Foth Thomas, Block Karen, Stamer Maren, Schmacke Norbert
University of Ottawa, Ontario, Canada.
Hamburger Betreuungsbüro, Hamburg, Germany.
Glob Qual Nurs Res. 2015 Jan 21;2:2333393614565185. doi: 10.1177/2333393614565185. eCollection 2015 Jan-Dec.
To better understand why cooperation between health care professionals is still often problematic, we carried out 25 semistructured face-to-face expert interviews with physicians and nurses in different rural and urban areas in northern Germany. Using Mayring's qualitative content analysis method to analyze the data collected, we found that doctors and nurses interpreted interprofessional conflicts differently. Nursing seems to be caught in a paradoxical situation: An increasing emphasis is placed on achieving interprofessional cooperation but the core areas of nursing practice are subject to increasing rationalization in the current climate of health care marketization. The subsequent and systematic devaluation of nursing work makes it difficult for physicians to acknowledge nurses' expertise. We suggest that to ameliorate interprofessional cooperation, nursing must insist on its own logic of action thereby promoting its professionalization; interprofessional cooperation cannot take place until nursing work is valued by all members of the health care system.
为了更好地理解为何医护人员之间的合作仍然常常存在问题,我们在德国北部不同的农村和城市地区,对医生和护士进行了25次半结构化的面对面专家访谈。运用梅林的定性内容分析法对收集到的数据进行分析,我们发现医生和护士对跨专业冲突的解读有所不同。护理似乎陷入了一种自相矛盾的境地:人们越来越强调实现跨专业合作,但在当前医疗保健市场化的环境下,护理实践的核心领域却面临着越来越多的合理化调整。护理工作随后系统性地贬值,使得医生难以认可护士的专业知识。我们建议,为了改善跨专业合作,护理必须坚持自身的行动逻辑,从而推动其专业化;只有当护理工作得到医疗保健系统所有成员的重视时,跨专业合作才能够实现。