To every nurse who has ever swapped a room, tag‑teamed a tough family, or quietly caught a near‑miss on a busy shift: you know firsthand that great nursing is never a solo act. The same teamwork that keeps patients safe on the floor can also protect your energy, especially when you’re juggling PRN shifts on top of everything else.
Teamwork goes beyond making friends or being nice—it's building relationships so that you and your teammates are covered when you need a second set of hands for a code or a difficult titration.
Per diem contract nurses who go to new facilities face an added challenge because they must foster or support team spirit and positive relationships on their first shift. It can be hard, but it’s possible, and strong teamwork slashes miscommunication (linked to 80% of medical errors, per The Joint Commission) through mutual support, transparency, and reduced fear of rejection or misunderstandings.
Here are 5 practical ways to build teamwork with colleagues during PRN shifts.
Why is teamwork vital for nurses?
The importance of teamwork in healthcare cannot be overstated. Clinical skills—such as starting IVs, interpreting EKGs, and managing complex drips—are often considered the core of providing high-quality patient care. They are vital, but a collaborative nursing practice allows those skills to be truly effective.
When nursing teamwork strategies are implemented correctly, the benefits are twofold:
- Patient safety: Nursing teamwork and patient safety are closely linked, providing multiple sets of eyes to catch subtle changes in status or potential medication errors.
- Nurse wellbeing: Nursing is emotionally and physically taxing. Knowing you have a team that has your back reduces the cognitive load and emotional exhaustion that lead to burnout.
By improving nursing teamwork, we move away from an individualistic mentality in which each nurse is on their own. True patient advocacy requires interprofessional collaboration, in which the nurse serves as the central link between:
- The physician’s orders
- The therapist's treatments
- The patient’s bedside needs
From your nursing education and experience, you probably already understand the principles of teamwork. However, the reality of PRN work requires learning how to integrate into a team on the first day.
The following team-building tips are designed to help you bridge the gap between feeling like an outsider and becoming an essential part of the unit's success.
1. Use shared communication models and tools
One of the greatest challenges in nursing teamwork for PRN staff is the variation in how hospitals communicate. To succeed, you must adapt to the facility's specific communication tools. Effective communication in nursing teams relies on standardized tools that reduce the "noise" and get straight to the facts.
Situation, Background, Assessment, Recommendation (SBAR)
The SBAR is a widely recognized structured communication framework for quick, concise updates. There are also variations of SBAR that include identifying yourself, your role, and the patient as an introduction.
Call out
Call outs are used during an urgent event to inform the entire team of vital changes and anticipate next steps, typically involving a direct statement of a finding (e.g., "Airway is clear!" or "The patient’s blood sugar is 45!").
Check-back
This is closed-loop communication. If a clinician sends a call out, "Airway is clear”, the team leader or another relevant team member repeats back, "Got it. Airway is clear,” to confirm that they received the correct information.
If the clinician calls out “The patient’s blood sugar is 45!”, another team member might check back with “Blood sugar is 45. Do you want me to give an ampule of 50% dextrose in water (D50) or the oral glucose gel?” The final confirmation could be “Give the D50 now.”
Handover/Handoff
A structured method for transferring care. For handovers, you can remember: Illness severity, Patient summary, Action list, Situation awareness, and Synthesis by the receiver (I-PASS).
Situation, Task, Intent, Concern, and Calibrate (STICC)
STICC is often used to plan complex tasks in an urgent manner. For example:
- Situation: The fetal heart rate is dropping.
- Task: Position the mother on the left side.
- Intent: The blood flow must be improved.
- Concern: There may be potential cord compression.
- Calibrate: Do you have any other suggestions?
Effective nursing collaboration and teamwork depend on good communication skills. Here are some pro-nursing tips for per diem communication:
- Ask open-ended questions: Instead of asking, "Any questions?" (which usually gets a "No"), try, "What questions do you have for me?" This is more inviting and shows that you value their input.
- Pre-shift prep: Review the unit’s specific handoff tool before you start your first medication pass. Recognizing their format prevents you from missing key details during the shift and in your handoff for the next.
- Leverage technology: Use platforms like Nursa to connect with facilities and communicate with them. Being proactive about how you communicate through the app can set the stage for a smoother shift before you even walk through the doors.
2. Create psychological safety
Building strong nursing teams requires more than just clinical competence; it also calls for psychological safety. This is the belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes.
Interprofessional nursing teamwork thrives when everyone—from the most senior surgeon to the newest certified nursing assistant (CNA)—feels seen and heard.
As a PRN nurse, you can project this tone within the first hour of your shift. For example, during the first-hour huddle or handoff, you might say something like: "I’m [name], happy to be here today. Is there anything specific I can prioritize to help the flow of the unit this morning?"
