Short and long term groups.

A selfie in Madurai.

I’m just back from an excellent holiday in South India.

This is my first post for a few weeks. For the last 3 weeks my wife and I enjoyed a trip to South India in the company of 8 other travellers from around the world, plus a tour leader and driver.

The 12 of us started the trip as strangers but soon became a group. 20 days later we returned to our various homes this weekend, after exchanging contact details and with a flourishing WhatsApp group in which to share photographs and memories.

Groups form naturally both for both short- and long-term purposes, usually some shared experience or goal. Groups are strong when they share a sense of common purpose and commitment.  A strong commitment to a group does not necessarily depend on its permanence. Short-term groups, including holiday groups, can form strong bonds through intense shared experiences and the anticipation of future trip highlights. A 14hr overnight train ride from Madurai to Mysuru was certainly an intense shared experience, although not a particularly comfortable one.

A holiday group shares mutual enjoyment and relaxation. Despite the strength of the bonds formed in the trip, the group will often dissolve some time after the trip ends, even after exchanging emails, and holiday pictures in the WhatsApp group. In probability most of our holiday group will not meet again. 

Health Professionals groups relate to specific posts.

It is possible, indeed almost essential, for Health Professionals to form strong groups even if the job lasts only a few months. In my 10 years in training, I worked in 12 different Hospitals with the longest single post in one place lasting just 12 months. During each of these jobs a group formed, with deep connections often developing through extended collaboration, challenging circumstances and the many hours spent working together. Groups like these are sustained by effort and common values. A group will become committed  if the benefits of membership, such as emotional support, professional growth and the feeling that colleagues ‘have your back’, outweigh the effort of collaboration.  

Strength depends on the importance of goals.

The holiday group was informal, formed serendipitously because we happened to be enjoying the same trip together. It was built on our shared experiences and interactions. The lack of any goal beyond the Holiday meant that it was easy to ignore each other’s occasionally irritating foibles (including my own!) in the knowledge that the group was short term and would not survive in the same form beyond the holiday.

Hospital Teams may be formed as randomly as a holiday group but each member has a defined role. Members work under stressful conditions within, and often beyond, their roles. These groups achieve critical objectives based on a desire to deliver the best possible patient care. The members recognise the need to collaborate, which in turn increases trust and loyalty over time. Members of the group who cannot be trusted or relied upon can easily destabilise a hospital group and may fatally damage its effectiveness.

Both Holiday and Hospital groups can be meaningful, but their impact depends on the intensity of shared activities and the emotional investment involved. Both groups can break up at the end of a task, and as is the case for Holiday groups, the members of Hospital groups who have developed a common purpose and loyalty to each other may never work together again.

Health professionals are frequently reorganised.

A quote (wrongly) attributed to Petronius Arbiter relates to the effectiveness of the groups that form for specific activities: ‘We trained hard... but it seemed that every time we were beginning to form up into teams we would be reorganised’. Anyone who has worked in the NHS over a period of years will recognise the frustration of repeated reorganisation and its effect on morale and performance. However, as Doctors we have to cope reorganising ourselves from an effective working group into a new group every few months. The advice to ‘not become ill during the first weeks of August or February’ is not unreasonable, as the newly appointed staff in these months need time to form into effective groups. Reorganisation both of services and groups can disrupt cohesion, creating confusion and inefficiency and poorer care levels. 

 Any group can be meaningful.

Groups come and go. Short-term groups can be as meaningful as long-term ones if they make connections through shared experiences. However, the longevity of a group allows for deeper bonds and greater achievements. Whether in a holiday setting or a professional environment like a hospital team, the strength of a group lies in its ability to align members toward common goals while navigating challenges together. It grows by its commonality and by the acknowledgement of each others roles in the team’s successes.

Changing jobs every 6-12 months is an relatively unusual stress experienced specifically by Doctors. This frequent restructuring of working teams can undermine morale and stability. It is hard to leave a post you have enjoyed and to face the unknown in another Hospital, with a new group of people you may have never met. And finally spare a thought for Doctors who work as Locums, and who join a new team every few weeks. It is difficult!

We all need to help each other to work together, whether our shared roles are short or long term. The ability to form strong teams, even if they last for only a few months, is one of the key strengths of the NHS. It is however an additional stress on top of many others. Many Doctors experience burnout, or leave medicine altogether, as a result of these combined stresses.

If the constant change of teams is affecting you, or if you are finding it difficult to establish a new team in your current role, please seek help from an Executive Coach. You might consider a free no obligation 30 minute on-line conversation with me. You can book your session here. If I am not the right Coach for you, I will recommend somebody else who might be.

Please check my website and sign up to my mailing list if you want to receive posts like this directly to your inbox.