Non collaborative relationships and negative interactions between physicians and nurses can adversely

affect patient care. The importance of collaboration in the perioperative arena was shown in a study by
Espin and Lingard, who found through observations of errors during surgical procedures that multiple
errors were related to poor-quality interpersonal relationships in the perioperative setting. Results from
a 2003 survey conducted by the Institute for Safe Medication Practices showed that patient safety is at
risk as a result of antagonistic work environments in which nurses or pharmacists who question
medication orders are the recipients of intimidating behaviors from physicians or prescribers. In a 2003
AORN Workplace Safety Task Force survey, verbal and physical abuse by physicians, lack of respect,
and the absence of a code of conduct were reported as factors of concern by perioperative nurses.
Efforts to improve the safety and quality of surgical patient care are dependent on teamwork and are
jeopardized by barriers in communication and collaboration between physicians and nurses.

NURSE AS a RESEARCHER
Nurse researchers are scientists who study various aspects of health, illness, and health care. By
designing and implementing scientific studies, they look for ways to improve health, healthcare
services, and healthcare outcomes.
Nurse researchers identify research questions, design and conduct scientific studies, collect and analyze
data, and report their findings. They often rely on grants to fund their work, which requires writing
grant proposals and meeting certain reporting requirements. Many teach in academic or clinical
settings, and often write articles and research reports for nursing, medical, and other professional
journals and publications.
Nurse researchers may begin their research careers in positions such as research assistant, clinical data
coordinator, and clinical research monitor. The title of principle investigator reflects the most senior
research role and greatest responsibility and accountability associated with a research study. Studies
conducted by these dedicated researchers are uncovering such things as new and better ways to:
 Deliver healthcare services more effectively and efficiently
 Improve quality of life for patients suffering from chronic illnesses
 Encourage patients to make healthy choices about nutrition, fitness, and lifestyle
 Assure patient safety and prevent injury and illness
 Provide care and comfort to patients at the end of life
Nurse researchers often partner with scientists in other fields, such as pharmacy, nutrition, medicine,
and engineering, to better address complex questions and problems.
The results of nursing research help build the knowledge base and provide the evidence to guide
interventions by nurses and other health care workers. For example, nursing research is improving
prenatal care, patient recovery after heart transplant, and pain management for cancer and other
patients.

NURSE AS a MANAGER
The role of nurse manager of an acute or critical care unit is one of the most difficult roles in
healthcare today. This individual must juggle patient care issues, staff concerns, medical staff

EXTENDED AND EXPANDED ROLES IN ICU AND EMERGENCY