Power & Conflict between Doctors and Nurses: Breaking through the Inner Circle in Clinical Care

By Maureen A. Coombs | Go to book overview

Chapter 2

Collaboration

Working partnerships or sleeping with the enemy?

The previous chapter has explored the contextual issues that have influenced medical and nursing roles. This chapter has, as its focus, how doctors and nurses work together in the clinical environment. Review of the literature demonstrates that much has been written on the nature of working relationships between doctors and nurses. In this section, I will critically review the concepts that most frequently arise in literature relating to doctor-nurse relationships. The terms used to describe clinical team functioning are explored, together with the specific concept of collaboration. As the review will demonstrate, over time there have been subtle changes in the definitions used to describe team working. I suggest that these reflect the historical socialisation and contemporary dynamics of health care teams. Such definitions and developments, therefore, need to be understood cognisant of the health care context at that time.

In the latter half of this chapter, I explore the nursing and sociological literature to examine interdisciplinary working in order to understand the working relationships between doctors and nurses. This review will demonstrate how sociological perspectives can provide alternative readings on everyday clinical events, such as the ward round and the nursing handover. The chapter concludes with consideration of whether collaborative working partnerships are of interest to all within the health care team.


Collaboration in health care: definitions and concepts

Many frameworks and concepts have been used to describe the working relationships between medicine and nursing. At present, the most frequently cited concept in health care policy and literature is that of 'collaboration', meaning 'to labour together': although alternative definitions are offered that imply a willingness to co-operate with one's enemy (Webster 1990).

Collaboration is defined as being non-hierarchical in nature and a 'co-operative venture based on shared power and authority. It assumes power based on a knowledge base or expertise as opposed to power shared on role or function'

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Power & Conflict between Doctors and Nurses: Breaking through the Inner Circle in Clinical Care
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Illustrations vii
  • Acknowledgements ix
  • Abbreviations and Glossary xi
  • Introduction xv
  • Chapter 1 - Nursing Role Developments 1
  • Chapter 2 - Collaboration 11
  • Chapter 3 - Clinical Management Teams 25
  • Chapter 4 - The Study 37
  • Chapter 5 - Understanding the Context 52
  • Chapter 6 - Clinical Decision Making and the Hierarchies of Knowledge 63
  • Chapter 7 - Roles in Clinical Decision Making 84
  • Chapter 8 - Power and Conflict on the Clinical Decision-Making Stage 97
  • Chapter 9 - Breaking Through the Inner Circle 118
  • References 127
  • Index 144
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