Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Suggested strategies for building relationships and trust

Individual strategies
 -Have an open door policy; post when you’ll be available
 -Practice management by walking around and spend time on the unit (Fletcher, 2001; McGilton et al., 2004; Peters& Waterman, 1982; Ray et al., 2002; Upenieks, 2002b)
 -Check in at meetings and open forums to hear issues and concerns and what’s going on in people’s lives to foster relationships and provide support (Kofman, 1994)
 -Communicate support to staff by determining and clarifying what they expect of their leaders (Kramer, Schmalenberg & Maguire, 2004)
 -Provide ongoing informal feedback for jobs well done
 -Learn mentorship skills (Doran et al., 2012)
 -Volunteer to become a mentor and also a mentee (Doran et al., 2012)
 -Learn about interprofessional practice and how to facilitate team-based work (Doran et al., 2012)
 -Particpate in RNAO clinical practice fellowships (Doran et al., 2012)
 -Learn project management skills and volunteer to participate or lead a project or change initiative
 -Support change initiatives and actively discuss projects and change initiatives with colleagues
 -Learn about and implement interprofessional councils (Wesorick, Shyiparski, Troseth, Wyngarden 1998)
 -Volunteer to be council member or leader for your unit (Brody, Barnes, Ruble, & Sakowski, 2012).
 -Talk with colleagues about what matters to them and bring it forward at council meetings (Wesorick et al., 1998)
 -Share information with colleagues after council meetings and take their perspective back to council (Wesorick et al., 1998)
 -Recognize contributions (Patrick, 2011)
 -Build a network of advisors and informants who will provide an honest and unbiased perspective when you need information and advice (Joni, 2004)

Team/Unit/Organization Strategies
 -Create a collective vision and values statement for the team/unit/organization (Gillespie & Mann, 2004) and work with the team to develop behavioural standards to reflect that vision
 -Design clear accessible role descriptions, including leadership responsibilities
 -Design responsibility grids detailing duties and levels of accountability (e.g. input versus decision-making) (Recker, Bess & Wellens, 1996)
 -Do regular performance appraisals
 -Design interview guides for hiring for leadership positions, incorporating questions about respect for individuals and the value of nursing
 -Formalize recognition for nurses who demonstrate excellence in practice with awards, certificates, newsletter articles and events during Nursing Week to recognize achievements
 -Establish a council infrastructure. The idea comes from the work of Bonnie Wesorick, a specialist in creating healthy workplaces for nurses. She and her team describe council infrastructures as a safe place to learn, develop, and practice leadership skills, including learning to build relationships through dialogue, appreciative enquiry, conflict management, and polarity management. Council infrastructures are a place where point-of-care leaders engage in decision making with managers. Councils can work in numerous areas, including healthy work environments; patient safety; quality improvement; strategies for recruitment and retention; improving patient-client satisfaction; use of resources, enhancing competency and even connecting with other health care organizations. Council infrastructures are also important in integrating evidence-based practices across disciplines (Wesorick et al.1998; Wesorick & Shiparski,1997)

For complete references, please refer to the guideline at