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ss spotlight - spring 2020,  teamwork: a dream or living nightmare?

teamwork: a dream or living nightmare?

James Howitt shares his perspectives and experiences of working in the MDT as a junior doctor

In 2002, John Maxwell wrote a book entitled Teamwork makes the dream work. His idea was that effective teamwork is what allows us to fulfil our aspirations, passions and desires.

I hope we can all remember teams that we've been part of that were cohesive and unified, where all the pieces moved as they should and became greater than the sum of their parts. However, bad teams can turn dreams into nightmares, and I'd wager most of us have all too often had experience of that at some point whilst working in healthcare.

Multidisciplinary teams (MDTs) are made up of a wide variety of individuals of different disciplines (obvious really, as it's right there in the name). But each discipline comes with its own training and culture, and it seems to me that trying to mesh these cultures together is a key factor in good or bad NHS teamwork. There will always be the occasional bad apple, an obstinate colleague who can't or won't gel with the team, but in my experience most healthcare professionals want to work well with others, and yet all too often we find ourselves tripping one another up. The reasons for this are incredibly complex and nuanced and certainly cannot be fully covered in 750 words, however within my own professional career I have observed several recurring issues that cause friction between teams.


It is human nature to define ourselves by our groups, which allows us to understand who is 'in' and who is 'out'. When working as a junior in a large obstetrics and gynaecology team I quickly learnt that in that team, so far as was possible, we stuck with our own group. There was no social connection; the doctors, midwives and nurses all ate in separate spaces, took breaks in different areas and had separate Christmas social events. Much like teenagers at a school disco, the culture was one of staring at the group opposite from across the hall, but rarely, if ever, interacting. This made for poor communication channels and a lack of understanding about the decisions being made. Without a social connection, many staff were too afraid to admit they didn't know or understand something and to ask for help, which is a wholly unsafe and undesirable place in which to be.


I remember that I felt uncomfortable the first time I heard another doctor refer to a nursing colleague as 'incompetent' behind their back. Not only did the accusation have no basis in truth, as far as I could tell, it also seemed entirely disrespectful to another team member. I don't remember exactly when I stopped feeling uncomfortable about hearing doctors use language like that to describe colleagues (I don't specifically mean to single out doctors here by this example; I know it's just as prevalent in all disciplines). I can however, remember when I realised that I had started speaking the same way.

Several years later, having lunch with a group of other juniors, I was recounting a minor mistake a colleague had made which had really annoyed me, but that I was likely blowing out of all proportion and a chorus of similar overblown minor mistakes were echoed from the others. One doctor, not a Christian, refused to be part of the discussion and called us out for being rude and demeaning to our colleagues and suggested we'd all benefit from a bit less mouth and a bit more humility. I was utterly ashamed, and rightly so, because how we speak about others affects how we treat others.

the call to be countercultural

As Christians in healthcare, we must recognise that we are 'cultural architects' within the NHS. The world around us and our work on this earth of partnering with God to build his kingdom is far more affected by our actions, than by quietly held beliefs.

It doesn't happen by accident and it isn't easy, but if our heavenly Father loved us and saved us by grace, then we need to recognise that we must extend this to others. If we don't show grace, then our belief in such things is meaningless in the eyes of the world around us. What will the culture of the team surrounding you look like when you next go into work? How can you show God's grace?

James Howitt was a junior doctor and a CMF Associate Staff Worker. He now works full-time for his church.

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