Intraprofessional collaboration in acute care: Generating evidence to inform nursing workforce retention strategies

Globally, strategies to address nursing workforce shortages include strategic changes to support all nurses to maximize their scopes of practice. In Canada, the increased utilization of Registered/Licensed Practical Nurses (RPNs/LPNs) in acute care settings has amplified challenges related to role clarity, particularly in complex clinical situations.

This study explored: (a) the collaborative strategies used by Registered Nurse (RNs) and RPNs in complex clinical situations, (b) the unique role of RPNs in acute care settings, and (c) strategies to support RPNs to flourish in increasingly complex practice environments.

We used an interpretive description approach (Thorne, 2016). Twenty-four participants were interviewed, representing perspectives from RNs, RPNs, Personal Support Workers and nurse leaders: at a large academic hospital network in Ontario, Canada. Interviews were conducted virtually. Interview transcripts were analyzed inductively using interpretive analysis (Thorne, 2016).

Participants represented a wide range of years of experience in nursing (i.e., 1-35 years) and represented settings such as the emergency department, inpatient surgery, and critical care. We describe: (a) how RN-RPN collaboration is challenged at care decision points, (b) the need for improved role clarity, (c) the unique value of RPNs, and (d) recommendations for retention.

The findings can inform macro- and meso-level strategies to improve nurse retention, by supporting collaborative nursing work environments.