Collaborative practice: developing a structure that works

Nurse-physician collaborative relationship on nurses' self-perceived job satisfaction in ambulatory care

The dynamic restructuring of the healthcare environment from a primary acute care focus to an ambulatory care focus has prompted a migration of nurses to the ambulatory care setting. The predication of nursing job satisfaction is a complex process that has received little attention in the ambulatory care setting. The purpose of this study was to determine if a relationship existed between the nurse-physician relationship and nurses' self-perceived job satisfaction in the ambulatory care setting. While study findings demonstrated there was no significant relationship between the nurse-physician relationship and nurses' self-perceived job satisfaction in the ambulatory care setting, it did confirm that registered nurses working in the ambulatory setting have a moderate level of job satisfaction. The lack of correlation between the nurse-physician relationship and job satisfaction may have been attributed to limitations such as a limited sample size and the nurses having a relationship with a smaller number of physicians in the ambulatory care setting. Recommendations to further understanding of the nurse-physician relationship included further descriptive studies of nurses working in the ambulatory care setting and further studies on job satisfaction of nurses.

Role perceptions of freshman and senior nursing and medical students and attitudes toward collaborative decision making

David Kolb's (1981) experiential learning theory was used to examine differences between first- and fourth-year nursing and medical students' perceptions of competencies important for nursing and medicine. A convenience sample of nursing (n = 109) and medical (n = 108) students from a large Canadian research university was surveyed. Respondents completed the Environmental Press Questionnaire, the Adaptive Competency Scale, and a 6-item measure of attitudes toward collaborative nurse-physician patient care decision making. Nursing students' perceptions of competencies important for medicine were found to be more congruent with medical students' perceptions of these competencies than were medical students' perceptions of competencies important for nursing as seen by nursing students. Gaps in perceptions of each others' roles were significantly negatively related to attitudes toward collaborative patient care decision making.