Collaboration at risk: registered nurses' experiences on orthopaedic wards

J Clin Nurs. 2008 Jul;17(14):1907-14. doi: 10.1111/j.1365-2702.2007.02213.x.


Aim: To extract meaning from registered nurses' lived experiences in their professional collaboration with orthopaedic surgeons.

Background: Interprofessional collaboration between registered nurses and orthopaedic surgeons faces challenges on many levels. The literature offers theories on collaboration, but reality seems to be in conflict with theory, especially in somatic hospitals. Little empirical research on lived experience has been conducted in these settings.

Method: I conducted narrative interviews with five registered nurses who work on orthopaedic wards in two different hospitals in Norway. I analysed the data using a phenomenological hermeneutical method inspired by Ricoeur's theory of interpretation.

Results: The registered nurses emphasised disparate expectations and priorities when they described collaboration. They felt their performance was hindered and had difficulty in being assertive about their own area of work. Collaboration was perceived from the perspective of relations with orthopaedic surgeons, which were perceived as difficult as indicated by the themes identified: disparate expectations and priorities; feeling emotionally burdened; keeping a distance; accepting difficult relations; and being confident in difficult relations.

Conclusions: Registered nurses seem to focus on relations in work settings where chaos and unpredictability set the background for collaboration. They perceived relations through their focus on behaving responsibly. This highlights their resources and their ability to see and to meet others, as well as difficulties they experience in asserting the importance of their own professional sphere. Acknowledging strengths and weaknesses could help to strengthen nursing identity and make it more explicit.

Relevance to clinical practice: Both resources and weaknesses are revealed that could be used by all healthcare workers to improve collaboration with colleagues, thereby enhancing patient care.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Anger
  • Assertiveness
  • Attitude of Health Personnel*
  • Burnout, Professional / psychology
  • Conflict, Psychological
  • Cooperative Behavior*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medical Staff, Hospital / organization & administration
  • Medical Staff, Hospital / psychology
  • Norway
  • Nurse's Role / psychology
  • Nursing Methodology Research
  • Nursing Staff, Hospital / organization & administration
  • Nursing Staff, Hospital / psychology*
  • Orthopedic Nursing* / organization & administration
  • Orthopedics / organization & administration
  • Physician-Nurse Relations*
  • Professional Competence / standards
  • Self Efficacy
  • Surveys and Questionnaires
  • Verbal Behavior