This month AJN has published a qualititative study called ‘It Depends’: Medical Residents’ Perspectives on Working with Nurses. Why ask the doctors, not the nurses? That’s a good question, but put it in brackets for now. The study authors focused their questions on two aspects of coordination that theorists consider to be especially important in high-pressure work settings: “frequent, high-quality communication” and “high-quality relationships.” Here are some quotes from the study:
“I tell them tests that I need, but I don’t give them much information. They’re not making decisions about treatment or anything.”
“The day-shift nurses, some of them have a lot of experience and have actually been working for 20 years and, you know,[have] been educating themselves the whole time and getting better and learning from their experience, and then others have been doing the same things incorrectly for 20 years.”
“Some might tell you way too much, and it’s like there is no processing of it first . . . and others know exactly what to say and only call you when they really need you.”
The authors’ conclusions may anger some nurses, but they pose a challenge as well:
Although residents’ concerns about nurses’ cooperativeness and competence might be seen as professional posturing, still they represent an enduring critique of the nursing profession, particularly as it relates to professionalism and standardized education. Whereas some physicians grudgingly collaborate with nurses, surely some nurses—though eager for collaboration—actively withhold the communication and cooperation it requires. To the extent that nurses play a role in perpetuating undesirable nurse–physician interactions, perhaps the nursing profession has the power to change the rules of the nurse–physician game.
What do you think?