Is Teamwork and Professional Autonomy Compatible and Result in Improved Hospital Care?

Abstract

To investigate the relationship between patient and nurse interdisciplinary teamwork with autonomy, an online survey in which 10,022 nurses in 32 hospitals participating in Turkey are made and evaluated the quality of nursing care. It was found that the basic variables of nursing autonomy, control over resources, relationship with doctors, emotional exhaustion and decision-making were correlated with each other, as well as the quality of care assessed with nurses and nurse satisfaction. Nursing autonomy has been positively associated with better perception of the quality of service provided and higher levels of job satisfaction. Analysis of teamwork by job characteristics showed that there is a small but significant difference in teamwork level between full-time and part-time nurses. There were no significant differences in terms of contract type (permanent and short term), service / unit's expertise, shift length or job title. Nurses with higher teamwork scores are significantly more likely to be satisfied with their jobs, planning to stay in their jobs, and burnout scores. Higher teamwork scores were associated with higher nurse-assessed quality of care, perceived quality improvement over the past year, and patients' confidence that they could manage their care upon discharge. Nurses with higher teamwork scores also resulted in higher levels of autonomy and were more involved in the decision-making process. There is a strong relationship between teamwork and autonomy; this interaction suggested synergy rather than conflict. Therefore, organizations encourage nurse autonomy without fear, as it can undermine teamwork.