Braam Anoek, Buljac-Samardžić Martina, Hilders Carina, van Wijngaarden Jeroen
Department Health Services Management & Organisation (HSMO) of the Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
Reinier de Graaf Gasthuis, Delft, Netherlands.
J Nurs Manag. 2023 Dec 13;2023:8838375. doi: 10.1155/2023/8838375. eCollection 2023.
Being a nurse or physician in today's complex healthcare practice involves more than just responsibility for one aspect of care during one episode in a patient's care trajectory. Both professionals are expected to take on a clinical leadership role and contribute positively to the reduction of care fragmentation and help in spanning professional boundaries. Although nurses may be well placed to identify the needs for integration, they may lack the position and status (compared to physicians) to address those needs as leaders. The aim of this study is to analyse similarities and differences between nurses and physicians in clinical leadership roles within a hospital context and explore how this relates to their interdisciplinary collaborative behaviours and perception on their job.
A cross-sectional survey among physicians and nurses was conducted to measure clinical leadership, job satisfaction, workload, and interdisciplinary collaborative behaviours.
Our results suggest that nurses ( = 329) and physicians ( = 100) show similar clinical leadership behaviours, based on equivalent scores on the clinical leadership scale. However, physicians score higher on the global leadership scale indicating they are more likely to perceive themselves as leaders than nurses. As clinical leaders, both nurses and physicians are more likely to express interdisciplinary collaborative behaviours. Furthermore, physicians who scored higher on the clinical leadership scale reported higher satisfaction with their job, whereas, for nurses, their score on the clinical leadership scale did not relate to their job satisfaction.
As nurses in hospitals have the most frequent and direct involvement with patients, it seems inevitable for them to act as clinical leaders to promote patient-centred care. However, nurses less often perceived themselves as clinical leaders while showing suitable behaviours. Future studies should focus on the strategies nurses use to exert their clinical leadership, and for example, if nurses require the use of more dominant strategies to effect change.
在当今复杂的医疗实践中,护士或医生所承担的责任不仅仅局限于患者护理轨迹中某一阶段的某一方面护理工作。这两个专业群体都被期望发挥临床领导作用,并为减少护理碎片化做出积极贡献,助力跨越专业界限。尽管护士可能很适合识别整合需求,但与医生相比,他们可能缺乏以领导者身份解决这些需求的地位。本研究旨在分析医院环境中护士和医生在临床领导角色上的异同,并探讨这与他们的跨学科协作行为以及工作认知之间的关系。
对医生和护士进行了横断面调查,以测量临床领导力、工作满意度、工作量和跨学科协作行为。
我们的结果表明,护士(n = 329)和医生(n = 100)在临床领导量表上得分相当,显示出相似的临床领导行为。然而,医生在整体领导力量表上得分更高,表明他们比护士更倾向于将自己视为领导者。作为临床领导者,护士和医生都更有可能表现出跨学科协作行为。此外,在临床领导量表上得分较高的医生对工作的满意度更高,而对于护士来说,他们在临床领导量表上的得分与工作满意度无关。
由于医院中的护士与患者接触最为频繁和直接,他们似乎不可避免地要担任临床领导者以促进以患者为中心的护理。然而,护士在表现出适当行为的同时,较少将自己视为临床领导者。未来的研究应关注护士发挥临床领导力所采用的策略,例如,护士是否需要使用更具主导性的策略来实现变革。