NU512 Unit 7 team behavior analysis example

Same Program, Three Reactions: A Social Identity Analysis of Functional Carryover on a Composite Rehabilitation Unit

[Student Name]

Purdue University Global

NU512: Leadership, Organizational Theory, and Behavior

Unit 7 Assignment

[Instructor Name]

[Date]

Audit figures and staff reactions are composite and bracketed; the theory and research cited are published.

The Program

Functional carryover means nurses and nursing assistants practicing, outside therapy hours, the skills patients learn in therapy: dressing the lower body, sit-to-stand transfers, walking to the bathroom with the assistance level therapy has set. The unit launched a carryover program in [May] after the dispute over mobility status. Each patient's therapists posted three carryover activities a day on a bedside card, and nursing staff documented each one. In the second month, to capture change, nurses also began scoring patients' self-care on a short set of items borrowed from the rehabilitation assessment.

What Happened

A month's audit showed three reactions.

1. Nursing assistants completed [78] percent of scheduled carryover activities. Several asked to attend therapy sessions to learn techniques, and two were named by therapists in team conference.

2. Registered nurses completed [41] percent. Their comments in a unit meeting described carryover as "therapy's job moved onto us" and "more tasks on a full shift."

3. Two occupational therapists filed written objections when nurses began scoring self-care items, arguing that assessment of self-care is occupational therapy's work and that nurses were not trained to score it.

The Theory

Social identity theory holds that people derive part of their sense of self from the groups they belong to, compare their groups with others, and are motivated to keep a positive and distinct group identity (Tajfel & Turner, 1979). In organizations, professional groups are powerful sources of identity, and people respond to changes partly according to what those changes do to their group's standing and distinctiveness (Hogg & Terry, 2000).

Research on interprofessional teams adds a specific mechanism. Mitchell et al. (2011) found that professional diversity helped interprofessional teams when members identified strongly with the team, and worked against them when members felt their professional identity was under threat. The question the theory asks of each group is not whether it supports carryover but what carryover did to its sense of what its profession is for.

Nursing Assistants: A Gain in Standing

For nursing assistants, carryover added something. Their usual work, bathing, toileting and repositioning, is essential but rarely recognized in team conference. Carryover gave them a skill that therapists taught and valued and a reason to be named in front of the team. Social identity theory predicts that a change raising a group's standing and distinctiveness will raise commitment, and that is what the audit showed.

Registered Nurses: Work That Did Not Fit the Profession's Story

For registered nurses, carryover read as work transferred from another profession. Nurses on this unit describe their core work as assessment, medication management, safety and coordination across twenty-four hours. Practicing a dressing technique that a therapist designed fits poorly with that self-description, especially when it arrives as tasks on a card posted by another discipline. Their low completion rate tracks what nurses believe their profession is for, not unwillingness to help patients. Framed differently, as nursing's own contribution to function and safety across the night, the same activities might have fit.

Occupational Therapists: Assessment as Core Identity

The therapists' objection is the most instructive. Assessing self-care is at the heart of occupational therapy's expertise and its claim to distinctiveness. When nurses began scoring self-care items, the change touched the core of that identity, not its edge. The identity threat research describes this situation precisely: when professionals perceive that another group is taking over what defines them, they defend the boundary, and team functioning suffers (Mitchell et al., 2011). The objection was not obstruction; it was a predictable response to a design that encroached on another profession's defining work.

Why the Rollout Made It Worse

How the program was introduced sharpened each reaction. It was designed by therapy and the nurse manager in two meetings, announced at a nursing staff meeting and posted on bedside cards written by therapists. Nurses first learned what carryover involved from the cards themselves. Therapists learned that nurses would score self-care from a memo in the second month. In identity terms, both groups experienced the program as something done to their profession by another. The assistants, by contrast, were invited to observe therapy sessions in the first week, which gave them a role in the program before they were asked to carry it out. The same content introduced three different ways produced three different meanings, and the meanings predicted the audit.

What the Design Asked of Each Group

The analysis avoids calling any group resistant. Each group responded rationally to what the design asked of it. The program asked assistants to gain a skill; they did. It asked nurses to take on tasks framed as therapy's; they did less. It asked therapists to share their defining work without being asked; they objected. The pattern suggests three design changes.

First, frame carryover for nurses as nursing's contribution to function across the twenty-four-hour day, and let nurses choose the carryover activities that fit their assessment of each patient's night, rather than receiving a card.

Second, return self-care scoring to occupational therapy, and have nurses report observations that therapists use in scoring, which preserves each profession's distinct role while sharing information.

Third, build a shared team identity around the patient's function, for example by reporting carryover completion and functional gain together at team conference, so that all three groups can see themselves in the result.

A fourth change concerns the rollout itself. Before the program restarts, the unit should hold one joint meeting of night nurses, day nurses, assistants and therapists to agree on which activities belong to whom, and the agreement should be written by the group rather than handed to it. The research on identity threat suggests that the threat eases when professionals see their distinct contribution acknowledged within a shared goal, and that acknowledgment is easier to build in a room together than on a bedside card.

Limits

The audit covered one month and one unit, and completion rates reflect documentation as well as practice. The therapists' objection came from two people, who may not speak for all therapists. Other explanations, such as nurse staffing on particular shifts, may account for part of the registered nurse figure. The identity reading fits the pattern well, but it should be tested by checking whether the redesigned program changes the reactions.

References

Hogg, M. A., & Terry, D. J. (2000). Social identity and self-categorization processes in organizational contexts. Academy of Management Review, 25(1), 121-140. https://doi.org/10.5465/amr.2000.2791606

Mitchell, R. J., Parker, V., & Giles, M. (2011). When do interprofessional teams succeed? Investigating the moderating roles of team and professional identity in interprofessional effectiveness. Human Relations, 64(10), 1321-1343. https://doi.org/10.1177/0018726711416872

Tajfel, H., & Turner, J. C. (1979). An integrative theory of intergroup conflict. In W. G. Austin & S. Worchel (Eds.), The social psychology of intergroup relations (pp. 33-47). Brooks/Cole.