Informal Interactions, Gender, and Hierarchy: Barriers to Nurse-Physician Collaboration in a West Coast Hospital

Over the past half-century, the nursing profession has made great strides in terms of professionalization, status, and compensation. The pervasive focus on coordination and quality of health care in recent health care reform continues to stress effective partnerships between nurses and physicians. However, implicit and often gendered notions of professional authority continue to create barriers to effective communication between nurses and physicians. Relying on interviews and extended observations, this brief reports findings of an in-depth study of nurse-physician interactions in a California hospital. The research has direct implications for the job satisfaction and retention of nurses. The findings also highlight how subtle power dynamics limit the potential of promising organizational change initiatives in the wake of healthcare reform.