The nurse manager is vital in creating an environment where nurse-physician collaboration can occur and is the expected norm. It is she, who clarifies the vision of collaboration, sets an example of and practices as a role model for collaboration. The nurse manager also supports and makes necessary changes in the environment to bring together all the elements that are necessary to facilitating effective nurse-physician collaboration. Many authors (Alpert, Goldman, Kilroy, & Pike, 1992; Baggs & Schmitt, 1997; Betts, 1994; Evans, 1994; Evans & Carlson, 1993; Keeman, Cooke, & Hillis, 1998; Jones, 1994) have indicated that nurse-physician collaboration is not widespread and a number of barriers exist. The following will discuss the necessary ingredients for creating a nursing unit that is conducive to nurse-physician collaboration and supported through transformational leadership.

The first important barrier according to (Keenan et al., (1998) is concerned with how nurses and physicians have not been socialized to collaborate with each other and do not believe they are expected to do so. Nurse and physicians have traditionally operated und

Evans, J.A. (1994). The role of the nurse manager in creating an environment for collaborative practice. Holistic Nursing Practice. 8(3), 22-31.

Betts,V.T. (1994). Removing practice barriers. Health Systems Review. 27(3), 18-19.

Expectations for physicians to collaborate and to not handle situations aggressively appeared to be a stronger predictor of nurse-physician collaboration than any expected normative beliefs.

Transformational leadership is a process in which leaders seek to shape and alter the goals of followers. Cassidy & Koroll (1994) describe the process as incorporating the dimensions of leader, follower, and situation. The leader motivates followers by identifying and clarifying motives, values, and goals that contribute to enhancing shared leadership and autonomy. Transformational leaders are usually charismatic so they enhance energy and drive people towards a common vision and shifting the focus of control from leaders to followers. It is the transformational nurse manager that will be able to empower her workers to facilitate nurse-physician collaboration, for the common good of the patient.

inter-professional relationships and recommend appropriate strategies to support and maintain those relationships. The NJPC identifies four other structural elements necessary for a collaborative practice as primary nursing, integrated patient care records, joint patient care reviews, and emphasis on and support of nurse independent clinical decision making. These elements are an important cornerstone for creating a successful collaborative practice unit. In addition, several other factors have been identified by the NJPC as beneficial to maintaining an effective support systems when developing a collaborative practice such as appropriate staffing, committed medical leadership, standardized clinical protocols, and most importantly communication. Although a successful collaborative practice model has is a planned event. According to (Evans, 1994), it is important to realize that a collaborative relationship cannot be legislated, dictated, or mandated by anyone. It must be agreed upon and accepted by individuals who share responsibility for patient care outcomes.

Baggse, J.G. & Schmitt, M.H. (1997). Nurses' and resident physicians perceptions of the process of collaboration in an MICU. Research in Nursing & Health. 20(1), 71-80.

develop employees' awareness of organizational goals, delegate responsibility appropriately, communicate openly and directly with staff, and collaborate with peers. The significance of these behaviors in facilitating empowerment is seen as fundamental to creating collaborative practice environment.

Cassidy, V.R. & Kroll, C.J. (1994). Ethical aspects of transformational leadership. Holistic Nursing Practice. 9(1), 41-47.

Some common words found in the essay are:
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Approximate Word count = 2187
Approximate Pages = 9 (250 words per page double spaced)