A qualitative investigation to identify factors influencing relationship formation between pediatric nurses and pediatric interns

Abstract Background Collaborative relationships between nurses and physicians are fundamental to providing optimal patient care. However, effective communication, building trust and respect, and understanding each other can all be challenges in developing these relationships. Purpose We explore nurse and intern (first year resident) experiences of working together on two general care pediatric floors to more fully understand perceptions of their relationship and identify factors that influence or impede collaborative relationships. Methods Using a semi-structured interview guide, we conducted 3 focus groups; one of nurses (n = 5) and two of second year residents (total n = 6) on two general care pediatric teaching floors at a large academic medical center. Thematic data analysis following the “five stages to qualitative research framework” with three independent coders resulted in six themes. Results Six themes emerged as key factors in the formation of positive relationships between nurses and interns. They included “Roles,” “Trust,” “Communication,” “Respect,” “Relationships,” and “Time.” Both nurses and second year residents reflecting on the intern year identified factors integral to their relationship development. Nurses desire to be valued members of the healthcare team and interns desire to be respected as physicians in training. Both value the importance of effective, in-person communication, desire to be viewed as capable in their roles, appreciate that trust and respect are essential for optimal patient care, and understand that time is needed for these to occur. Conclusions Four shared key factors that lead to positive relationships between nurses and interns must be met for effective collaboration to occur. These include good communication, mutual respect, building trust, and role formation. The establishment of shared factors takes time and may have to be built and rebuilt when they are breeched; determining how to decrease the time for them to be established may enable relationship formation to occur earlier in the intern year.