Emergency nurses’ perspectives of inter-professional collaboration between doctors and nurses in managing patient deterioration: A qualitative study

Introduction: Emergency doctors and nurses do not always work collaboratively, which may lead to delays in the identification and escalation of clinical deterioration.

Aim: This study aimed to explore the collaboration experiences between doctors and nurses in the recognition and management of patient deterioration from the emergency nurses’ perspectives.

Method: A qualitative descriptive design using a semi-structured schedule was applied in an emergency department of the 3000-bed tertiary general hospital. A total of 18 registered nurses were recruited. The rapid response team and medical emergency team do not be established in this hospital, registered nurses report and collaborate with doctors to deliver appropriate interventions for patients. The data collection and content analysis were conducted simultaneously to determine the thematic saturation.

Results: Three salient themes emerged from the data analysis. The first, “Tacit understanding”, describes the tacit cooperation and the support culture between doctors and nurses in escalations of patient care for clinical deterioration. The second, “Senior nurses’ dominance”, reveals the leading role of senior nurses in the escalation of patient care sometimes, and the unilateral communication. The third, “Doctors’ stereotype”, depicts the doctors’ stereotype from nurses’ perspectives.

Conclusions: The inter-professional collaboration and communication in managing clinical deterioration between doctors and nurses may be improved by integrated training and organisational culture changes.