The effects of education and clinical specialization on nurses’ status affirmation by physicians: A quantitative analysis

Research has demonstrated a status gap between members of healthcare delivery teams. However, it is unclear which factors mitigate or exacerbate the status gap between healthcare providers. This paper examines the concept of status affirmation, the belief that others affirm the individual’s social standing, as one factor that can affect the status gap between healthcare professionals. The aim of this exploratory study was to investigate two factors that affect nurses’ status affirmation: nurses’ educational backgrounds and clinical specializations. A close-ended survey was administered to registered nurses in Indiana, a midwestern American state11. Aspiring nurses in America can become RNs by completing an accredited nursing training program, usually affiliated with an institution of higher education. Two-year associate degrees, four-year Bachelor of Science degrees, and three-year diploma programs can be accredited. After satisfactorily passing their coursework in an accredited program, prospective nurses must take an RN certification test (NCLEX, offered through the National Council of State Boards of Nursing). A passing test score becomes the permit for a license from a specific state. After obtaining their license, nurses can work in many specialties including, but by no means limited to, surgery, intensive care, obstetrics, outpatient nursing, educators, etc. If nurses wish to specialize in advanced practice (e.g., nurse practitioners, certified nurse midwives, etc.), they require postgraduate education. (N = 1262) to identify which nurses are likely to have their status affirmed by physicians, in general. Results of multinomial logistic regression analyses suggest that highly educated nurses are unlikely to receive status affirmation, and there are differences in status affirmation across clinical specialties. In addition, nurses with advanced degrees often do not work in specialties that receive status affirmation. These results suggest that conflict among nurses and doctors is as likely to exist across divisions in nurses’ educational attainment as across work specializations. Status affirmation is posited as a theoretical antecedent to interprofessional collaboration.