Understanding collaboration between nurses and physicians as knowledge at work.

BACKGROUND: Collaboration between nurses and physicians is linked to positive outcomes for patients, especially in the intensive care unit. However, effective collaboration poses challenges because of traditional barriers such as sex and class differences, hierarchical organizational structures in h...

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Published in:American Journal of Critical Care Vol. 16; no. 5; pp. 470 - 479
Main Authors: Stein-Parbury J, Liaschenko J
Format: CEU exam questions research Journal Article
Published: American Association of Critical-Care Nurses Sep2007
Online Access:View this record in EBSCOhost
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      dt: Sep2007
      vid: 16
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        10.4037/ajcc2007.16.5.470
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        atl: Understanding collaboration between nurses and physicians as knowledge at work.
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        au:
          Stein-Parbury J
          Liaschenko J
        affil: Professor, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, and the South Eastern Sydney Illawarra Area Mental Health Service, New South Wales, Australia
      sug:
        subj:
          Collaboration
          Critical Care
          Critical Care Nursing
          Knowledge
          Nurse-Physician Relations
          Academic Medical Centers
          Adult
          Audiorecording
          Australia
          Communication
          Confusion
          Data Analysis
          Education, Continuing (Credit)
          Ethnographic Research
          Field Notes
          Interviews
          Knowledge Classification
          Nurse Attitudes Evaluation
          Nursing Assessment
          Nursing Knowledge
          Organizational Culture
          Participant Observation
          Patient Assessment
          Purposive Sample
          Qualitative Studies
          Registered Nurses
          Students, Medical
          Triangulation
          Human
          Adult: 19-44 years
      ab: BACKGROUND: Collaboration between nurses and physicians is linked to positive outcomes for patients, especially in the intensive care unit. However, effective collaboration poses challenges because of traditional barriers such as sex and class differences, hierarchical organizational structures in health-care, and physicians' belief that they are the final arbiter of clinical decisions. OBJECTIVE: To further analyze the results of an investigation on how intensive care unit culture, expressed through everyday practices, affected the care of patients who became confused. METHODS: A model of the types of knowledge (case, patient, and person) used in clinical work was used to analyze the breakdown in collaboration detected in the original study. RESULTS: Breakdown of collaboration occurred because of the types of knowledge used by physicians and nurses. Certain types of knowledge were privileged even when not applicable to the clinical problem, whereas other types were dismissed even when applicable. CONCLUSION: Viewing collaboration through the conceptual lens of knowledge use reveals new insights. Collaboration broke down in the specific context of caring for patients with confusion because the use of case knowledge, rather than patient knowledge, was prominent in the intensive care unit culture.
      pubtype: Academic Journal
      doctype:
        CEU
        exam questions
        research
        Journal Article
      ougenre: Article
    language: English
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