Getting work done: a grounded theory study of resident physician value of nursing communication

ABSTRACT

Poor communication between nurses and physicians results in patient injury and increased healthcare costs. While multiple attempts have been made to improve communication between the two professions, evidence confirms little progress has been made. Previous research focused on standardizing communication processes and protocols between nurses and physicians rather than examining the relational component of these human interactions. The purpose of this study was to explore physician valuing of nursing communication in the context of patient care. Interviews were conducted with 15 internal medicine resident physicians. A constructivist grounded theory approach was used to develop the substantive theory of Getting Work Done. Getting Work Done incorporated three major categories: discerning the team, shifting communication, and accessing nurse knowledge and abilities. Hierarchical behaviors and language, and nurse collusion in both, characterized nurse-physician communication and situated the nurse outside the decision-making team. Complex work environments further devalued nurse-physician communication. Interprofessional education and practice must advance the unique and essential role of all health care professionals such that mutual valuing replaces hierarchical actions with collaborative systems for determining the most effective approaches to patient care.

KEYWORDS:

• Interprofessional
• communication
• valuing
• grounded theory

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Thompson H. Forbes

Thompson H. Forbes is Assistant Professor in the Department of Nursing Science at the East Carolina University College of Nursing.

Kim Larson

Kim Larson is Professor in the Department of Nursing Science at the East Carolina University College of Nursing.

Elaine S. Scott

Elaine S. Scott is Professor and Chair of the Department of Nursing Science at the East Carolina University College of Nursing.

Herbert G. Garrison

Herbert G. Garrison is Associate Dean for Graduate Medical Education at the East Carolina University Brody School of Medicine.