University of Botswana, Botswana.
Princess Marina Hospital, Botswana.
Nurs Ethics. 2020 Feb;27(1):206-220. doi: 10.1177/0969733019840753. Epub 2019 Apr 23.
Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings.
RESEARCH QUESTION/AIM: The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels of hospitals in Botswana (referral, district, and primary).
Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants' written informed consent was obtained.
Respondents' ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse-doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants' views about how their work experiences could be improved.
Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom-and not a sufficient number of nursing staff.
Collaboration between physicians and nurses is critical to optimizing patients' health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment.
医生和护士之间的合作是改善患者护理的关键。我们对非洲医疗保健环境中的合作和跨学科实践知之甚少。
研究问题/目的：本研究旨在探讨博茨瓦纳临床实践和教育中跨学科合作的伦理挑战。
这项定性描述性研究是在博茨瓦纳的公立医院进行的，共有 39 名参与者（20 名医生和 19 名护士）参加了半结构化访谈，这些医院是经过精心挑选的，代表了博茨瓦纳的三级医院（转诊、地区和初级）。
在宾夕法尼亚大学和博茨瓦纳卫生部的机构审查委员会批准后，获得了参与者的书面知情同意。
受访者的年龄从 23 岁到 60 岁不等，工作经验从 0.5 年到 32 年不等。数据中出现的主要定性主题集中在工作环境的性质、护士与医生合作的价值观、合作的性质、支持合作和工作顺利进行的可用资源以及参与者对如何改善工作经验的看法。
参与者表示担心他们的工作环境会影响他们为患者提供高质量和安全护理的能力。医生人员结构被描述为由少数顶尖专家组成，中间有空缺，应由高级医生填补，而初级医生则处于底层，护士人数也不足。
医生和护士之间的合作对于优化患者的健康结果至关重要。这不仅在美国如此，在博茨瓦纳等发展中国家也是如此，那里的医疗保健专业人员报告说，他们的伦理挑战源于资源短缺、不同的专业态度和紧张的工作环境。
