Comparison of physician's and nurses's opinions of autonomous nursing functions

The purpose of this study was to identify the extent of agreement and disagreement between physicians and nurses as to the independent and dependent nature of specific nursing activities. An opinionnaire was developed from nursing activities identified by faculty members of two colleges of nursing which they believed should be independent nursing functions of the nurse. A pilot study which consisted of 20 physicians and 20 nurses was made to test the clarity of the directions and the items, and to determine the time required to complete the opinionnaire. It was then given to 235 nurses on the staff of 5 hospitals and 116 physicians who practice at these hospitals. It was expected that the nurse would select significantly more nursing activities as independent functions than the physicians. The difference was not found to be statistically significant. No correlation was found between the number of activities identified as independent functions and the years of experience of the physicians and the nurses. A significant difference was found between the mean scores of the independent responses of the diploma and the baccalaureate graduate. The major concensus as to the independent nature of nursing activities was for items representing the areas of patient teaching, emergency measures, providing for emotional needs of the patient, and observation and recording. These activities also received the largest number of independent responses. The major concensus as to the dependent nature of nursing activities was for items representing nursing activities which would require judgments about the treatment process. These also represented the areas of major disagreement between the physician and the nurse. Items with the greatest disagreement within the physician and nurse samples were found to be varied and not representative of any one area of nursing activities. It was found that 85% of the respondents did not consider the educational preparation of the nurse in determining whether a nursing activity should be independent or dependent. Physicians reported that the main way they learn what activities nurses perform is from observation and experience working with them in the hospital. Sixty per cent of the nurses reported that the main way they learn what activities the physician performs is from instruction during their educational preparation, with this information augmented by observation and experience working with physicians in the hospital. Suggestions for nursing and medicine based on the findings of the study were made, and areas for further research studies identified.