Impact of Antecedent and Organizational Differences on Nurse-Social Worker Collaboration in a Retirement and Assisted Living Community with Skilled Nursing Care.

Abstract

Nurse-social worker collaborative interactions in long-term care settings have received limited attention. This qualitative thematic study of 23 participants (11 social workers and 12 nurses) at an urban retirement and assisted living community explores experiences of collaborative work. Two themes of contrasts in responding to resident complexity and contrasts in peer-to-peer work highlight four subthemes reflecting: (a) social workers' orientation toward resident self-determination, requisite care, and advocacy; (b) nurses' orientation toward resident safety, tasks, and clinical outcomes; (c) social workers' devalued professional identity; and (d) nurses' attribution of collaborative challenges to individuals. Social workers showed greater openness toward working with nurses and viewed nurses as close partners. Nurses showed greater separation from social workers and non-clinical peers and maintained a greater intraprofessional focus. Whereas challenges may stem from antecedent disciplinary training nurses and social workers receive, organizational triggers related to residents' care and associated decision-making exacerbate them. Interprofessional education may strengthen collaboration.