should pass all the agreed team action plans
suggestions about:
together to the team manager along with a brief
a) positive aspects of team climate already overview of the sessions, being careful to maintain
present and actions to maintain those strict confidentiality.
positive aspects
Facilitators and team managers should
b) aspects of team climate that need to be discuss how the agreed team actions plans
improved and actions to improve them should be shared with the rest of the team and
taken forward.
c) other comments they want to be recorded
(allow five minutes)
Follow-up
• S
 hare ideas and compile an agreed team action
plan (ATAP) to enhance the team interpersonal Completion of the tools and participation in
climate, including any learning or training a group session will not resolve all problems
requirements. overnight and forever. It is important that this
exercise is seen as the beginning of an on-going
• C
 heck that the participants realise that process to enhance working relationships and
this constitutes the feedback that may be produce a culture where bullying and harassment
communicated. are less likely to occur. Both short-term and long-
• T
 o other members of the team who were not term follow-up are essential.
present at the session, and to managers.
Short-term
• C
 heck that all participants are in agreement If several group sessions have been held for a
with the ATAP. Remove anything that has not work team, the ATAPs should be shared with all
been agreed. members of the work team, but without breaking
confidentiality (see Safeguards opposite). It is
5. close the session (5-10 minutes) important in these circumstances that a short
• E
 nsure that all participants understand what follow-up session is held to consolidate the
will happen after the session in terms of follow- findings of the separate groups and formulate an
up of the ATAP(s) from the group session(s). overall action plan using the follow-up progress
form. A progress review might constitute part of a
• C
 heck that everyone is happy with the regular team meeting.
conclusion of the session and that no one has
outstanding issues or queries concerning the The overall action plan should be implemented as
session. soon as practically possible in order to maintain
the momentum initiated by the team exercise.
• B
 ring attention to the sources of support such
as staff counsellors and bullying/harassment Long-term
advisers.
This exercise should not be seen as a one-off,
• R
 e-emphasise the confidentiality of anything but should be repeated after a period of, say, two
said in the session. years, or if the work team changes substantially.
Formulation of the overall action plan ought to
• Close the session. include discussion of how the momentum of the
exercise can be maintained in the interim.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 11

Safeguards • u
 se progressive strategies to defuse situations
that appear likely to lead to ill-feeling in the
One of the possible problems with the use group session, such as:
of tools such as these is that any existing
problems between members of staff might be – acknowledging that the particular issue
exacerbated. This would be counterproductive. is causing some problems and steering
It is important that safeguards are built into the discussion on to positive behaviours that are,
tools and their use. or might be, used in relation to the issue

Built in safeguards include: – again, acknowledging the problem

and moving discussion away from the
• it is clear that individuals are not expected to contentious issue on to another subject
show their completed assessment tools to
anyone else. Individuals retain ownership of – if the situation is becoming destructive, end
their own completed tools and may dispose of the session, explaining why and reminding
them as they wish participants about confidentiality and the
positive nature of the exercise
• t he TAT is deliberately focused on positive
and supportive behaviour rather than • e
 nsure that staff counsellors and bullying/
negative behaviour in order to promote harassment advisers are aware that the
supportive discussion exercise is occurring

• t he introductory notes stress that the TAT and • p

 rovide details of staff counsellors and bullying/
discussion must be used constructively harassment advisers to all team members
involved in the sessions
• a
 statement of confidentiality is included in the
introduction to the TAT. • b
 e aware that staff may choose to contact their
trade union representative if they believe they
Guidelines for use include: are experiencing bullying and harassment.
• u
 se an independent and skilled facilitator
for the team session rather than using the
operational team leader as the facilitator
• e
 stablish confidentiality by agreeing that what
is said in the group session remains absolutely
confidential to the people present, and that any
information gained will not be used to harm any
other member of the group in any way. Only the
agreed team action plan may be shared with
other members of the work team, and passed
to managers for information
• e
 mphasise throughout that the aims of the
session are to encourage reflection and
development, and to discourage a climate of
blame and acrimony
• a
 void the temptation to probe issues raised too
deeply or to try to act as a counsellor. It is not
always necessary for the facilitator to know all
the details of a situation
12 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

3. References
RCN (2012) Beyond breaking point – a survey report
or RCN members on health, wellbeing and stress.
London: RCN.
Available online at www.rcn.org.uk/publications
RCN (2015) Bullying and harassment – guidance
on the prevention and management of bullying and
harassment in health and social care organisations.
London: RCN.
Available online at www.rcn.org.uk/
healthyworkplace
Andersson LM and Pearson CM (1999) Tit for tat?
The spiralling effect of incivility in the workplace,
Academy of Management Review, 24(3), 452-471.
Illing JC, Carter M, Thompson NJ, Crampton
PES, Morrow GM, Howse JH, et al (2013) Evidence
synthesis on the occurrence, causes, consequences,
prevention and management of bullying and
harassing behaviours to inform decision making in
the NHS. Final report. NIHR Service Delivery and
Organisational programme; 2013.
Available at
www.nets.nihr.ac.uk/__data/assets/pdf_
file/0006/.../FR-10-1012-01.pdf
(accessed 29 June 2015)
Maben J, Peccei R, Adams M, Robert G,
Richardson A, Murrells T and Morrow E (2012)
Patients’ experiences of care and the influence of
staff motivation, affect and wellbeing. Final report.
NIHR Service Delivery and Organisation
Programme; 2012.
Available at www.nets.nihr.ac.uk/__data/assets/
pdf_file/0007/.../ES-08-1819-213.pdf
(accessed 29 June 2015)
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 13

Appendices: documents for

participants
(To be downloaded and photocopied by facilitator.)

