Teamwork – Dr Monique Peris

In uncertain times unspoken tensions are more likely to surface

7 MINUTE READ

from Luke’s Journal 2021 | Fire in the Belly 2021 | Vol.26 No.1

“I am not looking forward to today.”
“Why?”
“X is on today, you know what they’re like.”
“Yeah, I was on with them last week. Nightmare. I thought about saying something but what’s the point?”
 

Have you ever been in a conversation similar to this one? Most people can relate to a situation where they have worked with a difficult person or team.
In the strange and uncertain times of the COVID-19 pandemic, unspoken tensions are more likely to surface. 

Just as illness stems from a part of the body not functioning properly, so medical teams can become less functional if there are issues within the team. 

“Even so, the body is not made up of one part but of many. Now if the foot should say, “Because I am not a hand, I do not belong to the body,” it would not for that reason stop being part of the body.  And if the ear should say, “Because I am not an eye, I do not belong to the body,” it would not for that reason stop being part of the body.  If the whole body were an eye, where would the sense of hearing be? If the whole body were an ear, where would the sense of smell be? But in fact God has placed the parts in the body, every one of them, just as he wanted them to be. If they were all one part, where would the body be? As it is, there are many parts, but one body.” 2 Corinthians 12:14-20 

Just as tension between parents can influence children, so dysfunction between team leaders and senior clinicians affect junior medical staff. Just as we diagnose and manage the illnesses of our patients, we need to recognise and address the behaviours that may cause injury to our teams, and ultimately compromise the care of patients. 

“We need to recognise and address the behaviours that may cause injury to our teams.”

So, as Christians in our workplaces, what can we do? Here are a few questions to ask yourself when reflecting on the situation. 

Have you prayed? 

The Bible is very clear about praying for our enemies. This isn’t excusing the behaviour, but bringing it and the person before God and allowing Him to give you His wisdom and strength for the situation. 

“You have heard that it was said, ‘Love your neighbour and hate your enemy.’ But I tell you, love your enemies and pray for those who persecute you, that you may be children of your Father in heaven.
He causes his sun to rise on the evil and the good, and sends rain on the righteous and the unrighteous. 
If you love those who love you, what reward will you get? Are not even the tax collectors doing that?  And if you greet only your own people, what are you doing more than others? Do not even pagans do that?  Be perfect, therefore, as your heavenly Father is perfect.”
Matthew 5:43:48 

Working with a difficult team member can take its toll. Know that Christ came to set us free, which includes not feeling oppressed or dominated in this life. 

“Continue to acknowledge and respect the expertise of each individual in the team.”

“Jesus returned to Galilee in the power of the Spirit, and news about him spread through the whole countryside.  He was teaching in their synagogues, and everyone praised him. 

He went to Nazareth, where he had been brought up, and on the Sabbath day he went into the synagogue, as was his custom. He stood up to read,  and the scroll of the prophet Isaiah was handed to him. Unrolling it, he found the place where it is written: 

“The Spirit of the Lord is on me, because he has anointed me to proclaim good news to the poor. He has sent me to proclaim freedom for the prisoners and recovery of sight for the blind, to set the oppressed free, to proclaim the year of the Lord’s favour.”

Then he rolled up the scroll, gave it back to the attendant and sat down. The eyes of everyone in the synagogue were fastened on him. He began by saying to them, “Today this scripture is fulfilled in your hearing.” Luke 4:14-20 

Remembering that Jesus is the ultimate Saviour, setting the oppressed free brings a heavenly perspective to the situation. 

Is it one person or a culture? 

Cultural shifts can be as difficult as managing one person. Often once battle lines are drawn and sides are chosen it can be difficult for a group to see what started the divide in the first place. The first point is to recognise that the team has become dysfunctional. This may be evidenced by subtle indicators such as lateness to important meetings or increased sick days. At other times, it may become obvious through clear disagreement in regards to patients and differences in opinion regarding management. 

External processing or “venting” is a way of processing a situation with the aim of coming to a solution. It is a recognised form of mental processing. The problem develops when the instances of venting do not reach a solution endpoint. It then may become a vicious cycle that can ultimately infect a team and further isolate the person or persons involved. If this occurs it is often a sign that conflict resolution needs to take place. One way to move forward is to consider a third party mediator – just as couples may seek out a marriage counsellor, a third party may assist mediation in teams. 

Is there a power differential? 

In the work of medical training, there will be occasions where a person who was previously the junior then becomes the senior. This can cause contention amongst team members. Ultimately, it is important for team members who are now in the more junior position to recognise that the responsibility of the patient or decision is now on that person’s shoulders. Also, it is important for the person in the new senior role to be sensitive to the power shift without feeling guilty for what they have achieved. It is helpful in moving forward to continue to acknowledge and respect the expertise of each individual in the team, just as they would have as a junior. Depending on the personalities involved, sometimes stating the obvious awkwardness is a good way of acknowledging that it exists. 

Is there illness/burnout?  

Staffing shortages seem to be an ongoing pattern in medicine that will continue if we don’t look after the workforce we have. This starts with looking after each other. Sometimes we are so close to the problem, that we can’t see the forest for the trees. Consider bringing in a third party such as a financial adviser who can crunch the numbers and review the number of patients to be seen and the ideal staffing. Present these findings in a structured way to your hospital review board or budget committee. You may want to encourage your staff to log the extra hours they are required to work so that there is evidence of the need. Working outside our means is ultimately not sustainable, and compromises our ability to care for ourselves and our patients. 

As Christians, we all have a part to play in spreading the gospel and being the hands and feet of Jesus. We serve a God who will not leave us or forsake us and for whom no challenge is too great, no situation too difficult, no person he cannot reach. 

“May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.” Romans 15:13


Dr Monique Peris     
Dr Monique Peris is a General Paediatric Advanced Trainee working in Melbourne, Victoria. She completed her medical training in NSW, joining the CMDFA community in her first year of medical school in 2007 through Transfusion camp.  

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