Informal Interactions, Gender, and Hierarchy: Barriers to Nurse-Physician Collaboration in a West Coast Hospital

The American healthcare system is in a moment of tremendous change. Spurred on by inflating costs, changing patient needs and the Affordable Care Act (ACA), health care providers are scrambling to meet new demands and challenges. Nurses are at the center of these changes. In addition to the increasingly prominent role of Advanced Practice Nurses (APNs) and Doctors of Nursing Practice (DNPs) as primary care providers, the ACA’s emphasis on prevention, wellness, and coordination of care requires registered nurses to play a more pivotal role in healthcare. While these changes have enormous potential to improve patient care, their success in many ways depends on building collaborative relationships and good communication between nurses and physicians.