Collaboration among nurse practitioners and registered nurses in outpatient oncology settings in Canada

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This article is a report on a case study that described and analysed the collaborative process among nurse practitioners and registered nurses in oncology outpatient settings to understand and improve collaborative practice among nurses.


Changes in the health system have created new models of care delivery, such as collaborative nursing teams. This has resulted in the increased opportunity for enhanced collaboration among nurse practitioners and registered nurses. The study was guided by Corser's Model of Collaborative Nurse-Physician Interactions (1998).


Embedded single case design with multiple units of analysis.


Qualitative data were collected in 2010 using direct participant observations and individual and joint (nurse dyads) interviews in four outpatient oncology settings at one hospital in Ontario, Canada.


Thematic analysis revealed four themes: (1) Together Time Fosters Collaboration; (2) Basic Skills: The Brickworks of Collaboration; (3) Road Blocks: Obstacles to Collaboration; and (4) Nurses' Attitudes towards their Collaborative Work.


Collaboration is a complex process that does not occur spontaneously. Collaboration requires nurses to not only work together but also spend time socially interacting away from the clinical setting. While nurses possess the conceptual knowledge of the meaning of collaboration, findings from this study showed that nurses struggle to understand how to collaborate in the practice setting. Strategies for improving nurse–nurse practitioner collaboration should include: the support and promotion of collaborative practice among nurses by hospital leadership and the development of institutional and organizational education programmes that would focus on creating innovative opportunities for nurses to learn about intraprofessional collaboration in the practice setting.

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