Discrepant attitudes about teamwork among critical care nurses and physicians.
OBJECTIVE
To measure and compare critical care physicians' and nurses' attitudes about teamwork.


METHODS
Cross-sectional surveys.


METHODS
Eight nonsurgical intensive care units in two teaching and four nonteaching hospitals in the Houston, TX, metropolitan area.


METHODS
Physicians and nurses who worked in the intensive care units.


RESULTS
Three hundred twenty subjects (90 physicians and 230 nurses) responded to the survey. The response rate was 58% (40% for physicians and 71% for nurses). Only 33% of nurses rated the quality of collaboration and communication with the physicians as high or very high. In contrast, 73% of physicians rated collaboration and communication with nurses as high or very high. By using factor analysis, we developed a seven-item teamwork scale. Multivariate analysis of variance of the items yielded an omnibus ( [7, 163] = 8.37; p <.001), indicating that physicians and nurses perceive their teamwork climate differently. Analysis of individual items revealed that relative to physicians, nurses reported that it is difficult to speak up, disagreements are not appropriately resolved, more input into decision making is needed, and nurse input is not well received.


CONCLUSIONS
Critical care physicians and nurses have discrepant attitudes about the teamwork they experience with each other. As evidenced by individual item content, this discrepancy includes suboptimal conflict resolution and interpersonal communication skills. These findings may be the result of the differences in status/authority, responsibilities, gender, training, and nursing and physician cultures.
Thomas
Eric J
EJ
University of Texas-Houston Medical School, Department of Medicine, Division of General Internal Medicine, USA.
Sexton
J Bryan
JB
Helmreich
Robert L
RL
D000328:Adult; D001291:Attitude of Health Personnel; D001318:Authoritarianism; D003142:Communication; D003220:Conflict, Psychological; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003659:Decision Making, Organizational; D005163:Factor Analysis, Statistical; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D033183:Interdisciplinary Communication; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology*; D008875:Middle Aged; D015999:Multivariate Analysis; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration*; D010819:Physician's Role; D019555:Physician-Nurse Relations; D011795:Surveys and Questionnaires; D013781:Texas