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Background: This study explored collaborative practice between Registered Nurses (RNs) and Registered Practical Nurses
(RPNs) in Specialized Acute Care (SAC) units like Nephrology, Transplant, and Emergency Rooms, using Action Research. With
ongoing nursing shortages, a skilled-mix model was introduced to SAC units, integrating RNs and RPNs in roles traditionally
filled by RNs alone. This shift led to challenges affecting patient outcomes and job satisfaction.
Purpose: To identify barriers to collaboration and develop strategies to strengthen teamwork between RNs and RPNs on SAC
units.
Method: Using Action Research and frameworks like Convergent Care and Systems Theory, the study involved semi-structured
interviews and focus group discussions.
Results: The interview results revealed that 94% of nurses lacked an understanding of each other鈥檚 scope of practice, while
80% of RPNs felt they were working outside their scope. Additionally, 87.5% of RPNs reported experiencing verbal hostility,
and 75% felt unwelcome on SAC units. Focus group discussions emphasized the need for clear Scope of Practice definitions,
stronger enforcement of collaborative practices by organizational leadership, and the importance of team building and
education on respect to foster positive collaboration between RNs and RPNs.
Implications for Nephrology Care: Enhanced collaboration between RNs and RPNs in nephrology improves patient outcomes,
optimizes workflow, and supports a positive work environment.
Conclusion: Improving collaboration requires a comprehensive strategy involving leadership, education, and the integration
of collaborative principles into daily routines. This fosters an environment of teamwork and mutual respect.
Biography
Prof. Alicia E Jones is an experienced patient care coordinator with a demonstrated history of working in the hospital & health care industry. She is skilled in the Research, Management, Clinical Research, and an Educator. She has a Strong skills in the healthcare services with a professioal studies at University of Toronto and York University, Canada.
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