Interprofessional collaboration between nurses and physicians in intensive care and nurse's role in task allocation: A scoping review.
TL;DR
International research on interprofessional collaboration between physicians and nursing professionals in ICUs is mapped with a focus on task and responsibility sharing and the description of nursing roles within collaborative practice, highlighting that cultural and structural components are inseparable from agency.
Abstract
Objectives
Interprofessional collaboration is essential in intensive care units, where care is complex and highly demanding. However, overlapping tasks and responsibilities may create unclear professional boundaries between nurses and physicians and nursing roles. This review aimed to map international research on interprofessional collaboration between physicians and nursing professionals in ICUs, with a focus on task and responsibility sharing and the description of nursing roles within collaborative practice.
Methods
This scoping review followed PRISMA-ScR guidelines. A comprehensive search was conducted in PubMed, CINAHL, and the Cochrane Library in February 2026. Additionally, reference lists of included studies were screened. Publications addressing interprofessional collaboration between nurses and physicians in intensive care settings were eligible for inclusion.
Results
34 publications were included, most of which used qualitative study designs. Interprofessional collaboration was shaped by cultural, structural and action-related factors, as well as nursing roles. Key cultural influences included trust, respect, familiarity, and hierarchy. Structural factors comprised rounds, formal interprofessional discussions, and protocols. Action-related factors included communication and decision-making. Nursing roles were context-dependent and often described as constrained within interprofessional exchange, despite nurses' valuable contributions and their reported desire for more active roles. Evidence of concrete task allocation was limited, although protocol-supported nursing autonomy was reported.
Conclusions
The results highlight that cultural and structural components are inseparable from agency: structures shape action, while agency continuously transforms those structures. This interplay is embodied when structured collaborative formats and shared mental models enable nurses to actively clarify roles and strengthen participation, thereby transforming interprofessional collaboration from within. IMPLICATIONS FOR CLINICAL PRACTICE Intensive care practice may benefit from implementing shared mental models and structured collaborative formats, such as formal interprofessional discussions, rounding checklists, and protocols that support greater autonomy for nurses.