Psychology comes into play more than you think in the corridors of our hospitals and nursing wards
Medical error, conflicts over patient care and communication breakdowns are all prevalent in the UK’s health system, but why do they happen?
According to new research from LSE, it could partly be due to basic psychological differences between doctors and nurses.
Dr Ben Voyer, a Visiting Fellow in LSE’s Department of Social Psychology, has just completed a research study with colleague Dr Tom Reader which suggests that different views about collaboration and team work could result in errors concerning patient care.
In a study of 102 doctors and nurses in three nursing homes in Belgium, clear patterns emerged between the two groups in the way they perceived themselves in a work context which, the researchers argue, affects their roles and responsibilities where patients are concerned.
Doctors place far greater emphasis on making independent decisions whereas nurses prioritise team work. Because the latter have substantially more face-to-face contact with patients – particularly older people – they have more empathy with the patient and their families.
“Doctors and nurses differ in their beliefs about the importance of multidisciplinary collaboration,” Drs Voyer and Reader claim.
“In domains such as surgery, doctors – both male and female - have a strong desire to maintain steep hierarchies when it comes to making decisions about the patients, probably because the ultimate responsibility rests with them.
“Even trainee doctors are less likely than experienced nurses to believe that team work is productive, necessary and of benefit to patients,” they say.
Previous studies have found that nurses are dissatisfied with the amount of patient information shared by doctors and believe their input is not always valued.
Dr Voyer says the differences are often explained by professional cultures.
“In their training, doctors are more exposed to situations where they have to take risks so they need to adopt an independent approach in this regard. Judging clinical risk is a more salient part of their work, whereas nurses tend to analyse situations from the perspective of patients and care givers.”
Even the way doctors and nurses communicate is quite different. The former tend to be more direct and explicit, whereas nurses are usually more diplomatic but this approach can be less effective in quickly identifying medical errors.
What conclusions can we draw from this?
The researchers say compromise on both sides is necessary because health care – by its very nature – is multidisciplinary and requires collaboration.
“Previous research has identified errors in patient care where health professionals do not work cohesively as part of a team. If we take into account how doctors and nurses perceive their roles and relate to others, it is a good starting point to make changes,” Drs Voyer and Reader say.
Posted August 2013
“The self-construal of nurses and doctors: beliefs on interdependence and independence in the care of older people “ by Dr Benjamin Voyer and Dr Tom Reader from the Department of Social Psychology at LSE was first published online in the Journal of Advanced Nursing in May 2013.
Dr Ben Voyer is a chartered psychologist and chartered scientist, and a researcher in applied psychology. He is a Marketing and Psychology researcher working at ESCP Europe Business School, London and the Institute of Social Psychology at the London School of Economics and Political Science.
Dr Tom Reader is a lecturer in Organisational and Social Psychology, and a Chartered Applied Psychologist at the London School of Economics and Political Science. His research, teaching, and consultancy applies organisational and social psychology theory to explain why catastrophic safety failures occur in high-risk organisational settings (e.g. aviation, healthcare, oil and gas), and to identify ways of preventing future mishaps.
The Department of Social Psychology is a leading international centre dedicated to consolidating and expanding the contribution of social psychology to the understanding and knowledge of key social, economic, political and cultural issues.