Team Identification as a Psychological Resource: A Differentiated Model of Nurse Resilience and Team Effectiveness in an Underground Hospital Facility

Background: Healthcare professionals working under extreme and constrained conditions face sustained demands that may challenge psychological well-being and team functioning. Team identification may serve as an important social resource for maintaining resilience and coordinated functioning. Objectives: This study examined whether cognitive, affective, and behavioral dimensions of team identification were differentially associated with nurse resilience and perceived team effectiveness during deployment in an underground hospital facility during a national emergency. Methods: A concurrent mixed-methods, cross-sectional study was conducted among nurses and nursing assistants deployed to an underground hospital facility (N = 269). Participants completed measures of team identification, hope, optimism, resilience, and perceived team effectiveness. Structural equation modeling tested a division-of-labor model in which cognitive identification was associated with affective and behavioral identification; affective identification was associated with hope and optimism, which were associated with resilience; and behavioral identification was associated with perceived team effectiveness. A fully crossed model examined the unique contributions of affective and behavioral identification. Open-ended responses were analyzed thematically. Results: Cognitive team identification was indirectly associated with resilience through affective identification and the personal resources of hope and optimism, but was not directly associated with resilience or perceived team effectiveness. In the fully crossed model, affective identification was uniquely associated with hope and optimism, whereas behavioral identification was uniquely associated with perceived team effectiveness. Qualitative findings highlighted emotional support, shared belonging, and coordinated action as important features of functioning in the constrained environment. Conclusions: Team identification may function as a multidimensional social resource for healthcare professionals working under extreme conditions, with distinct affective and behavioral pathways contributing to resilience and perceived team functioning. These findings highlight the potential importance of team-based social resources for workforce well-being and effective functioning during disruptive or constrained healthcare operations. Implications for Practice: Healthcare managers and nursing leaders should consider strategies that strengthen team belonging, emotional connection, and coordinated team behaviors to support workforce resilience and team functioning in high-demand and emergency settings. Longitudinal and intervention studies are warranted.