A. Individual assessment tool

Introduction to the self- Stage 2
assessment tools Stage 2 is a group discussion in which the team
uses the team assessment tool (TAT) to examine
Ideally, health care workers enjoy good working and encourage positive team behaviour, and to
relationships in supportive teams. However, consider how the team would (or should) manage
most people encounter a mixture of positive and some problem scenarios.
negative experiences in their relationships with
colleagues. Team members share issues that arise from
completing the tools, but should anonymise
Unfortunately, there is evidence that some health examples of behaviour or difficult situations to
care workers feel that they are, or have been, safeguard individual identity and prevent any
subjected to bullying or harassment (RCN, 2012; scapegoating. This is to encourage reflection and
Illing et al 2103 ). Working with care is a set of tools development, and discourage a climate of blame
designed to help health care workers and teams to and acrimony. Again individuals are not required to
improve interpersonal relationships by increasing show their individual responses to anyone else.
positive experiences and decreasing negative
behaviours. In particular, they should help to At the end of the session, the group produces an
produce a culture or team climate where bullying agreed team action plan to enhance the team
or harassment are unlikely to occur. interpersonal climate. This constitutes feedback
that will be communicated to other members of
The tools are designed for use by all members of the team, and to managers, who were not present
a work team, ideally by overlapping work teams at at the session. However, anything else that is said
all levels of a health care organisation. The work or written, or anything that happens during the
team should hold a session dedicated to exploring session has to be kept absolutely confidential to
and enhancing the team interpersonal climate. the group present at the session.
The exercise consists of two stages.
Please complete the individual assessment tool
Stage 1 before the team session, even though you will
keep it private and will not have to disclose your
In Stage 1, the individual assessment tool (IAT) is answers. The IAT and its explanatory notes cover
completed by each team member to help them issues that are vitally important as background
think about their own attitudes and behaviour to the team session. At the team session, you
towards other team members, both positive will talk about positive behaviours and pool
and negative. The IAT may be distributed and constructive ideas for enhancing the team climate.
completed before the main session. Individuals This exercise is intended to improve interpersonal
are not required to show their responses to relationships and supportiveness within teams.
anyone else.
14 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

However, it deals with some sensitive matters.

If you need to talk to someone about any issues
raised, or if you want further information, you
should contact a staff counsellor or the bullying/
harassment adviser.

Completing the individual

assessment tool
This individual assessment tool encourages you
to examine your own behaviour towards others,
to acknowledge and affirm positive behaviour,
and to recognise and address negative behaviour.
Complete the IAT being as honest as you can.
There is no scoring and you are not expected to
show your completed IAT to anybody else. It is
simply a tool to help you reflect on how you relate
to others at work and identify your own strengths
and weaknesses. Some explanatory notes are
provided. It will probably take you 20-30
minutes to complete the tool and read the
explanatory notes.
In this tool, colleague refers to anyone else you
work with, whether senior, junior, or at a similar
level to you, whether clinical or non-clinical,
managerial or support staff.
A few of the questions relate to people with
managerial or supervisory responsibilities. If you
do not have such responsibilities, you may not be
able to answer the question. However, it is still
important that you think about the question so that
you are aware of the behaviour involved.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 15

Section 1: common positive how much you agree or disagree. Some of these
behaviours may seem trivial or so routine that
behaviours you don’t think about them. However, they are
Read the following statements. Think about how all-important. Such routine, positive behaviours
they relate to your normal behaviour at work. For create a friendly atmosphere and set a supportive
each statement, tick the box that best represents culture (see explanatory notes overleaf).

Strongly Disagree Neither Agree Strongly

Disagree agree nor Agree
disagree
1. “I try to say ‘thank you’ whenever a colleague
is helpful”

2. “I praise colleagues when I think they have done

a good job”

3. “I try to smile at colleagues when I pass them”

4. “I try to make sure that no one is left out of

informal discussions or social occasions”

5. “I offer to make/fetch coffee/tea, etc for other

members of the work team when they are very busy”

6. “I make a point of welcoming new members of

the team, helping them to learn the systems and
procedures, and to get to know other staff”

7. “I regularly offer to help others when they are

overworked or are having some other difficulty”

8. “I often ask for other people’s views and try to show
that I value those opinions”

9. “I always look out for the safety of other colleagues”

10. “I respect other colleagues’ jobs and the tasks that
they have to carry out, and I always try to co-operate
when those tasks affect me”

11. “When problems occur, I always try to assume the

best about all my colleagues, that is, I give them
the benefit of the doubt”

12. “I always try to respect the cultural differences and

religious beliefs of my colleagues”

13. “I always try to be helpful to more senior colleagues

and carry out what they ask as well as I can”

14. “I try to be considerate to more junior members

of staff and respect their abilities and willingness
to learn”
16 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Strongly Disagree Neither Agree Strongly

