Male nurse and female physician(iStock Photo, 2005)
The expanding role of nurse practitioners in healthcare also affects nurse-doctor relationships. Nurse practitioners have started to step into doctors’ domains with their health-care practices. For example, some families have replaced their family physician with a nurse practitioner. Studies of nurse practitioners in family practice show that a “nurse practitioner can provide first contact primary clinical care as safely and effectively and with as much satisfaction for patients as can a family physician”(Gray, 1983, p. 1306).
Nurse practitioner and patient (University of Cincinnati Magazine, 2006)
As nurse practitioners take on increasing responsibilities, differences in status and power result and the relationship between nurses and doctors are affected (Siegler & Whitney, 1994). Nurse practitioners challenge the power of doctors, who society places on a pedestal because of perceived high social and economic status.
Cartoon emphasizing social stereotype of doctors and nurses (Biffsniff.com, 2008)
Cultural influences also play a part in nurse-doctor relationships. One article comparing American, Israeli, Italian, and Mexican nurse-doctor collaborative relationships proposes two different types of nurse-doctor relationship models that are evident in different cultures. One model is the hierarchical model that is typical in societies where nurses have little autonomy and physicians have total dominance in health care decisions. In this model, nurses have very little power and are often perceived to be physicians’ handmaidens.
Handmaiden role of nurses (View Images, 2004)
According to the article, the hierarchical model is more apparent in Israeli and Mexican culture than it is in American and European cultures.
The second model is the complementary model, which “places more emphasis on the importance of education, common experiences, shared autonomy, and mutual authority“(Hojat et al., 2003, p. 428). This model is more typically found in Western cultures.
Although nurse-doctor relationships vary culturally, findings have shown that “nurses desire a collaborative physician-nurse relationship more than physicians do, regardless of cultural differences” (Hojat et al., 2003, p. 432).
In essence, the nurse-doctor relationship is affected by many issues; we should take care to address these issues in order to form healthy relationships between nurses and doctors.
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Cowen, P.S., & Moorhead, S. (2006). Current Issues in Nursing (7th ed.). St. Louis: Mosby Elsevier.
Gordon, S. (2005). Nursing Against the Odds: How Health care Cost Cutting, Media Sterotypes, and Medical Hubris Undermine Nurses and Patient Care. Ithaca: Cornell University Press.
Gray, C. (1983). Nurse practitioners: stepping into the doctor’s domain? Canada Medical Association Journal, 128, 1305-1309.
Hojat, M., Gonnella, J.S., Nasca, T.J., Fields, S.K., Cicchetti, A., Scalzo, A.L., et al. (2003). Comparisons on American, Israeli, Italian and Mexican physicians and nurse on the
total and factor scores of the Jefferson scale of attitudes toward physician-nurse collaborative relationships. International Journal of Nursing Studies, 40, 427-435.
Siegler, E.L., & Whitney, F.W. (Eds.). (1994). Nurse-Physician Collaboration: Care of Adults and the Elderly. New York: Springer Publishing Company.
Zelek, B. & Phillips, S. P. (2003). Gender and power: Nurses and doctors in Canada. International Journal for Equity in Health, 2, 1-5.