Also, try to learn your CNAs' and techs' names immediately. This simple act of appreciation instantly builds rapport.
You could explicitly tell your support staff: "I’m new to this floor today, so if you see anything that looks off with our patients, please pull me aside immediately. I value your eyes on the patient."
When a CNA feels safe telling a registered nurse (RN) they noticed a change in skin turgor or a slightly confused look in a patient's eyes, a pressure ulcer or a stroke might be prevented.
3. Clarify goals
Enhancing nursing collaboration is much easier when everyone is rowing in the same direction. In the chaos of a busy unit, it is easy to lose sight of the "big picture" for each patient.
During a daily huddle, look to the nursing team's leadership to clarify the day's goals. Explicitly asking about these goals reduces friction on the nursing team by setting clear expectations for everyone involved.
For example, in the morning, you could say: "The goal for the patient in room 402 is early ambulation to prevent pneumonia before their discharge tomorrow. What time shall we aim to get the patient up and moving?"
By vocalizing the goal, you’ve invited the rest of the team to help you achieve it.
4. Leverage teamwork to fight burnout
One of the greatest benefits of teamwork in nursing is its buffer effect regarding the mental toll of the job. Stronger social support is associated with significantly lower levels of compassion fatigue and burnout.
Scientific research shows that increased social support is associated with decreased compassion fatigue and burnout, underscoring the importance of healthy nursing team dynamics.
Overcoming teamwork barriers in nursing often means stepping out of your own "to-do" list to help another. If a colleague is visibly stressed, try this script: "I have 5 minutes before my next med pass; what is 1 thing I can take off your plate?"
This simple gesture proves you aren't just an "outsider" or a "temp." You are a teammate.
5. Ensure an effective handoff
A clean, organized handoff is a crucial act of teamwork with the incoming shift. It shows respect for your colleagues’ time and mental energy. When you provide a structured, thorough report using the facility’s preferred model (such as I-PASS), you ensure the next nurse starts well-informed.
What does nursing teamwork look like in practice?
Teamwork isn't just a buzzword; it’s a series of actions. Consider these real-world instances of nursing teamwork.
The safety net
You can treat a second set of eyes on a high-alert medication check not as a "policing" burden, but as a team-based safety net that protects both the patient and your license.
Tag teaming
A collaborative strategy where 2 or more nurses rotate roles or switch off routine tasks to maintain high-quality patient care and prevent individual fatigue, especially when 1 is overwhelmed with a critical task.
Assignment swap
Swapping patients when a particular family member is becoming verbally aggressive or draining. Usually, at the charge nurse's request, 1 nurse collaborates with another, taking over the patient's care to preserve the other's mental health and to provide a "fresh start" with the family and the patient.
The synchronized response (code blue example)
Imagine a patient goes into cardiac arrest. Here, teamwork is a synchronized response:
- Nurse A starts high-quality chest compressions.
- Nurse B documents every med and rhythm change, keeping the team on a timeline.
- The respiratory therapist manages the airway and ventilation.
- The CNA clears the room of extra furniture and brings the crash cart.
Because they have a shared goal and defined roles, they function as a single organism rather than a chaotic crowd.
Leave the unit better than you found it
Do you want to be the outsider that the team and the facility will probably forget? Or do you want to be the team member that every unit wants back?
To make a difference on your shift as a PRN nurse and leave a lasting impression with the facility, notice what’s needed and lend a helping hand. Observe your patients, check the facility’s communication tools and strategies, and use them.
You can also clearly communicate your observations to your teammates and ensure your hand-offs are complete.
This team-player mindset can make you their go-to nurse for future shifts or even for a permanent position, if you’re interested.
How technology powers your professional reputation
The Nursa platform fosters teamwork among facilities and nurses, even before you work there, with technology that enables direct, transparent, and well-informed communication for everyone who signs up and creates a profile.
The Nursa technology has special features designed to streamline the communications:
- Favorites list: Facilities can add PRN nurses who have already worked at their location to their Favorites list, electronically marking these clinicians with a red heart icon to make them easy to identify in a list of applicants.
- Auto-Scheduling: The Favorites feature works in tandem with Nursa’s Auto-Schedule tool, allowing facilities to approve and fill open shifts automatically with clinicians from their Favorites list.
- Notify me: Enable this feature to receive alerts when new shifts open up.
Being a team player can inspire a Charge Nurse to Favorite you in the Nursa app, giving you priority access to the best shifts at that facility.
Ready to be the nurse every unit wants back? Sign up with Nursa and browse high-paying PRN shifts today.
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