“What is Found There”1: Qualitative Analysis of Physician–Nurse Collaboration Stories

McGrail, Kathleen A.; Morse, Diane S.; Glessner, Theresa; Gardner, Kathryn

doi:10.1007/s11606-008-0869-5

Cited by 33 publications

(41 citation statements)

References 37 publications

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“…RCC stresses partnership, careful attention to all relational processes, shared decision-making, and selfawareness -principles which have much common with those of NAA. In fact, it is easy to agree with those authors (Egan & Jaye, 2009;McGrail & Gardner, 2009;Safran & Beckman, 2006) who have pointed out the paradox between traditional clinical education (structured around individuals) and clinical practice (which is based on teamwork and relationships).This research also shows parallels with the views of those authors who have noted the unrealistic expectations attached to psychiatric expertise , and who have called for a reframing of the concept of responsibility in a more relational way (McNamee & Gergen, 1999). In the NAA tradition there have been several ideas for utilizing and developing teamwork.…”

supporting

confidence: 71%

“…The interview protocol had a tendency to develop into a critical evaluation of the treatment. In line with the literature concerning relationship-centered care (Beach, 2006; Suchman, 2006), this study shows how the psychiatrists took actions in the treatment situation not only as professionals, but also as persons -individuals who had their own characteristics and emotional reactions, and genuine relationships with their co-workers.Though we were unable to trace methodologically similar qualitative studies, parallel findings have been discovered in various fields of medicine: the physician's role in the welfare of their workmates is prominent (Jimmieson, 2010), interprofessional collaboration is crucially important for novices, and challenges in professional collaboration are associated with crises in patient care and affects (McGrail, 2009), and with the boundaries in health care organizations .The majority of the few papers concerning workmate relationships in psychiatry do not focus on the personal characteristics of professionals; however, the following are relevant to the findings of this study. Psychiatrists' respect for and trust in workmates'…”

mentioning

confidence: 82%

“…Several authors (Egan & Jaye, 2009;McGrail & Gardner, 2009;Safran & Beckman, 2006) have emphasized that whereas in clinical schools education is mainly structured around individuals, clinical practice mainly involves relationshipcentered teamwork. The concept of relationship-centered care (RCC) (Beach & Inui, 2006;Safran & Beckman, 2006;Suchman, 2006aSuchman, , 2006b) has been used to recognize the importance of relationships for health outcomes, encompassing the personhood and emotions of all the participants and the context of reciprocal influence.…”

Section: Therapeutic Relationships In a Multi-agent Treatment Settingmentioning

confidence: 99%

“…Thus, for example, it was found that in operating rooms the patterns of communication were complex, socially motivated, and tensioned (Lingard & DeVito, 2002). Research had also been conducted on the crucial components of physicians' respect for nurses (Rosenstein, 2002;Schmalenberg & Rapp, 2005), the importance of interprofessional collaboration for novices ( Lingard & Espin, 2002;McGrail & Gardner, 2009), and the major impact of boundaries in health care organizations .The reflective practice of expertise, described by Schön (1983), sheds light on the multi-agent professional practice of NAA. When the situation is complex and uncertain, and when there are many competing views, discussion between professionals and with clients is needed, as much to identify the problem as to solve it.…”

mentioning

confidence: 99%

“…The challenges and problems concerning workmates were one of the major issues in the interviews. They resulted not just from the challenges bound up with the treatments, but also from institutional aspects, and from more personal or even private issues in professional or clinician-clinician relationships.Various fields of medicine have given rise to research with parallel findings, including the crucial role of teams in clinical work (Engqvist & Nilsson, 2010;Jimmieson & Gallagher, 2010;, the importance of interprofessional collaboration for novices (McGrail & Gardner, 2009), the major importance of boundaries in health care organizations , and the contradictions relating to a uni-professional culture, teamwork, and responsibility ( Herrman, 2002;. The results of the present research indicate that the concept of relationship-centered care (RCC) (Beach & Inui, 2006;Safran & Beckman, 2006;Suchman, 2006b), which has mainly been used in general and somatic medicine, could be utilized also in psychiatry and in the treatment of psychosis.…”

mentioning

confidence: 99%

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The Need-Adapted Approach in Psychosis: The Impact of Psychosis on the Treatment and the Professionals

