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4 Simple, Low-Cost Team Exercises That Will Change Your Unit’s Culture

Relationships and interpersonal communication are some of the biggest stressors in healthcare settings, where you rely on your colleagues so often and the stakes of errors can be sky-high.

Research indicates that teamwork can demonstrably improve patient care. But units often fail to collaborate effectively when employees don’t feel invested in the department’s goals and values, notes Charles Kunkle, MSN, CEN, CCRN, who’s written a book about energizing bedside caregivers titled No Time to Care.

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“Most people who work at the bedside don’t know what their mission statement is,” Kunkle says. “It doesn’t ring true to them because, number one, they didn’t make it.”

Kunkle sat down with Florence Health to share some effective exercises that, in his experience, can change a unit’s culture in just a few days.

Shared values board

“Create your own vision statement made up of rules and philosophies that your department makes — not the leaders, but everyone from the housekeepers to the registrars to the nurses to the physicians,” Kunkle says.

For this activity, all you need is a pack of notecards. Hand them out to everyone in your department and ask them to write down their answers two questions: What makes a great department to work in? What makes a great team member?

The organizer should then collect the responses, synthesize every answer into a set of meaningful values, and pin them to a bulletin board ideally in a central location in the department.

The end result is individual accountability and community support, Kunkle says. Employees want to uphold the values they decided were important and encourage others to do the same.

Beads for Deeds

Kunkle shared this trick during his keynote speech at the 2019 Magnet Conference. An ER team he worked with several years ago proposed this program.

Buy wine rings for every employee in your department and a bunch of beads. Participating employees should attach the wine ring to their ID, and every time they do a good deed, they can add a blue bead to the ring. After earning five blue beads, they can trade up to another color bead or receive a lower level prize.

The process continues for two more colors. After receiving five beads of the fourth color, the employee has earned a day off.

Perhaps the most interesting part of the initiative, however, was that over 10 years, Kunkle says only one person traded in the beads. Why?

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“When you traded in your beads, you had to start all over at blue, and nobody wanted to do it,” Kunkle notes. “They’d say, ‘I wear these beads with pride. This is who my colleagues say I am, what I’ve done … or patients ask me what the beads are and I get to tell them about all the wonderful things I’ve done, and they get the confidence that I’m an awesome care provider.'”

Strengths, weaknesses, needs, pet peeves

This activity is especially educational for people in management positions. Take a notecard and divide it into four sections. In each section, write your strengths, weaknesses, needs and pet peeves.

After you’ve filled it out, bring it to a loved one, whether that’s a partner or close friend, and ask him or her to be completely honest and add to it. Then, if you’re feeling really brave, bring it into work and ask a coworker you trust to look it over and add to it again.

This process highlights the differences between the way you see yourself and what others notice. You can use it to improve behaviors that you might not have otherwise realized can discourage or upset coworkers.

Golden urinal awards

Kunkle says he has three requirements for team-building programs: they must be fun, simple and inexpensive. With those parameters, an ED team early on his career created the “golden urinal awards.”

Kunkle’s team reserved the auditorium, which required no money, and various members stashed urinals (to be given out as prizes) in his office over the course of several months. Next came the award categories: funny, “lift us up,” and “-of the year.” Inspirational titles included, “the ER tech you want by your side when your patient is crashing,” and “rookie of the year.”

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Employees loved the program so much that they expanded it without poking or prodding. The “crafters,” as Kunkle calls them, customized the urinals to look like the awards they represented and created “the golden urinal hall of fame” to present the title winners’ plaques in the hospital.

The most effective part of the program — more than the motivation that comes from the possibility of recognition, Kunkle stresses — was the act of building it as a team: “When do things together, we can do amazing things.”


Charles Kunkle, Interview, Oct. 11, 2019.

Last updated 10/15/2019.

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