Disagree agree nor Agree
disagree
15. “I try to help, or make allowances for, staff who
have particular problems to overcome, such as
the physical limitation or language difficulty”

16. “I try to support colleagues whom I know to be

having personal difficulties”

Explanatory notes Questions 5, 7 and 9: looking after

Some of these notes may appear self-evident colleagues
or obvious. But remember, ordinary, everyday Looking out for colleagues’ physical safety
behaviours, which we take for granted, set the and their state of mind helps to build trust and
working atmosphere and the team climate. increase feelings of security. You may be able
Unfortunately, these behaviours can so easily go to help directly to ease someone’s workload. If
wrong without us noticing. We sometimes need to you can’t help directly with the work, doing little
sit back and consider the routine and obvious. things, such as fetching a drink, or whatever is
appropriate, can help to ease the pressure on
Questions 1 and 3: creating a friendly them and keep everyone’s morale up. Many jobs
atmosphere in health care involve some risks from accident,
Basic politeness and courtesy are fundamental violence or clinical mishap. If all members of the
to establishing and maintaining good working team keep alert for unsafe situations that might
relationships. Sometimes, it’s easy to forget and affect each other, then everyone will feel safer and
take colleagues for granted. Smiling can make more supported in their work.
all the difference to the atmosphere in a team
and it will be noticed by patients and clients too.
Questions 1, 2, 10, 13-15: showing
Remember that body language conveys at least appreciation of the work that people do
as much information to others as the words that praise and thanks do not have to be effusive
we say. Just a quick word is usually all that is needed. Co-
operation with others to enable them to carry out
Questions 4 and 6: helping everyone to feel their jobs also reinforces the value that you place
part of the team on their work. In addition, if we co-operate with
In any work team, some people interact easily with them, they are more likely to co-operate with us!
their colleagues. Others find it more difficult for One source of conflict common in nursing is
all sorts of reasons. Their job may mean that they the value of experience versus qualifications,
work away from the rest of the team, they may particularly with the changes in nurse training over
lack confidence, or they may perceive themselves recent years. Some very experienced nurses may
to be different in some way, such as age, gender, resent younger, or less experienced, colleagues
language or culture, or they may just be new to the with higher formal qualifications and try to ‘put
team. It is easy to feel isolated and left out in such them in their place’. Equally, some more recently
circumstances. The rest of the team making an qualified nurses may flaunt their qualifications and
effort to include them can make a real difference not give due respect to the experience of longer-
to how they feel and, in turn, how they behave serving colleagues. Respecting the different
positively towards others. types of knowledge that come from academic
study and practical experience, and pooling those
resources graciously, is a much more constructive,
supportive and comfortable way of behaving for all
concerned.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 17

Questions 8, 11, 12, 14, 15 and 16: Section 2: common negative

demonstrating respect and consideration
for other people
behaviours
Showing consideration for colleagues and Complete this section in two steps.
demonstrating that they are valued as people,
not just as workers, builds a good basis for Step 1
mutual respect, which benefits us as well as the Consider the following list of behaviours. Which
other person. of them do you think constitute bullying or
harassment, or both? For each of them tick
column 1 and/or 2, or 3. (Don’t get worried about
the distinction between bullying and harassment
as they do overlap.)

Bullying Harassment Neither Have had it Have

done to me done it
17. Blaming/criticising someone without having all of
the evidence, that is, assuming the worst

18. Not acknowledging the good work that colleagues

have done

19. Belittling colleagues’ work when talking to others

20. Voicing doubt about the integrity of a colleague

without very good reason

21. Making sarcastic or insinuating remarks to, or

about, colleagues

22. Verbally threatening a colleague

23. Deliberately damaging the property of another

member of staff

24. Deliberately withholding information from another

member of staff who needs it

25. Ignoring another member of staff or excluding them

from the conversation

26. Pressurising other members of staff to do a task

or produce work despite knowing that they have too
much else to do

27. Setting very tight deadlines for leave, training or

promotion without giving the member of staff a good
and valid explanation

28. Refusing applications for leave, training or

promotion without giving the member of staff a
good and valid explanation

29. Removing a responsibility from a member of staff

without consulting with them first
18 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Bullying Harassment Neither Have had it Have

done to me done it
30. Using disciplinary or competence procedures as a
threat to a member of staff

31. Changing the requirements for staff performance

(“shifting the goalposts”) to keep staff on their toes

32. Making rude comments or derogatory gestures to

other members of staff

33. Making jokes or negative comments about another

member of staff’s gender, sexual orientation, race,
religion, age or disability

34. Requiring a member of staff to do something

inappropriate to their personal, cultural or religious
beliefs

35. Showing favouritism to one member of staff or a

small group at the expense of others

36. Joining in or laughing if other colleagues are teasing

or making negative comments about someone

37. Shouting or criticising when under pressure

38. Using swear words or expressions that others might

consider blasphemous, rude or offensive

39. Making comments of a suggestive nature to other

members of staff

40. Using your charm or charisma to persuade someone

to do something that should not be their first priority

Every one of these behaviours could constitute bullying or harassment in some circumstances
(see explanatory notes below).

