The Impact of Nurse-Physician Interprofessional Relationship on Nurses' Willingness to Engage in Leadership Roles

Saturday, 23 February 2019: 8:30 AM

Sulaiman Dawood Al Sabei, PhD
Department of Fundamentals and Nursing Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
Amy Miner Ross, PhD
School of Nursing, Oregon Health & Science University, Portland, OR, USA

Nurse leaders play an essential role in shaping health policy and sustaining a high quality of patient care delivery. Hence, several healthcare organizations have called to increase the number of nurse leaders across all levels and in every practice setting. Engaging more nurses in leadership positions is becoming strategically important due to an aging nursing workforce and projected retirements of experienced nurse leaders. Based on the projected shortage of 4,842 registered nurses by 2027 in Oman and the fact that only 8% of the nursing workforce holds formal leadership positions, the profession will have a shortfall of an approximated 1,480 nurse leaders in the next decade (Ministry of Health, 2014). There is a regional (Al-Riyami, Fischer, & Lopez, 2015) and global (Sherman, Saifman, Schwartz, & Schwartz, 2015) concern that as more existing nurse leaders leave their positions, recruiting nurses to hold future leadership positions will be challenging. Several studies reported lack of interest among nurses to assume future leadership roles (Cziraki, Read, Laschinger, & Wong, 2018; Laschinger et al., 2013; Wong, Cummings, & Ducharme, 2013). Identification of factors influencing nurses’ willingness to lead can inform healthcare leaders and policy makers to design potentially illuminating strategies for establishing favorable work environments that motivate nurses to engage in leadership roles. The quality of the nurse-physician relationship is one of the work environment factors that have been repeatedly found to improve patient outcomes and reduce healthcare cost (Matthys, Remmen, & Van Bogaert, 2017). Engaging both professions in collaborative practices can create a culture of respect and subsequently enhance their work attitude. Furthermore, the nurse-physician relationship contributes to nurses’ overall work engagement (Havens, Gittell, & Vasey, 2018), but less is known about its impact on the nurses’ engagement in leadership roles specifically. The aim of this cross-sectional study was to investigate the impact of nurses’ perceived interprofessional relationship with physicians on nurses’ willingness to engage in future leadership roles. The study was conducted at a public hospital in Sultanate of Oman over a four-month period between August and November 2016. A total of 171 registered nurses participated. The interprofessional relationship was measured with the 3-item nurse-physician relations’ subscale of the Practice Environment Scale of the Nursing Work Index- (PES-NWI). Nurses’ willingness to lead was measured by asking the participants to rate their willingness to seek out opportunities to engage in leadership roles. A multilevel modeling was used. Findings revealed that 70% of nurses were likely to seek out opportunities to engage in leadership roles. Nurses reported a moderate level of interprofessional relationship (mean = 2.7, SD± 0.8). The quality of the nurse-physician collegial relationships was a significant predictor of nurses’ willingness to engage in leadership roles (β = 0.29±0.13; p = 0.02). Findings from this study advance nurse leaders’ knowledge in how to motivate and engage nurses in leadership roles. Previous evidence has focused primarily on the nurse demographic characteristics and traits in the selection and recruitment of potential nurse leaders. The findings of the current study indicated that work-related characteristics may have a greater impact on nurses’ willingness to lead than demographic and personal characteristics. Establishing a work environment culture having positive nurse-physician relationships is critical to enhance nurses’ work attitude and engage them in leadership roles. One example of the strategies that can strengthen the nurse-physician relationship is to engage both professions in inter-professional collaborative activities that aim to create a culture of respect.
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