Borchers¹,

Seikkula

Arnkil

2014

Ethical Hum Psychol Psychiatry

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This research aimed to describe the inner dialogues of psychiatrists in the context of the Need-Adapted treatment of psychosis. It strived to show that the experiences of professionals can have an impact on the treatments offered. In addition, the research aimed to clarify how the phenomenon of professionals' inner dialogues may be studied.The data for the three studies of the research consisted of eight videotaped and transcribed stimulated recall interviews with psychiatrists, who recalled their inner dialogues, assisted by videos from co-research interviews. The dialogues took place in multi-agent discussions with patients, with the family members of patients, and with other professionals. The first study provided an overall picture of the research material, with a focus on psychiatrists' inner dialogues concerning their workmates. The second study focused on how the psychiatrists viewed their agency. The third study dealt with the impact of psychosis on the treatment, the psychiatrists, and other professionals. The first two studies used adaptations of dialogical-narrative analysis, while the third study used an adaptation of qualitative content analysis.From the perspective of real-world clinical practice the studies suggested the following: (i) since psychiatrists interact with the clients and with other professionals, they respond as embodied individual human beings with possibly strong emotions; this suggests that the experiences and inner dialogues of the participants may be interdependent; (ii) clinician-clinician relationships can be of crucial importance in the treatment; (iii) especially in the inpatient setting, institutional forces can have an enormous impact on psychiatrists' agency by reducing professional creativity, and occasionally, by leading to a kind of agentless situation; (iv) psychiatrists seem to be more or less aware of the many harmful effects of (in particular) inpatient treatment; (v) the interview methods used in the research increased professionals' reflective opportunities, indicating that such interviews could be helpful in the dilemmas professionals encounter in practice. Tämän tutkimuksen tavoite oli kuvata psykiatrien sisäistä keskustelua psykoosien tarpeenmukaisen hoitomallin kontekstissa. Se pyrki osoittamaan, että ammattilaisten kokemuksilla voi olla vaikutusta tarjottuun hoitoon, ja selvittä-mään, miten ammattilaisten sisäistä keskustelua voidaan tutkia. Kolmen osatutkimuksen aineisto koostui kahdeksasta videolle tallennetusta ja transkriptoidusta stimulated recall -haastattelusta, joissa psykiatrit yhteisen tutkimisen haastattelun kuvanauhan avulla palauttivat mieleensä sisäistä keskusteluaan. Yhteisen tutkimisen haastattelu oli ryhmäkeskustelu, jossa oli lääkärien ohella läsnä potilas, hänen perheenjäseniään sekä muita ammattilaisia. Ensimmäisessä osatutkimuksessa kuvattiin tutkimusaineistoa kokonaisuudessaan ja keskityttiin psykiatrien työtovereita koskevaan sisäiseen keskusteluun. Toisessa osatutkimuksessa paneuduttiin psykiatrien kokemukseen toimijuudestaan....

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supporting

confidence: 71%

mentioning

confidence: 82%

Section: Therapeutic Relationships In a Multi-agent Treatment Settingmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

The Need-Adapted Approach in Psychosis: The Impact of Psychosis on the Treatment and the Professionals

Borchers¹,

Seikkula

Arnkil

2014

Ethical Hum Psychol Psychiatry

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Do physicians’ beliefs influence treatment options at the end of life?

Kross

2012

Intensive Care Med

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Dissonant role perception and paradoxical adjustments: an exploratory study on Medical Residents’ collaboration with Senior Doctors and Head Nurses

Fiordelli

Schulz

Zufferey

2013

Adv in Health Sci Educ

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A good collaboration between health professionals is considered to have benefits for patients, healthcare staff, and organizations. Nevertheless, effective interprofessional collaboration is difficult to achieve. This is particularly true for collaboration between Medical Residents (MRs) and the immediate colleagues they interact with, as Senior Doctors (SDs) and Head Nurses (HNs). Role understanding is one of the factors that may explain difficulties in interprofessional collaboration. Based on this hypothesis, this paper focuses on MRs' role, devoting particular attention to differences in role perception between MRs, SDs, and HNs, and to their consequences for interprofessional collaboration. An exploratory qualitative study inspired by Grounded Theory was conducted in April 2009 in a small peripheral and non-university hospital in Switzerland. Data came from two focus groups with MRs (13), one with SDs (8), and one with HNs (7), and were analyzed using the constant comparative method. Findings show that the expected and the enacted role of MR are perceived differently by SDs, HNs and MRs themselves. To face the inconsistencies within MR's role, the three professional groups develop some adjustments that eventually prove to be paradoxical: on one side, they make collaboration possible and preserve the functioning of the ward, while on the other side they lead to mutual misunderstanding and discontent. These findings suggest that there is an urgent need of defining the role of MRs, of delimiting its boundaries and thereby distinguishing it from other health workers, and eventually of promoting a shared representation of it.

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“What is Found There”1: Qualitative Analysis of Physician–Nurse Collaboration Stories

Cited by 33 publications

References 37 publications

The Need-Adapted Approach in Psychosis: The Impact of Psychosis on the Treatment and the Professionals

The Need-Adapted Approach in Psychosis: The Impact of Psychosis on the Treatment and the Professionals

Do physicians’ beliefs influence treatment options at the end of life?

Dissonant role perception and paradoxical adjustments: an exploratory study on Medical Residents’ collaboration with Senior Doctors and Head Nurses

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