Cultivating a High-Performance Nursing Team

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Directly Above Shot Of Medical Team Stacking Hands Together At Hospital.In a hospital setting, nurse leaders oversee patient care, ensure the delivery of quality improvements, and supervise nursing staff. Ultimately, nurse leaders cultivate synergy that brings healthcare teams together to solve problems and improves patient outcomes.

High-performance leadership creates effective and productive nursing teams, but developing and cultivating teams is not easy. High-performing teams happen due to the synergy between employee engagement, employee retention, and the patient and family experience, Lenetra King and Kirsten Drake said in the journal Nursing Management.

“To succeed in an increasingly competitive healthcare space, it will take strong and competent leaders to create cultures in which frontline staff members are engaged, aligned and committed to delivering excellent service to our patients and families while producing strong clinical outcomes, King and Drake said in “How to Drive Employee Engagement Through High-Performance Leadership.”

To cultivate team nursing, nurse managers use problem-solving tools they learn by earning advanced degrees. Registered nurses (RNs) who have a master’s in nursing degree, including from an online master’s in nursing program, can earn a post-master’s certificate to expand professional expertise and skills.

Driving Employee Engagement

In their Nurse Management article, King and Drake said nurse leaders should commit to employee engagement through these steps:

1. Growing leadership skills

For advanced-degree nurses, the first step in developing leadership skills is determining where their competencies are in the first place. Use assessment tools to determine individual leadership skills or seek leadership development programs to help build and refine strengths. According to King and Drake, the American Organization of Nurse Executives divides nurse leadership skills into three distinct categories: science, art and leadership.

“It isn’t enough to have the technical competency to perform the nurse manager role; the leadership component is becoming more significant to organizational priorities and results,” the authors said in the journal article.

2. Setting clear expectations and accountability standards

Front-line workers depend on leaders to set a tone on the unit, especially during times of crisis. The best leaders understand their position and set their responses and reactions accordingly. Remember the phrase, “what you permit, you promote,” the authors said.

The authors also said leaders must acknowledge positive performances as much as negative ones. Set the performance bar high and align expectations around attainable goals.

“The end game is to manage your culture so that your culture doesn’t manage you,” King and Drake said.

3. Creating dependable onboarding procedures

Welcoming a new employee should include more than providing a preceptor and a competency checklist. The employee should be integrated into a team and department to build positive relationships. King and Drake recommend nurse managers ask new employees “stay” interview questions, which are aimed at understanding why employees stay in their jobs or what prompts them to leave.

“Again, the focus is to ensure that new staff members have the tools necessary to succeed within the first few months in their new role,” the authors said.

4. Focusing on communications

The best leaders find multiple ways to communicate with their teams to make sure everyone understands the message. Sending an email is not enough. Use staff huddles, communication boards, department meetings and shift handoffs to communicate.

Employees should also be given a chance to provide feedback on the information or present original information in the meetings, the authors said. 

5. Rewarding and recognizing staff

Staff members need to be recognized for a job well done to feel connected. Set clear expectations and ensure all members of a team are acknowledged and rewarded for their exceptional work. The recognition does not have to be elaborate but should help employees feel valued. Seek information from staff members about how they want to be recognized.

At its core, building a strong team through high-performing leadership is tough but attainable, King and Drake said.

“The work that it takes to truly be a high-performing leader, consistently building on the attributes that lead to outstanding performance, is no small feat. As healthcare organizations are forced to do more with less while at the same time delivering exceptional patient and family experiences, reliable and consistent care, and excellent clinical outcomes, dynamic leadership is at the core,” they said. 

Problem-Solving Tools for Nurse Managers

In a Nursing Management article, authors Elizabeth Zwillinger and Tammy Huster said part of building a good team is hiring a person who fits with the culture. During an interview, nurse managers in charge of hiring should ask questions designed to predict future behaviors. Behavioral interview questions should demonstrate the job candidate’s ability to work with teams and patients while demonstrating care, respect and integrity, the authors said.

“Having the perfect outcome to a behavioral question isn’t necessary, only that the candidate is able to articulate meaningful experiences even if those experiences were unsuccessful, Zwillinger and Huster said in Cultivating a High-Performing Team.

The authors also said staff members should be involved in the process in some way to drive collaboration and morale.

“Successful teams don’t happen by accident,” the authors said. “By participating in shared decision making, employees feel that they can voice their ideas and their contributions are valued.”

For nurse leaders who already have an MSN degree, another crucial step toward building a successful team is earning an online post-master’s certificate in nursing. At Duquesne University, the post-master’s certificate program is designed to advance nursing skills and professional growth.

About Duquesne University’s Online Post-Master’s Certificate in Executive Nurse Leadership & Health Care Management

RNs enrolled in Duquesne University’s online post-masters certificate programs can study for careers as nurse leaders. Courses are presented online so students can continue their family and career responsibilities while pursuing advanced educational goals.

The university also offers post-master’s certificates in other tracks:

  • Forensic Nursing
  • Nurse Education and Faculty Role
  • Family (Individual Across the Lifespan) Nurse Practitioner


Nursing Management, “How to drive employee engagement through high-performance leadership”
Nursing Management, “Cultivating a high-performing team”