Collaboration between hospital physicians and nurses: an integrated literature review

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.

Keywords: Attitudes; Inter-Professional Collaboration; Inter-Professional Education; Nurse-Physician Relations; Physician-Nurse Collaboration.