Explanatory notes Bullying may occur from superior to subordinate

(downward bullying), between co-workers
Bullying or not? (horizontal bullying), or from subordinate to
All these behaviours (questions 17 to 40) may superior (upward bullying), at any level of the
constitute bullying or harassment, or both, but not organisational hierarchy.
on every occasion.
Many definitions of bullying also require that the
Bullying normally involves behaviour that is behaviour is persistent or repeated. However,
damaging to the target and involves an imbalance some actions can be so severe and obvious that
of power, so that the target feels that he/she is one occurrence would constitute bullying.
not able to defend himself/herself effectively.
Bullying may be overt, that is, it is obvious to the
Such power may be that of superior status in
person being bullied and to other people. However,
the organisation, but may also be possession
it may also be covert, that is, either the damaging
of such things as information, knowledge and
action or the person responsible for that action is
skills, access to resources or social position.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 19

concealed from the target or from other people. persistently; threatening someone verbally or by
Such covert bullying can be very subtle, and not gesture or posture; and using physical violence
always recognised as bullying behaviour. Look towards a person or their property.
again at the list!
3. Isolation (see questions 24, 25, 28, 35
Conversely, some reasonable behaviour may and 36)
appear to be bullying to the apparent target,
because there is always the possibility of This covers any behaviour that causes people
misunderstandings, mismatches in expectations to feel that they are not one of the team or one
or differences in culture. In these cases, either of the in-crowd, that they are being treated
the apparent perpetrator is not aware that their differently from others. Isolation includes, for
actions are perceived as bullying, or has cause to example: withholding information; freezing out,
feel that their actions are perfectly justified and ignoring, excluding, intentionally turning your back
reasonable. Some apparently bullying actions on someone when they speak to you; refusing
may have valid reasons behind them, for example, applications for leave, training, promotion without
“using disciplinary or competence procedures as good reason; and showing favouritism to some at
a threat to a member of staff” might be justified the expense of others.
if the member of staff is deliberately under-
performing. However, in this situation, the use of 4. Overwork (see questions 26, 27 and 40)
such procedures should be explained, and applied a) This is a difficult area, particularly in health
consistently and transparently. care where shortages of staff and resources
may cause high workloads for teams. However,
So what behaviours may constitute bullying? They
good management includes helping staff to
can be classified into five broad types (Rayner &
prioritise work, and setting realistic limits
Hoel, 1997):
on what can be achieved. Overworking staff
1. Threat to professional status (see includes: pressurising them to produce work;
and setting impossible deadlines.
questions 17, 18, 19, 30 and 37)
This includes either undermining a colleague’s b) Using charm or charisma or a bribe to get
ability to do their job effectively, or adversely someone to overwork can also be a type of
affecting other people’s perception of that covert bullying.
colleague’s ability to do the job. Such behaviours
include: criticising unjustly; belittling a colleague’s 5. Destabilisation (see questions 18, 28, 29
work (either to that person or to others); and 31)
humiliating someone, perhaps through an This covers attempts to make it difficult for people
apparently harmless joke related to their work to work effectively and have their work valued,
performance; and using discipline or competence including changing working arrangements without
procedures as a threat. consultation. Examples are: shifting the goal
posts, that is changing work targets without good
2. Threat to personal standing (see reason and/or without adequate time or resources;
questions 20-23, 32, 33, 36-39) undervaluing work; attempting to demoralise;
This relates to attacks on the person rather than and removing areas of responsibility without
their ability to do the job. These include actions consultation.
that damage, or threaten to damage, a colleague
physically or materially, or undermine their Harassment or not?
self-confidence. They also include actions that What constitutes harassment or discrimination?
undermine other people’s respect for a colleague. Harassment and discrimination involve negative
Examples are: throwing doubt on someone’s behaviour concerning a colleague’s gender, sexual
personal honesty or integrity; using sarcasm and orientation, race, religion, age or disability.
innuendo; making inappropriate jokes; teasing
20 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Questions 33, 34, 38 and 39: behaviour that b) whether you ever behave in any of these ways.
may be harassment and discrimination Be honest with yourself. Remember that no-
one is perfect and very few of us can truly say
Again the behaviour may be intentional or there
that we have never done any of these. All of us
may be misunderstanding and mismatch of
behave sometimes in ways that we wish we
expectations. Such negative behaviour includes:
had not.
making negative comments or gestures; making
inappropriate jokes; touching inappropriately; Tick the relevant boxes in columns 4 and 5.
ignoring someone or excluding them from
activities; and requiring them to carry out There are other behaviours that may not constitute
inappropriate tasks. bullying or harassment in themselves, but may
help to create an atmosphere in which bullying and
Step 2 harassment are likely to occur (see explanatory
notes below). Look at the following and indicate
Now look at the list again and consider: whether you ever behave in that way.
a) whether you have ever experienced any of these.

