Gleddie Megan, Stahlke Sarah, Paul Pauline
a University of Alberta, Edmonton Clinic Health Academy , Edmonton , Alberta , Canada.
b Faculty of Nursing , University of Alberta, Edmonton Clinic Health Academy , Alberta , Canada.
J Interprof Care. 2018 Dec 30:1-11. doi: 10.1080/13561820.2018.1562422.
Interprofessional teamwork is touted as essential to positive patient, staff, and organizational outcomes. However, differing understandings of teamwork and divergent professional cultures amongst healthcare providers influence the success of teamwork. In labour and delivery, nurse-physician teamwork is vital to safe, family-centered maternity care. In this focused ethnography, the perceptions of obstetrical nurses were sought to understand nurse-physician teamwork and the features that facilitate or impede it. These nurses acknowledged working in a normative hierarchy, with physicians ultimately responsible for patient care decision-making. They described myriad ways in which they navigated traditional power dynamics and smoothed working relationships with physicians, such as circumventing disrespectful behaviors, venting with each other, highlighting their own autonomy, using tactical communication, and managing unit resources. According to these nurses, key facilitators of functional nurse-physicians relationships were time, trust, respect, credibility, and social connection. Further, the nature of their working relationships with physicians influenced their perceptions regarding intent to stay, workplace morale, and patient outcomes.
跨专业团队合作被认为对患者、医护人员和组织取得积极成果至关重要。然而，医护人员对团队合作的不同理解以及不同的专业文化会影响团队合作的成效。在分娩过程中，护士与医生的团队合作对于安全、以家庭为中心的产妇护理至关重要。在这项聚焦人种志研究中，研究者探寻产科护士的看法，以了解护士与医生的团队合作以及促进或阻碍这种合作的因素。这些护士承认在规范的等级制度下工作，医生最终负责患者护理决策。他们描述了多种应对传统权力动态并与医生建立融洽工作关系的方式，比如规避无礼行为、互相倾诉、强调自身自主性、运用策略性沟通以及管理科室资源。据这些护士所言，功能性护士与医生关系的关键促进因素包括时间、信任、尊重、信誉和社会联系。此外，他们与医生的工作关系性质影响了他们对留任意向、工作场所士气和患者治疗结果的看法。
