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Nurses' role in accomplishing interprofessional coordination. Lessons in 'almost managing' an emergency department team.

AIM
To describe how nurse coordinators accomplished day-to-day interprofessional coordination in an Australian emergency department team, drawing some lessons for the design of nurse coordinator roles in other settings.


BACKGROUND
Previous studies have examined leadership within nursing teams, and there is a growing number of registered nurses employed as care coordinators. There is limited literature on how the day-to-day coordination of interprofessional teams is accomplished, and by whom.


METHOD
19 semi-structured interviews with emergency department registered nurses, doctors and nurse practitioners analysed thematically.


RESULTS
Three themes describe how coordinators accomplished interprofessional coordination: task coordination and oversight; taking action to maintain patient flow; and negotiating an ambiguous role.


CONCLUSION
Better-defined nurse coordinator roles with clearer authority and associated training are essential for consistent practice. However, accomplishing interprofessional coordination will always require the situated knowledge of the complex nursing-medical division of labour in the workplace, and the interpersonal relationships that are only gained through experience.


IMPLICATIONS FOR NURSING MANAGEMENT
The design of nurse coordinator roles must include the thorny question of 'who leads' interprofessional teams in the day-to-day coordination of tasks. New and inexperienced nurses may not have the necessary situated knowledge or interpersonal relationships to succeed. However, such roles offer an important development opportunity for future nurse managers.