Page 360 - Encyclopedia of Nursing Research

NuRSe AND PHySICIAN INTeRDISCIPLINARy COLLABORATION n 327

the increase in the public’s level of awareness identified as the primary root cause of
of disease management and outcomes, the wrong-site operations and other sentinel
transition of nursing education from hospital events according to the Joint Commission on N
based to the university level, and the decline Accreditation of Healthcare Organizations
of public esteem for physicians. Increased (2007).
nurse specialization, the expansion of nurse Nurse–physician relationships are evolv-
practitioner and clinical nurse special- ing in significant ways. A number of histori-

ist roles, and participation in independent cal factors have influenced each profession’s
and collaborative research have resulted in roles and responsibilities, including educa-
enhancing the image and value of nurses as tion and socialization which have at times
collaborators. Increasingly, more nurses and created conflict and disagreement. Nurses
physicians value interrelationships concern- and physicians are now becoming equal
ing working and learning together and the partners in the clinical domain and are mov-
manner in which the relationship can mature ing away from the traditional relationship
and develop (Schmalenberg, Kramer, & with its significant disparity in power and
King, 2005). Nurse–physician collaboration, influence. The current environment and chal-
however, is not commonplace in the majority lenges of health care require mutual interde-
of health care organizations (Barrere & ellis, pendence of nurses and physicians which
2002). can guide the way to true collaboration and
Collaboration and teamwork initiatives teamwork (Boyle & Kochinda, 2004; Horak,
have been identified as an integral compo- Pauig, Keidan, & Kerns, 2004; Zwarenstein &
nent of quality health care with a number of Bryant, 2004).
positive outcomes including improvement To practice successfully and in the inter-
in patient care, enhancement in professional est of safe patient care, positive collabora-
nurse and physician satisfaction, increased tive communication between nurses and
productivity and efficiency, and reduction physicians must occur. Nurses and physi-
in health care costs (Kohn et al., 2000; Powell cians bring different perspectives to patient
& Hill, 2006). effective collaboration can care. Placing value and understanding on
help to create a supportive environment and the unique contributions of the other disci-
develop a sense of success and establishment plines role can result in a discovery of their
of an esprit de corps and interprofessional mutual goals and ability to effectively col-
cohesiveness which can result in an improve- laborate, with the patients’ well-being as
ment in productivity, increased employee the primary focus. The challenge for health
and patient satisfaction, and optimally an care organizations is to identify collaborative
improvement in patient care outcomes. strategies that enhance communication, pro-
Barriers to effective nurse and physi- mote positive nurse–physician collaboration,
cian collaboration exist in an array of health and produce positive patient outcomes. The
care settings. Role ambiguity, perceptions majority of research that has been performed
of power differentials, degrees of respect, on nurse–physician collaboration has been
autonomy, and perceptions of decision conducted by nurses. Physicians have not
making were reported to contribute to bar- examined nurse–physician relationships to
riers in nurse–physician collaborative rela- the same extent which may demonstrate a
tionships (Castledine, 2004; Chaboyer and perception that relationships are collegial. A
Patterson, 2001; Fairbanks, Bisantz, & Sunm, number of national initiatives have identified
2007; Resnick & Bonner, 2003; Rosenstein, the importance of promoting interdisciplin-
2002; Thomas, Sexton, & Helmreich, 2003). ary collaboration in education and shared
Breakdowns in communication between competencies. The increased emphasis on
nurses and physicians have recently been collaboration has resulted in the inclusion of