Role differentiation between nurse and physician: implications for nursing

The aim of this study was to determine whether a series of systematic dialogue sessions among nurses, consumers, and physicians would result in consensus regarding (a) unique areas of nursing practice as differentiated from medical practice and (b) areas of common practice shared by both professions. A stratified sample of 72 nurses, consumers, and physicians met monthly for 20 months in small multidisciplinary groups to discuss areas of health care such as health promotion and maintenance, communication in health relationships, access to medical records, illness self-care, cost considerations, and ethics. Perceived areas of role differentiation between nurse and physician were identified through analysis of (a) verbatim transcripts of the structured dialogue sessions and (b) a subsequent Likert-type inventory completed by all dialogue participants. While no unique nursing domain emerged from the respondents' data, a substantial percent of responsibilities and behaviors were viewed as overlapping areas of practice for nurses and physicians. The data suggested (a) demonstrated health-care arenas where nursings' role is formally acknowledged, (b) lack of clarity within the nursing profession regarding competencies unique to the discipline of nursing, and (c) a continuing public image of nursing as an extender of functions performed by the physician.