Never Occasionally Sometimes Often

41. Generally muttering or complaining about people
behind their back

42. Grumbling when asked to do something by a

manager or senior colleague

43. Gossiping about other members of staff

44. Seeing something negative occurring and taking

no action to stop it

45. Not listening to others or not taking their

difficulties seriously

46. Demanding that other managers or supervisors

meet a target without considering whether it is a
realistic target for his/her team

47. As a manager, not taking notice of warning signs in

a team or an individual, such as high absenteeism,
low productivity or morale, many people leaving

Explanatory notes behaviour is acceptable. In these circumstances,

negative behaviour can easily escalate or be
Questions 41-47: behaviour that increases adopted by others and a bullying culture develops.
the likelihood of bullying or harassment Cynical or macho group cultures can produce
occurring to others an atmosphere in which negative behaviour is
Bullying and harassment may primarily be the tolerated or even encouraged.
fault of the direct perpetrator, but if others in the Other behaviours may make individuals vulnerable
team know what is happening and do nothing to negative behaviour from others. Look at the
about it, or even join in the bullying, they are following and indicate how typical they are of your
also morally responsible. If nothing is done, behaviour. Again, be honest with yourself.
the perpetrator and others may assume such
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 21

Very Untypical Typical Very

untypical typical
48. Taking offence easily at things that other people
say or do

49. Keeping myself to myself rather than socialising

with other members of the work team

50. When relating events, putting myself in a good

light compared to others, or boasting about my
achievements

51. Reacting aggressively to criticism

52. Dressing differently to shock

53. Not making an effort at work, cutting corners, or

not pulling my weight

54. Being unwilling to compromise

55. Avoiding issues that might cause conflict

56. Being unassertive

57. Continually complaining or making negative or

cynical comments

58. Being fussy about accuracy even when it is not of

great importance

59. Arriving late, leaving early, taking long lunch breaks

or taking days off, for no obvious reason

60. Dominating, for example, by talking too much, by

having to be in the right or always wanting to have the
last word

Explanatory notes you cry alone”. Of course, when people are in real
difficulty, others are generally inclined to listen and
Questions 48-60: behaviour that is likely sympathise, but they can get fed up of continual
to increase vulnerability to bullying or complaining about relatively trivial issues.
harassment
Dressing differently from most of our colleagues
There is some research evidence (see Zapf, 1999) can leave us vulnerable to criticism or teasing.
that people who are low in assertiveness, who try Of course, there are cultural and religious reasons
to avoid conflicts and who make little effort to be for people to wear particular types of clothes, and
part of a team may be more vulnerable to bullying most colleagues respect those reasons. Indeed,
than others. That doesn’t mean that any of these it could be seen as harassment if they did not.
characteristics cause bullying, but they may not However, if we dress differently in order to shock
protect against it. others in some way, then that may generate
Other behaviours that may increase vulnerability comment. Dressing in a revealing or
include always complaining or looking miserable. sexy manner may also increase vulnerability to
There is a certain amount of truth in the saying sexual harassment.
“laugh and the world laughs with you; cry and
22 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Section 3: friendly behaviours

open to misinterpretation
Read the following statements. Think about how
they relate to your normal behaviour at work. For
each statement, tick the box that best represents
how often you do the following.

Never Occasionally Sometimes Often

61. Touch the arm or shoulder of another member of
staff when talking to them

62. Hug or put an arm round another member of staff

to be friendly

63. Tell jokes to make everyone laugh

64. Tease other members of staff about their height,

size, appearance, accent, personal life, or other feature

65. Compliment others on their appearance

66. Pass on personal information about a member of

staff when you feel someone else needs to know

All of these can be very positive and can add to the

friendliness in a team. However, all can be misused or
misinterpreted, or may just be unwanted by some
individuals. Use them all carefully.

Explanatory notes Questions 63 and 64: friendly teasing or

cruel tormenting?
Questions 61, 62 and 65: friendliness or
sexual harassment? Teasing can also be a sign of acceptance and
friendship. However, unless we are really close
Touching someone can be a real sign of friends, it is impossible to know whether another
friendship or empathy. Unfortunately, it can also person enjoys our teasing or simply tolerates it.
be interpreted as sexual harassment if done to Teasing often concerns the characteristics that
someone who doesn’t welcome being touched. we are most sensitive about and can increase
Judging who welcomes your touch, who tolerates that sensitivity. Similarly, jokes can be great fun
it and who is offended by it can be difficult. and can lift the morale of the team in awkward
Similarly, complimenting someone on their circumstances. However, if the jokes come at the
appearance can be very supportive. However, expense of a member of the team, they can be
if it is done too often or in a manner that could very destructive.
be construed as suggestive, for example, telling
someone that they look sexy, it may be interpreted
as sexual harassment.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 23

Question 66: friendly concern or malicious Section 4: retrieval behaviours

gossip?
Sometimes, particularly at very busy times, things
Passing on personal information about a go wrong and we realise that we have acted
colleague to others may occasionally be necessary unreasonably in some way, or our actions have
and justified. However, unless we have their been misunderstood. Alternatively, someone
permission to pass it on, we may be doing them else may have acted unreasonably. What can we
a great disservice. Colleagues need to be able to do to retrieve the situation? Read the following
trust our discretion knowing that they can tell us statements. Think about how they relate to your
things without them being passed on to others. If behaviour at work after a problematic situation.
we are not careful, it is easy to slip into enjoying For each statement, tick the box that best
idle or malicious gossip. represents how much you agree or disagree.
Strongly Disagree Neither Agree Strongly
Agree agree nor Agree
disagree
67. “I usually apologise when I realise that I have been
in the wrong”

