DOCTOR-NURSE GAME: INFERRED ROLE REVERSAL NORMS.
Contributors: University of California, Santa Barbara.
Published: 1987
Number of pages: 273
Subjects: Health Sciences, Nursing.
Description: The purpose of this exploratory study was to gain insight into the norms and practices that have been developed which allow for a reversal of the usual personal and professional roles in the interaction process that occurs between physicians and nurses. The research intended to gain insight into the context in which this interaction occurs and the factors that impinge on the nurse's success in influencing the outcome of the interaction.

Field research methodology was utilized to interview a convenience sample of nurses to obtain this information. A total of ninety-two patient situations were analyzed through a series of qualitative descriptions. This analysis provided a detailed and comprehensive account of how the nurse participates in the physician-nurse interaction to influence patient care outcomes and what factors impinge on her success in this interaction.

The findings demonstrate that there is a complex two level informal normative system which can be inferred and that is operative in the interaction sets described. The first level norms fit the formal organization. This normative system is one in which the usual initiator (the physician) becomes the respondent in the interaction and an acceptable temporary role reversal takes place. When the nurse in this role reversal is perceived as competent, then she is successful in influencing patient care outcomes most of the time.

The second normative level becomes operational when the first one fails and the nurse is unsuccessful in her attempt to influence patient care outcomes. The role reversal pattern is then modified in this instance and noncompliance or choosing not to act is adopted by the nurse.

In addition, this research demonstrated that nurses, particularly specialty nurses, were able to successfully influence patient care outcomes the majority of the time. However, contrary to the popular perceptions of the nurses, the interaction pattern utilized was not collegial. The frequency with which nurses describe their use of the doctor-nurse game suggests that the physician dominance and nurse deference pattern still predominates in the acute care setting.

Specific issues such as how experience, gender, specialty, practice settings and other variables affect physician-nurse relations are also explored.
Notes: Source: Dissertation Abstracts International, Volume: 48-11, Section: B, page: 3252.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SANTA BARBARA, 1987.

School code: 0035.