1. Beal, Judy A. DNSc, PNP, RN
  2. Freda, Margaret Comerford EdD, RN, CHES, FAAN

Article Content

Hallas, D. M., Butz, A., & Gitterman, B. (2004).Journal of Pediatric Health Care,18 (2), 77-86.

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The subject of doctor-nurse communication and collaboration is receiving increasing attention these days, as it should. Few of us work in a vacuum, so it is essential that we work together productively, as partners in the care of our patients. Therefore, these authors chose to study how nurses and doctors collaborate, specifically in the context of pediatric collaborative practice. Questionnaires were mailed to 24 PNPs and 24 pediatricians; the authors found that collaborative practice required "open communication, a relationship built on respect and trust, knowledge sharing, and clinical expertise." The word "consultation" was found to be an important concept for both types of professionals. The PNPs wanted a pediatrician collaborator who was "available for consultation on an ongoing basis"; the pediatricians wanted a PNP who "seeks consultation when she recognizes unusual clinical presentations." In the area of "sharing knowledge," the authors found that PNPs and pediatricians had differing views. Pediatricians did not completely view the PNPs as having reached a collegial status regarding sharing expert knowledge. Another important concept was complementary practice styles, as might be expected. Critical components of a collaborative practice were found to be: trust and mutual respect, communication, competency, and a shared vision. This study also found several "red flags" of poor collaboration including territorial or control issues. If the PNP felt that the pediatrician undermined her plan of care, changed the plan of care without discussion, or was inflexible, then a detrimental working situation ensued. One major area of difference between the pediatricians and PNPs was the use of the word "supervision." PNPs rarely used the word "supervision," and when asked about it, they reacted to it negatively. However, the pediatricians used "supervision" freely, and with a positive intent. While they viewed their collaborative practices as successful, they used "supervision" to mean that "a physician is always available" to the PNP. This study suggests that PNPs and pediatricians react differently to certain issues in collaborative practice (e.g., "supervision"), and that the word "consultation" has a better connotation, for it is used in similar manners by PNPs and pediatricians. I have always been interested in how the words we use influence the actions we taken (Freda, 1995), and this research reinforces that interest.


Comment by Margaret Comerford Freda




Freda, M. C. (1995). Arrest, trial and failure. Journal of Obstetric, Gynecologic and Neonatal Nursing, 24 (5), 393-394. [Context Link]