Interprofessional relations between doctors and nurses: perspectives from South Wales

This paper discusses findings from a study of interprofessional relationshi ps between doctors and nurses in medical wards in three provincial general hospitals in south Wales. The aim of the research was to investigate the ch anging nature of doctor-nurse relations, and in particular, how far the not ion of the doctor-nurse game, as developed by Leonard Stein (Stein 1967, 19 90), remains relevant to contemporary hospital work. The present paper conc entrates on a subset of the findings concerned with doctors' and nurses' ac counts of the hospital division of labour and the extent of any overlap in their work activities. Semi-structured interviews were conducted with 20 do ctors and 39 nurses in their places of work over a period of 4 months. Indu ctive analysis of the data indicated that, whilst doctors and nurses percei ved their roles in largely traditional terms, there was some recognition of blurring of occupational boundaries, especially when considering work pres sures, working at night and differences in practice in more specialized cli nical areas. Although nurses were generally reluctant to challenge doctors' authority, some used the notion of patient 'advocacy' to frame and justify their questioning of particular decisions. Whilst doctors valued 'experien ce' in nurses and saw experienced nurses as the group who might most legiti mately move into doctors' territory, nurses valued formal education and saw advanced nursing qualifications as the route to role expansion.