Article Type: Report
Subject: Nurse and physician (Analysis)
Nursing (Practice)
Nurses (Beliefs, opinions and attitudes)
Nurses (Practice)
Medicine (Practice)
Medicine (Research)
Authors: Scholl, Elizabeth
Jenkins, Peggy
Pub Date: 03/22/2011
Publication: Name: Journal of the New York State Nurses Association Publisher: New York State Nurses Association Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 New York State Nurses Association ISSN: 0028-7644
Issue: Date: Spring-Winter, 2011 Source Volume: 42 Source Issue: 1-2
Topic: Event Code: 310 Science & research; 200 Management dynamics
Product: Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: England Geographic Code: 4EUUE England
Accession Number: 278760668
Full Text: Churchman, J., & Doherty, C. (2010). Nurses' views on challenging doctors' practice in an acute hospital. Nursing Standard, 24(40), 42-47.

Despite the shift in women's roles in the workforce into areas of skilled employment, studies have shown that subordination of nurses still exists. In general, subordination of nurses is not viewed as a problem; however, studies show that a lack of interdisciplinary cooperation and collaboration and poor communication contribute to harm occurring to patients in the hospital setting. This study looked to evaluate the willingness of nurses to challenge physicians' practice in the acute care setting. Of the 55 nurses invited to participate only 12 volunteered. All participants were female with the mean age of 47 years, and the youngest was 34 years old. The self-selected purposive sample was from a 400-bed acute care hospital in the South of England.

This study used a qualitative approach employing in-depth recorded interviews asking participants to identify an occasion in which they challenged physician practice or a situation in which they did not challenge a physician's practice, but wish that they had. A thematic approach identified core themes, subtexts, and repetitive words. Through thorough analysis, two main themes were identified: "the battle of challenging" and "playing games." Participants described "the battle of challenging" as a psychological process protecting them from the "uphill battle" of challenging physicians. Nurses felt intimidated by aggressive actions of physicians and felt that their opinions were not being heard. "Playing games" involved manipulation especially through charm and flirting to subtly insinuate ideas. "Playing games" allowed nurses to influence patient care without "ruffling the fragile ego of physicians." Nurses stated a belief in their assertiveness, but observation of their practice contradicts this statement. Quality and Safety Education for Nurses, a program funded by the Robert Wood Johnson Foundation, highlights the same occupational hierarchy for nurses here in the United States. The program has created an initiative promoting education and strategies in interdisciplinary collaboration and communication through encouraging confidence in knowledge, skill, and ability to challenge physicians.

Elizabeth Scholl, Hartwick College, Oneonta, NY

Peggy Jenkins, Hartwick College, Oneonta, NY
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.

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