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Nurse-Physician Work Relations and Role Expectations

Physicians and nurses have a unique opportunity to provide quality patient care in a collaborative manner. Congruence of role expectation is key to the success of this team. Many hospitals today aspire to achieve Magnet status. An important aspect of a Magnet hospital is good working relationships between nurses and physicians. In 3 different surveys of nurses, Laschinger et al found that job satisfaction and workplace empowerment were positively related to collaboration with physicians and perceptions of autonomy and control. Although nurses and physicians work together to treat patients, their professional cultures tend to be quite different. In addition to an imbalance in authority, nurses sometimes focus more on the individual patient, whereas physicians focus more on the science of medicine. Although there are important benefits from collaboration, this emphasis is often not sufficiently stressed in medical education. Successful collaboration is dependent on the mindset of the practitioners. Physicians often have expectations suggesting that nurses are an extension of them, whereas nurses want to apply their knowledge directly to patient care. In the mind of physicians, collaboration is sometimes seen as undermining their authoritarian role. Baggs argued that collaboration between physicians and nurses was not yet a reality, emphasizing the divergent points of view inherent in these professions. Obstacles to good working relationships often emerge from incongruent role expectations.