MSc (Nursing), Faculty of Health Sciences, University of the Witwatersrand / Nurses working with critically ill patients in intensive care units (ICUs) have a unique role to play in health care. They spend 24 hours with patients and come into contact with all the disciplines which come to review these patients. Nurses therefore need to effectively collaborate with the multidisciplinary teams, especially physicians, in order to meet patients’ needs and maximise patient care outcomes. The purpose of this study was to identify and describe nurses’ perceptions towards nurse-physician collaboration in the intensive care units. A non experimental descriptive study design was utilised in this study. Data were collected using a questionnaire developed from the Jefferson Scale of Attitude toward Physician-Nurse Collaboration with additional two open-ended questions to cover the rest of the study objectives. Data were analysed using descriptive and inferential statistics as well as content analysis. Results showed that nurses working in Intensive Care units (ICUs) had positive attitude towards nurse-physician collaboration regardless of gender, years of working in the ICUs and whether registered intensive critical care nurse or not. The findings also showed that nurses perceive that the process of nurse-physician collaboration in Intensive Care Units provokes a number of challenges, such as superior-subordinate relationships which exist between nurses and physicians, workload and overlapping responsibilities hence, nurses feel inferior, undermined, mostly overwork and become frustrated. However, nurses suggested that promoting team-work; a focus on patient-centered care and staff motivation would assist in creating effective collaborative environment. collaborative environment

Creating a safety culture is the focus in the current healthcare environment. An inhouse, around-the-clock laborist service delivery model has been associated with positive outcomes, but little is known about the laborist structure’s contribution to the labor-anddelivery working environment. The purpose of this descriptive correlational study was to explore the effects of physician service delivery model on safety culture, nurse-physician collaboration, and nurses’ job satisfaction. An additional purpose was to examine associations between nurses’ perceptions of safety culture, nurse-physician collaboration, and job satisfaction. Ray’s (1981, 1989) Theory of Bureaucratic Caring and Homan’s (1974) Social Exchange Theory guided this study. A survey consisting of demographic questions, the Collaborative Practice Scale (Weiss & Davis, 1985), the Hospital Survey on Patient Safety Culture (Agency for Healthcare Research and Quality, 2015; HSOPSC), and the McCloskey and Mueller Satisfaction Scale (McCloskey & Mueller, 1990) was distributed to registered nurses (RNs) nationwide. The results indicated that nurses in facilities using the around-the-clock model had higher perceptions of nursephysician collaboration, but not of safety culture or job satisfaction in relation to the physician service-delivery model. Significant moderate-to-strong correlations between nurses’ perceptions of patient safety and job satisfaction, and a weak correlation between bedside nurses’ perceptions of nurse-physician collaboration and job satisfaction were demonstrated. Additional significant correlations were found between the instrument subscales. Control/responsibility in the MMSS scale was positively associated with both management support for patient safety, supervisors’ and managers’ expectations and actions promoting patient safety, and overall perceptions of safety in the HSOPSC scale. Praise and recognition in the MMSS scale were positively associated with supervisor/manager expectations and actions promoting patient safety in the HSOPSC scale. Further appraisal is needed to understand the mechanism by which the laborist model affects patient care and work environment. Recommendations for future research include replicating the study with a larger sample sizes in specific groups based on the role and scheduled shift, conducting the study in a single system or location to mitigate the effects of other variables; and exploring physicians’ perspectives on the variables being studied. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection