Effective workplace cultures make an organisation a good place to work. The National Guardian Office annual report stated that 38.5% of the total cases raised with Freedom to Speak Up (FTSU) guardians last year related to inappropriate behaviours and attitudes (The National Guardian Office, 2024). The report highlighted incivility, favouritism, shouting, swearing and belittling. Cultural issues were identified by internationally educated nurses. There were also a number of cases reporting discrimination towards protected characteristics. The annual report goes onto identifying culture as a patient safety issue. The concept of workplace culture is amorphous, so the simple definition of culture of ‘how things are done around here’ (Drennan, 1992) can be used to start thinking about exploring our own workplace culture. Healthy workplace cultures are crucial in ensuring high quality patient care and improved patient outcomes (Braithwaite et al, 2017; The National Guardian Office, 2024).
Exploring team culture presents an opportunity for community nurses to actively listen to each other and critically reflect on their own team culture. There are a number of theoretical models exploring culture that may be used within a team and support the team to make positive changes. Cardiff et al (2020) identified ‘four guiding lights’ that together contribute to a more positive working environment and improved team relationships. These guiding lights are: collective leadership within the team; living shared values; safe, critical, creative learning environments; and change for good that makes a difference.
The National Guardian Office identifies October as the month for raising awareness and celebrating the individual's freedom to speak up when something is not right. This year's theme was ‘listen up’. Making time to listen is essential, if we want the quality of our workplace culture to improve. We all have a responsibility to listen to each other and everyone can commit to a positive action to support this year's campaign. This may take the form of each person in the team pledging to take an action and committing to ‘listen up’.
Each team member has to be clear that everybody has a voice. Teams may decide to find out more about culture and further explore the ‘four guiding lights’ principles; others might review how new and existing members feel welcomed, valued and included within the team setting. Using a strengths-based approach, such as appreciative inquiry, to ‘listen up’, community nurses can identify what is working well in teams, highlight gaps and contribute their ideas for making improvements that will result in their teams performing even better.
It is everyone's business to support individual members of a team to speak up when they witness inappropriate behaviours and attitudes. It is the community nurse's duty to collectively listen, identify shortcomings and take remedial actions as appropriate, as well as encourage individuals to escalate concerns using established mechanisms. Spending time ‘listening up’ can support our teams to co-create a workplace culture where everyone feels valued and listened to. It will increase job satisfaction and ultimately result in better patient outcomes and improved care.