68. “I usually have no difficulty accepting apologies from

a colleague and moving on”

69. “After problems have occurred, I usually find it

useful to discuss calmly what went wrong, with the
others concerned”

70. “If a colleague us criticised for something I know

he/she didn’t do, I stick up for him/her and try to
explain the misunderstanding”

71. “If I find it difficult to like a colleague, I try to hide it

and still work well with them”

72. “I always try not to apportion blame after a problem

has occurred but to find out what has happened and
learn from it”

Explanatory notes Recognising that we have been in the wrong and

apologising can so often be all that is needed to
Questions 67 to 68: apology and forgiveness repair a relationship with a colleague. The sooner
Realistically, all of us behave at times in ways that it is done, the better it usually is. But sometimes it
we wish we had not. Alternatively, we may have can be very difficult both to apologise and to accept
offended someone completely unintentionally. apologies. However, not doing either of these can
In all working relationships there has to be a lead to deep bitterness. Trying to empathise, that
level of acceptance of each other’s fallibility, and is to understand the other person’s point of view,
mechanisms by which unfortunate situations can or their reasons for behaving in a particular way,
be retrieved. can help in the process of forgiveness.

Some of these mechanisms involve: apologising; Questions 69 and 72: discussion and learning
accepting apologies; empathy; discussion and
Empathy can also help to avoid the
turning problem situations into opportunities for
destructiveness of always wanting to blame
learning.
someone else whenever something goes wrong.
24 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

A blame culture can also be avoided by openly Remember that we all make mistakes sometimes
discussing problems and mistakes, and using and behave less well than we would like. However,
them as opportunities to learn. if we acknowledge this and apologise, we can
usually retrieve the situation.
Question 71: putting differences aside
This exercise is intended to help improve
Occasionally, it is not possible to reach agreement interpersonal relationships. However, if you found
over a particular incident, or we find that there is it difficult or distressing, contact a staff counsellor
a colleague whom we just find it difficult to like. or the bullying/harassment adviser.
However, it is usually possible to find a way to
continue to work productively with them and to References
treat them courteously, by trying to concentrate on
their positive qualities. This makes for a happier RCN (2015) Beyond breaking point – a survey report
atmosphere for all than continually bringing up of RCN members on health, wellbeing and stress.
the grievance and, over time, they may redeem London: RCN.
themselves, if we give them the chance. Available online at www.rcn.org.uk/publications
Illing JC, Carter M, Thompson NJ, Crampton
Question 70: explaining misunderstandings PES, Morrow GM, Howse JH, et al (2013) Evidence
Retrieving situations where others have been synthesis on the occurrence, causes, consequences,
blamed for something that was not their fault can prevention and management of bullying and
be a difficult and brave undertaking. However, it harassing behaviours to inform decision making in
may prevent someone becoming victimised, and it the NHS. Final report. NIHR service delivery and
helps to demonstrate and consolidate team trust organisational programme; 2013.
and cohesion. Available at www.nets.nihr.ac.uk/__data/assets/
pdf_file/0006/.../FR-10-1012-01.pdf
(accessed 29 June 2013)
Section 5: reflection
Rayner C and Hoel H (1997) A summary review of
Now take some time to consider the issues you literature relating to workplace bullying. Journal of
have thought about while completing this tool. Community and Applied Social Psychology, 7,
pp181-191.
Read through the explanatory notes if you have not
already done so. Zapf (1999) Organisational, work group related
and personal causes of mobbing/bullying at work,
Most of us find that taking stock of our behaviour
International Journal of Manpower, 20 (1-2),
in this way is a salutary experience. It makes
pp70-85.
us realise that many of the routine things we
do are very positive, but others are not quite so
commendable. Also there may be things that we
don’t do that we should try to do.
• W
 hat did you find encouraging? What are your
strengths?
• W
 hat behaviours do you need to be careful
about? What are your weaknesses?
• W
 hat positive things could you try to do more
often?
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 25

