Group Meetings in a Pediatric Intensive Care Unit

Work relationships among staff in a pediatric intensive care unit (ICU) are probably of critical importance to patient care, as well as to staff well-being. Group discussions were introduced in one ICU to encourage the staff to raise issues about work relationships and about the effectiveness of the care they were providing. Three kinds of issues recurred: work roles and functions, leadership and decision making, and conflict arising from stereotypic assumptions about opposed groups. The frequency of conflicts rooted in these issues demonstrated their origin in factors over and above individual "personality problems." While there were clear limitations to what such group meetings could accomplish, they did provide a forum for the expression of tensions and anxieties, the identification and resolution of some conflict, and the initiation of needed policy change. The authors encourage further experimentation with this practice, and studies of its effectiveness.