Lyn Gilbert 1, Ian Kerridge 1
1 Centre for Values, Ethics and the Law in Medicine, University Of Sydney, Camperdown, NSW, Australia
It is known that doctors comply poorly with HAIPC compared with nurses. To understand this better, we interviewed senior doctors and nurses, at a Sydney teaching hospital, to gain insight into their perceptions of doctors’ roles and responsibilities in IPC.
Interprofessional differences are recognised, but roles and expectations of doctors and nurses are changing. “Professionalism” is, prima facie, a potential framework for managing interprofessional relationships, for patients’ benefit, but professionalism can be a barrier rather than an incentive for improving doctors’ adherence to IPC.
1. Doctors’ value their professional autonomy and their right to disregard “rules”, based on clinical judgment; nurses are, culturally, more willing to conform with protocols.
2. Senior consultants, traditionally, are role models and teachers of junior doctors, but competing commitments often leave little time for this, compared with time spent on in-service training of nurses, especially in preventative aspects of clinical care.
3. Doctors become aware of HAIs when they cause significant morbidity or mortality; they regard IPC as of limited interest or relevance and primarily as “nurses business”.
4. Many doctors have little cultural commitment to the (public) hospitals where they work, believing their traditional power has been ceded to administrators and senior nurses, who control budgets and many aspects of clinical care. As one participant put it: “they have no ‘skin in the game’”.
Conclusion: “Professionalism” can militate against collaborative interprofessional approaches to IPC adherence, because of differences in how doctors and nurses envision their roles and responsibilities for patient care and organizational administration.