Formal organisational structure
Nurses in these studies reported feeling frustrated with the lack of power they had in contrast with the overwhelming power of physicians. This was an issue not only concerning the content of decisions but also the process of making decisions in which nurses felt constrained by established guidelines and the hierarchical nature of the nurse-physician dyad. The following quotations from Manias and Street (2000) illustrate this theme;
“The nursing staffs are pushed to the back of the bed area [by doctors] and away from the patient, which represents hierarchical power to me”
Nurses also felt insecure and undervalued when doctors approach a patient they’ve been looking after. Aishling; who is a nurse describes her experience of this:
“At least 95% of the time, that by the time I get into the room they've [the doctors] already started. So I don't hear what's said before I got in there. You come in and you're not quite sure what they've talked about, or what the resident's said already. You're on the back foot.”
“This is disrespectful for the nurse, and to the nursing