B. Team assessment tool

Introduction Complete Section 1 being as honest as you
can. There is no scoring and you do not need
You should already have been given an individual to show your completed tool to anybody else.
assessment tool (IAT) before this session, and had When everybody has completed their inventory,
opportunity to read about it and complete it. If you you will be encouraged to share and discuss
have not seen an IAT, please ask to see one. The your views. In the discussion, try to concentrate
IAT is designed to help each person to think about on team supportiveness rather than on wider
their own attitudes, perceptions and behaviours organisational issues.
at work. You will not be expected to show your
completed IAT to anybody else. Confidentiality
This team assessment tool looks more at the It is very important that everyone feels free to
behaviour of the work team as a whole, and is voice their opinions without the fear that what
designed to examine and encourage positive team they say will be passed on to others, or used
behaviours. Section 1 includes some of the same against them. At the end of the session, the group
questions that you applied to yourself in the IAT. will draft an agreed team action plan that will be
Section 2 provides some problem scenarios for communicated to any members of the work team
you to consider how the team would, or should, who were not present and to managers.
manage them. Members of the group then share
However, anything else that was said or written,
ideas about issues arising from completion of
or anything that happened during the session
the tools with behaviour and circumstances
must be kept absolutely confidential to the group
anonymised to a level that safeguards individual
present at the session. Each participant should
identity. This is to encourage reflection and
take away their own team assessment tool and
development, and discourage blame and acrimony.
dispose of it as they see fit.
At the end of the discussion session, the group
produces an agreed team action plan to enhance
working relationships in the team, including any
Section 1: team supportiveness
learning or training requirements. This looks again at ordinary, everyday behaviours,
which we tend to take for granted but which
The TAT is designed with the following objectives:
determine the working atmosphere. Recognising
• t o help you think about the behaviour and the supportive things that we do as a team can
attitudes of your work team as a whole be very productive. Encouraging these positive
behaviours enhances both the team climate and
• t o acknowledge and affirm positive behaviours our overall enjoyment of work.
and attitudes in the team
In this tool, colleague and similar terms refer to
• t o facilitate sharing and discussion of anyone else you work with, whether senior, junior,
generalised issues or at a similar level to you, whether clinical or
• t o consider how the team would/should non-clinical, managerial or support staff.
manage some problem scenarios. You have already thought about the following
Please remember that the main purpose of this behaviours and applied them to yourself in the
tool is to encourage reflection and development, individual assessment tool. Now consider how
and to discourage blame and acrimony. typical each behaviour is for the work team as
a whole.
26 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Not at all Slightly Moderately Very Extremely

typical typical typical typical typical
1. Saying “thank you” when a colleague is helpful

2. Praising each other for doing a good job

3. Smiling at each other when we pass

4. Making sure that no one is left out of informal

discussions or social occasions

5. Offering to help others when they are overworked or

are having some other difficulty

6. Offering to make/fetch coffee/tea, etc for others

when they are very busy

7. Making a point of welcoming new members of

the team, helping them to learn the systems and
procedures, and to get to know other members
of staff

8. Asking for other people’s views and showing that

we value their opinions

9. Sharing all appropriate information with other

colleagues who might need it

10. Looking out for the safety of other colleagues

11. Respecting each other’s jobs and the tasks that they
have to carry out, and trying to co-operate when
those tasks affect us

12. When problems occur, assuming the best about each

other, that is, giving them the benefit of the doubt

13. Respecting each other’s cultural differences and

religious beliefs

14. Being helpful to more senior colleagues and carrying

out what they ask as well as can

15. Being considerate to more junior colleagues and

respecting their abilities and willingness to learn

16. Helping, or making allowances for, staff who have

particular problems to overcome such as a physical
limitation or a language difficulty

17. Respecting and acknowledging each other’s abilities

and expertise

18. Respecting each other’s limitations and trying to

help when asked.
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 27

How much do you think the following are typical of the people in your work team?

Not at all Slightly Moderately Very Extremely

typical typical typical typical typical
19. People feel understood and accepted by each other

20. People in the team co-operate in order to help

develop and apply new ideas

21. People can openly share their ideas and feelings

22. People can talk freely to each other about difficulties

they are having in performing the task and know that
the other person will listen

23. People know that if they share ideas and task-related

problems their team-mates would respond
constructively and caringly

24. People trust and respect each other as co-workers

25. People consider each other to be trustworthy

Note: This is adapted from Kivimaki M and Elovainio M (1999) A short version of the Team Climate Inventory:
development and psychometric properties, Journal of Occupational and Organizational Psychology, 72, pp241-246.

Are there positive aspects of your work team that have not been covered in the questions above?
28 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Section 2: problem scenarios the duty roster is worked out. A member of

staff without such commitments feels that he/
Consider the following scenarios. Discuss how the she always has to do the unpopular shifts and is
team might deal with them. starting to resent this. How might this come to
light and how would/should this be handled by the
Scenario 1 team?
A member of the team is involved in an accident
that causes him/her to be off sick for several Scenario 4
months. How would the team react initially and During hectic work periods, one member of the
how would they handle it as the months went by? team regularly loses his/her temper and shouts at
a colleague. How would/should the team handle
Scenario 2 this?
Some members of the team think that one of their
colleagues is not doing his/her fair share of the Scenario 5
work. How would/should this be handled by the A new member joins the team. He/she has a
team? different cultural background from everyone
already in the team, for example, different race,
Scenario 3 language, religion or country of origin. How would
Several members of the team have family the team treat this person?
commitments that are taken into account when

Section 3: suggestions for and then list, in the first tables, positive aspects of
the team interpersonal climate that you think are
team action plan present and should be encouraged, and actions
Think about the discussions that you have had that the team should take to maintain them.

Positive aspects of team climate already present Action to maintain positive aspects

In the next table, list any aspects of the team interpersonal climate that you think need to be improved,
and actions that the team should take to improve them.

Notes
Healthy workplace, healthy you Working with care – improving working relationships in health and social care 29

C. Agreed team action plan

Name of team Date of session

Confidentiality Think about the discussions you have had and

agree what may be shared with other members
This agreed team action plan will be shared with
of the team or managers who were not present at
other members of the work team and may be
this session.
passed to managers for information. Anything else
that was said or written, or anything that happened In the first table below, list positive aspects of the
during the session must be kept absolutely team interpersonal climate that the participants
confidential to the group present at the session. agree are present and should be encouraged,
and actions that the team should take to maintain
them.

