Interprofessional collaboration among junior doctors and nurses in the hospital setting

OBJECTIVES: Evidence suggests that doctors and nurses do not always work collaboratively in health care settings and that this contributes to suboptimal patient care. However, there is little information on interprofessional collaboration (IPC) among new medical and nursing graduates working together for the first time in a multidisciplinary health care team. Our aim was to understand the nature of the interactions, activities and issues affecting these new graduates in order to inform interventions to improve IPC in this context. METHODS: We interviewed 25 junior doctors and nurses and explored their experiences of working together. Interviews were transcribed, entered into a qualitative analysis software package and data were coded against a theoretical framework for health care team function. RESULTS: Although interviewees expressed mutual respect, organisational structures often limited the extent to which they could establish professional relationships. Sharing information and agreeing goals were considered fundamental to good decision making, but the working environment and differing perspectives could make this difficult to achieve. Our data suggest that junior doctors and nurses see themselves as having complementary and non-competitive roles in patient care. The establishing of an interprofessional team was seen to require leadership, which was not always apparent. Without leadership, new members were not always well oriented to the team. The need to maintain an environment in which open communication could take place was acknowledged as important for patient safety, but there were some barriers to achieving this. CONCLUSIONS: Our data highlight the professionalism, respect and adaptability of these junior health professionals. We document the types of collaborative activities and tensions relevant in this context and, based on our findings, provide some strategies for improving IPC.