Hospitals need to promote occupational and patient safety, but doing so involves the cooperation of all the healthcare professionals on staff, particularly physicians and nurses. But a new study suggests they don’t always see eye-to-eye on the actual state of multiple factors that play a role in workplace safety.

In a new study in the BMC Health Services Research, Anke Wagner and colleagues looked at how nurses and physicians in two different German university hospitals felt about workplace factors that affect occupational and patient safety. They surveyed 2,512 people and received a total of 995 anonymous, completed replies, with a response rate of 39.6%. 

In all, they included data from 381 physicians and 567 nurses who answered questions about the following:

• Psychosocial working conditions. The Copenhagen Psychosocial Questionnaire (COPSOQ) was used to assess job satisfaction and burnout, including “Influence at work” and “degree of freedom” at work.

• Patient safety. The Hospital Survey on Patient Safety Culture (HSPSC-D) was used to measure management’s and supervisors’ support of patient safety measures.

• Hospital leadership. The leadership quality scale from the COPSOQ questionnaire and the short scale on Transformational Leadership (TLI-short) were used to assess the quality of leadership, particularly transformational leadership.

• Occupational safety. Questions were used to assess management’s support of occupational safety and included questions like the personal perception of the risk of infection. 

Nurses generally rated patient safety and psychosocial working conditions more negatively than physicians. Similarly, nurses said there were more occupational risks in their workplace than physicians. On the other hand, physicians reported higher levels of job satisfaction and lower levels of burnout than nurses. Overall, there were significant differences between physicians and nurses in 12 out of the 17 scales.

While nurses rated leadership quality higher than physicians, the difference was small, and there were no significant differences in their ratings of transformational leadership.

Regarding patient safety, nurses were significantly more likely to rate it as less safe than physicians. For example, nurses rated the safety grade in the medication processes as less safe than physicians. 

Germany is one country where the working conditions of nurses have been criticized, partly due to a shortage of nurses and an increase in patients with multiple chronic diseases and co-morbidities.

“Looking at the four topics provides an overview of where hospital improvements may be needed for nurses and physicians,” the authors conclude. 

When it comes to developing a workplace safety culture, hospitals should focus on improving working conditions in general, including patient and occupational safety, but with a special emphasis on the needs of nurses. In particular, for nurses, it’s essential to reduce role conflicts and high quantitative demands and improve work-privacy conflicts. 

“Also, existing resources, such as social support, possibilities for development, meaning of work, sense of community should be further supported.,” they write. “Especially for nurses, workplace commitment and the degree of freedom at work should be improved.”