Positive aspects of team climate already present Action to maintain positive aspects

In the next table, list any aspects of the team interpersonal climate that the participants agree need to be
improved, and actions that the team should take to improve them.

Aspects of team climate that need to be improved Actions to improve them

Other agreed findings

If the group wishes to add any further agreed comments, write them in the box below.
30 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

D. Follow-up progress form

Name of team:

Dates of follow-up meetings:

This follow-up progress form lists specific actions

agreed by the whole team, along with estimated
times for implementation and space to record
progress. These actions should be based on the
agreed team action plans from the group sessions
and any reports from the facilitator, and should be
realistic and achievable in the short term.

Specific action Time frame Progress

Healthy workplace, healthy you Working with care – improving working relationships in health and social care 31

E. Monitoring form 1
(To be completed at the end of the group session.) Working with Care Evaluation, Employment
Relations Department, Royal College of Nursing,
The RCN would like to monitor the use of these 20 Cavendish Square, London W1G 0RN
tools to ensure that they are effective. You are
asked to complete the following form and return Confidentiality
to the address opposite:
This monitoring form will be seen only by the
monitoring team at the RCN.

Name of team or key contact name (optional) Date of group session

Your work team

Please rate how supporting you have found your work team to be over the past six months (not including
this Working with care exercise).

Not at all Slightly Moderately Very Extremely

supportive supportive supportive supportive

Please indicate how many working relationships have been positive in your work team over the past six
months (not including this Working with care exercise).

Few Some Most Almost all All positive

positive positive positive positive

The individual assessment tool

Please indicate how much you agree with the following statements:

Strongly Disagree Neither Agree Strongly

disagree agree nor agree
disagree
1. “Completing the IAT helped to make me more aware
that ordinary positive behaviours are important”

2. “Completing the IAT should help us to avoid

behaviours that might allow bullying and
harassment happen”

3. “Completing the IAT made me think hard about the

way I behave to other people at work”
32 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

The group exercise

Please indicate how much you agree with the following statements:

Strongly Disagree Neither Agree Strongly

disagree agree nor agree
disagree
1. “Taking part in the group session should enhance
our working relationships”

2. “Taking part in the group session was an

uncomfortable experience”

3. “Taking part in the group session helped me to

appreciate other people’s point of view”

Please indicate your status in the work team:

Very Fairly Intermediate Fairly Very

junior junior senior senior

Please indicate where your team works:

NHS hospital Independent hospital GP practice

NHS community Independent care home Hospice/charity

NHS other Other independent Other

Please add any further comments about the exercise in the box below.

Thank you for completing this monitoring form.

Healthy workplace, healthy you Working with care – improving working relationships in health and social care 33

F. Monitoring form 2
(To be completed after approximately one month.) Working with Care Evaluation, Employment
Relations Department, Royal College of Nursing,
The RCN is keen to monitor the use of these tools 20 Cavendish Square, London W1G 0RN
to ensure that they are effective. You are asked to
complete the following form and return return Confidentiality
to the address opposite:
This monitoring form will be seen only by the
monitoring team at the RCN.

Name of team or key contact name (optional) Date of group session

Your work team

Please rate how supportive you have found your work team to be since the Working with care exercise.

A lot less Less Equally More Much more

supportive supportive supportive supportive

Please indicate how working relationships have been in your work team since the Working with care
exercise.

Much less Less Equally More Much more

positive positive positive positive positive

Please indicate how much you agree with the following statements:

Strongly Disagree Neither Agree Strongly

disagree agree nor agree
disagree
1. “We are more aware that ordinary positive
behaviours are important”

2. “We are more able to avoid behaviours that might

allow bullying and harassment to happen”

3. “We are more considerate to other people at work”

4. “Taking part in the exercise has enhanced our

working relationships”
34 Healthy workplace, healthy you Working with care – improving working relationships in health and social care

Strongly Disagree Neither Agree Strongly

disagree agree nor agree
disagree
5. “Taking part in the exercise has made our
relationships more difficult”

6. “Taking part in the exercise has helped us to

appreciate other people’s points of view”

7. “The work team agreed to an overall team action

plan following the group sessions”

8. “The team has taken steps to implement the overall

action plan”

Please indicate the steps that have been taken to implement the overall team action plan.

Please indicate your status in the work team:

Very Fairly Intermediate Fairly Very

junior junior senior senior

Please indicate where your team works:

NHS hospital Independent hospital GP practice

NHS community Independent care home Hospice/charity

NHS other Other independent Other

Healthy workplace, healthy you Working with care – improving working relationships in health and social care 35

Please add any further comments about the exercise in the box below.

Thank you for completing this monitoring form.

The RCN represents nurses and nursing, promotes
excellence in practice and shapes health policies
September 2015
RCN Online
www.rcn.org.uk
RCN Direct
www.rcn.org.uk/direct
0345 772 6100
Published by the Royal College of Nursing
20 Cavendish Square
London
W1G 0RN
020 7409 3333
www.facebook.com/royalcollegeofnursing
www.twitter.com/thercn
www.youtube.com/rcnonline
Publication code: 004 972

To find out more about the RCN’s healthy workplace

campaign, visit www.rcn.org.uk/healthyworkplace