Analysis of Nurses’ Perceptions of Their Role in a Multidisciplinary Team

Analysis of Nurses’ Perceptions of Their Role in a Multidisciplinary Team by Jessica A. Dempsey MSN, University of Phoenix, 2009 BSN, Ramapo College of NJ, 2004 Dissertation Submitted in Partial Fulfillment Of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University November 2019 Abstract A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of practice within a multidisciplinary care team of an acute care medical center and identify a new theory regarding RNs’ perceptions of their role. A grounded theory approach was used to explore and reveal these perceived role identifications through the lens of the accountability theory. The research questions and the guided interview explored RNs’ self-perceived role identifications that have shaped RNs’ expectations of their scope within the multidisciplinary care team model. The results found nurses to be experts of patient care and that the nursing role has a 24/7 responsibility while being the closest, most personal role to the patient, thus, the RN feels accountable for all the needs to the patient, even if the needs or actions are outside of the nursing assigned role or tasks. From these results emerged a new theory, the perpetual accountability theory. Identified recommendations regarding RNs’ roles and their utilization within the multidisciplinary care teams allow a positive social change of greater success at delivering best practices and optimum patient outcomes.A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of practice within a multidisciplinary care team of an acute care medical center and identify a new theory regarding RNs’ perceptions of their role. A grounded theory approach was used to explore and reveal these perceived role identifications through the lens of the accountability theory. The research questions and the guided interview explored RNs’ self-perceived role identifications that have shaped RNs’ expectations of their scope within the multidisciplinary care team model. The results found nurses to be experts of patient care and that the nursing role has a 24/7 responsibility while being the closest, most personal role to the patient, thus, the RN feels accountable for all the needs to the patient, even if the needs or actions are outside of the nursing assigned role or tasks. From these results emerged a new theory, the perpetual accountability theory. Identified recommendations regarding RNs’ roles and their utilization within the multidisciplinary care teams allow a positive social change of greater success at delivering best practices and optimum patient outcomes. Analysis of Nurses’ Perceptions of Their Role in a Multidisciplinary Team by Jessica A. Dempsey MSN, University of Phoenix, 2009 BSN, Ramapo College of NJ, 2004 Dissertation Submitted in Partial Fulfillment Of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University January 2019 Dedication I dedicate this dissertation to all the healthcare colleagues who I have worked among and beside who have shared in the arduous work and passion for improving patients’ and families’ wellness both selflessly and generously. I also would like to dedicate the commitment and dedication necessary to complete this program to my children, who can learn from my mistakes as well as my successes. I want to share with them the goal of leaving the world a better place than we found it. Acknowledgments This dissertation and the desire to improve the inpatient experience is a product of many patient care contacts and comradery within multi-disciplinary care groups. There are too many to thank, each one paved the path of this journey. My employers, both Johns Hopkins Medicine and Maryland Department of Public Safety, have encouraged my growth and development and I am grateful to them. Complementing my career experiences and goals, including the discussions, projects, and guidance received within the coursework at Walden University, specifically the encouragement, support, and knowledge shared by my URR Daniel Okenu, and my Committee Member Dr. Magdeline Aagard and Chair Dr. David Anderson. More than anything and anyone else, my family has supported me and gave me the courage to pursue that which initially seemed to be dauntingly unobtainable. My parents have molded my morals and ethics, birthing my passion for education and drive. My husband, Keith, had a parallel journey, one of support, frustrations, and sacrifice, which I never asked him to make, but one that he was given. Thank you. Table of