Theoretical Framework
Although nurses and physicians perform different functions, their major goal is to provide high-quality care and improve patient outcomes. Consequently, their cooperation should focus on quality. Thus, a theoretical framework for this type of interaction can be grounded on a middle-range theory developed by Joanne Duffy, which is known as Quality Caring Model (Smith & Parker, 2015). The Quality-Caring Model includes four basic concepts that are applicable to resolving a problem of relationships between nurses and physicians to improve patient outcomes. The first concept is humans in relationships. It implies that people are multidimensional beings with diverse characteristics.
These factors make people unique and determine their interactions with other humans (Smith & Parker, 2015). The center of this model includes the concept of relationship-centered encounters divided into collaborative and independent relationships. The collaborative relationship is the interaction between a healthcare team and a nurse, while the independent relationship represents the cooperation of patients and their families with both the healthcare team and nurses (Smith & Parker, 2015). Feeling cared for is another important concept, which is a reflection of the care quality a patient gets. Finally, self-caring is a concept that is stimulated by caring relationships. Applied to the objectives of the current project, it implies that properly organized relationships between nurses and physicians contribute not only to the improved patient outcomes inside of a hospital but stimulate self-caring skills, which allow an individual to provide self-care successfully after discharge.
Literature Review
In inpatient care, both safety, and quality are influenced by the environment where the care is provided. This environment comprises many aspects, including care organization, work conditions, equipment, and relationships among the staff members. In fact, the relationship between nurses and physicians is considered to be meaningful for the process of care. Research by Siedlecki and Hixson (2015) focuses on the peculiarities of these relationships and their meaningfulness for the process of care because they determine the quality of care environment in a facility. Thus, cases of abuse or disrespectful behavior towards nurses negatively influence nurse retention as well as patient outcomes. The study develops the idea of a positive professional practice environment, which is influenced by a physician, nurse, and organizational characteristics (Siedlecki & Hixson, 2015). The researchers claim that such an environment is supposed to bring mutual benefits. The research compared physicians’ and nurses’ perceptions of the professional practice environment, both within groups and between them. Moreover, behaviors that demonstrate respect were investigated. Therefore, nurses expect the physician to treat them with civility and dignity, solve problems without hostility or verbal abuse, and listen to nurses speaking.
Many researchers link successful work in a team and nurse job satisfaction. For example, Ajeigbe, McNeese-Smith, Phillips, and Leach (2014) study the effect that nurse-physician teamwork has on their perception and job satisfaction. The choice of an emergency department is not accidental because efficient cooperation is particularly important in acute and emergency settings. The study is based on data collected during three years and results in the following findings. First of all, the participants of the interventional groups demonstrated significantly higher levels of staff job satisfaction related to the improved practice of teamwork compared to the results of the control group, which did not apply teamwork principles (Ajeigbe et al., 2014). The researchers explain higher job satisfaction by the fact that the staff members who worked in the interventional group were cooperating and acted as equal partners in inpatient care. It also had a positive impact on interpersonal relationships and resulted in the reduction of hierarchical status among physicians and nurses. Still, these findings are only related to the results of the experimental group.
The issue of collaboration between nurses and physicians in a hospital setting is investigated by Tang, Chan, Zhou, and Liaw (2013). Since ineffective collaboration among healthcare professionals results in a decrease in job satisfaction and threatens the quality of patient care, there is a need to discover strategies for improving physician-nurse collaboration. The researchers revealed that three major directions in investigations related to the topic included attitudes towards physician–nurse collaboration when physicians underestimate the role of physician–nurse collaboration; the factors that influence physician–nurse collaboration, comprising “communication, respect and trust, unequal power, understanding professional roles, and task prioritizing”; and strategies for improving physician–nurse collaboration, such as inter-professional education and interdisciplinary cooperation (Tang et al., 2013, p. 291). On the whole, the authors define physician-nurse collaboration as a complex interpersonal process that is significant for both professional relations and patient care outcomes.
Some studies related to the issue of nurse-physician collaboration involve specific objectives. Thus, Conn, Kenaszchuk, Dainty, Zwarenstein, and Reeves (2014) synthesize survey and ethnographic techniques that can be applied in nurse–physician collaboration in general internal medicine. The researchers stress the significance of effective nurse-physician collaboration since it is related to the quality of care, patient safety, and provider satisfaction. The authors suppose that perceptions of collaboration by nurses and physicians are characterized by discrepancies, which can lead to misunderstandings. Thus, the study investigates the differences in nurse and physician ratings of one another’s communication and skills (Con et al., 2014). One of the problems revealed by this study is the isolation felt by nurses due to the individual schedules of physicians. Also, hierarchal relations could be causing a problem for nurses, but it is resolved through effective leadership.
While nurse-physician collaboration has an impact on the patient’s condition as a whole, it can be related to some specific cases of inpatient care. For example, Boev and Xia (2015) discover peculiarities of this collaboration in conditions of hospital-acquired infections in critical care. The researchers supposed that nurse-physician collaboration could have an impact on healthcare-associated infections. The research under consideration focuses on two infections, ventilator-associated pneumonia, and central catheter–associated bloodstream infections. Multilevel modeling revealed the existing relationships. Thus, an increase in nurse-physician collaboration resulted in a decrease in both hospital-acquired infections. Also, staff qualification had an impact on infection incidence. For example, a higher proportion of certified nurses in acute care settings result in a smaller number of bloodstream infections. Consequently, the broad introduction of nurse-physician collaboration can be considered a tool for reducing the rates of hospital-acquired infections.
To summarizing, it can be mentioned that the issue of nurse-physician collaboration is a complex one. It comprises many specific features that depend on settings, qualifications of healthcare professionals, and their ability to interact successfully. On the whole, the majority of researchers agree that effective nurse-physician collaboration is beneficial for both staff members and patients. While patients demonstrate better health outcomes, both nurses and physicians experience higher job satisfaction that stimulating retention levels. Consequently, nurse-physician collaboration can be recommended for all types of care facilities to improve the quality of care as well as patient outcomes.
References
Ajeigbe, D., McNeese-Smith, D., Phillips, L., & Leach, L. (2014). Effect of nurse-physician teamwork in the emergency department nurse and physician perception of job satisfaction. Journal of Nursing and Care, 3(1), 141-146. Web.
Boev, C., & Xia, Y. (2015). Nurse-physician collaboration and hospital-acquired infections in critical care. Critical Care Nurse, 35(2), 66-72. Web.
Conn, G. L., Kenaszchuk, C., Dainty, K., Zwarenstein, M., & Reeves, S. (2014). Nurse–physician collaboration in general internal medicine: A synthesis of survey and ethnographic techniques. Health and Interprofessional Practice, 2(2), 1057-1070. Web.
Siedlecki, S. L., & Hixon, E. D. (2015). Relationships between nurses and physicians matter. The Online Journal of Issues in Nursing, 20(3).
Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice (4th ed.). Philadelphia, PA: F.A. Davis Company.
Tang, C. J., Chan, S. W., Zhou, W. T., & Liaw, S. Y. (2013). Collaboration between hospital physicians and nurses: An integrated literature review. International Nursing Review, 60, 291-302.