Collaboration between hospital physicians and nurses: An integrated literature review

Authors

  • C.J. Tang Candidate Bachelor of Science (Nursing) (Honour) program,

    Student
    1. Alice Lee Centre for Nursing Studies, National University of Singapore, National University Health System, Singapore, Singapore
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  • S.W. Chan PhD in Nursing,

    Professor
    1. Alice Lee Centre for Nursing Studies, National University of Singapore, National University Health System, Singapore, Singapore
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  • W.T. Zhou Advanced Practice Nurse, Master in Nursing,

    Lecturer
    1. Alice Lee Centre for Nursing Studies, National University of Singapore, National University Health System, Singapore, Singapore
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  • S.Y. Liaw Registered Nurse, PhD in Medical Education

    Assistant Professor, Corresponding author
    • Alice Lee Centre for Nursing Studies, National University of Singapore, National University Health System, Singapore, Singapore
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  • Conflict of interest: No conflict of interest has been declared by the authors.

Correspondence address: Dr Sok Ying Liaw, Alice Lee Centre for Nursing Studies, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore 117597, Singapore; Tel: (65)-65167451; Fax: (65)-67767135; E-mail nurliaw@nus.edu.sg.

Abstract

Background

Ineffective physician–nurse collaboration has been shown to cause work dissatisfaction among physicians and nurses and compromised the quality of patient care.

Aim

The review sought to explore: (1) attitudes of physicians and nurses toward physician–nurse collaboration; (2) factors affecting physician–nurse collaboration; and (3) strategies to improve physician–nurse collaboration.

Methods

A literature search was conducted in the following databases: CINAHL, PubMed, Wiley Online Library and Scopus from year 2002 to 2012, to include papers that reported studies on physician–nurse collaboration in the hospital setting.

Findings

Seventeen papers were included in this review. Three of the reviewed articles were qualitative studies and the other 14 were quantitative studies. Three key themes emerged from this review: (1) attitudes towards physician–nurse collaboration, where physicians viewed physician–nurse collaboration as less important than nurses but rated the quality of collaboration higher than nurses; (2) factors affecting physician–nurse collaboration, including communication, respect and trust, unequal power, understanding professional roles, and task prioritizing; and (3) improvement strategies for physician–nurse collaboration, involving inter-professional education and interdisciplinary ward rounds.

Conclusion

This review has highlighted important aspects of physician–nurse collaboration that could be addressed by future research studies. These include: developing a comprehensive instrument to assess collaboration in greater depth; conducting rigorous intervention studies to evaluate the effectiveness of improvement strategies for physician–nurse collaboration; and examining the role of senior physicians and nurses in facilitating collaboration among junior physicians and nurses. Other implications include inter-professional education to empower nurses in making clinical decisions and putting in place policies to resolve workplace issues.

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