A systematic review of respect between acute care nurses and physicians

Abstract

Background 

Interprofessional collaboration between nurses and physicians has become an essential part of patient care, which, when lacking, can lead to well-known challenges. One possible explanation for ineffective nurse–physician collaboration is a lack of respect.

Purpose 

This review aims to enhance our understanding of the role of respect in work between nurses and physicians by synthesizing evidence about the conceptualization of respect, its mechanisms and outcomes, and its origins.

Methods 

We performed a PRISMA-guided systematic literature review across five databases and reviewed 28 empirical studies about respect between nurses and physicians in acute care settings.

Findings 

Research about respect between nurses and physicians varied in its conceptualization of respect in terms of its nature (as an attitude or behavior), its target (respect for individuals or groups), and its object (respect for task-relevant capabilities or human rights). The greatest convergence was on respect’s object; the majority of studies focused on respect for task-relevant capabilities. The work reviewed offered insights into respect’s potential mechanisms (attention and civility), outcomes (e.g., collaboration, patient outcomes, and provider outcomes such as job satisfaction), and origins (e.g., professional status and competence)—the latter suggesting how respect might be generated, developed, and maintained.

Practice Implications 

Our review highlights a need to appreciate how respect for task-relevant capabilities relates to respect for human rights and what fosters each to avoid rewarding only one while hoping for both, allowing leaders to cultivate more effective nurse–physician collaborations and better patient and provider outcomes.