Excellence through evidence - Securing collegial/collaborative nurse-physician relationships, part 1

Multiple nurse-physician (RNMD) relationships coexist on hospital units; collegial and collaborative (C/C) relationships positively impact, more than others, patient outcomes. The goal of this multisite evidence-based management practice initiative was to identify structures that enable C/C RNMD relationships. In part 1, the authors discuss the methodology and selection of the sample of 141 physicians, managers, and staff nurses from 44 clinical units in 5 hospitals that had previously demonstrated extensive C/C RNMD relationships. These 141 experts were interviewed to identify structures enabling C/C RNMD relationships. Part 1 presents the structures that enable C/C RNMD relationships as described and tested in the literature, as. well as a description of the characteristics of the clinical units, experts, and C/C RNMD relationships found in this study. In part 2, the structures identified by the experts as needed for securing C/C RNMD relationships will be presented, along with suggestions for attainment. Collaboration is a process, not an event. When embraced as a core value and translated into behavior, collaboration becomes an organizational norm.(1) Collaboration is best viewed as a relationship, a process consisting of ongoing interactions. Relationships vary among nurses and physicians (RNMD). At least 5 types are known to coexist on clinical units.(2,3) Collegiality and collaboration, the 2 most effective with respect to patient outcomes,(4) are the focus of this article. It is the proportion and dominance of one type of relationship over others that create a unit climate or environment in which collegial and collaborative nurse-physician relationships (C/C RNMD) can become the prevailing norm.