Social System

The social factors that were mentioned during the interviews were power differences (hierarchy) between different professionals and the social status that makes up the clientele in some health centres.

One of the focus groups was theorizing on their observation that they were seeing greater buy-in to IPE and IPC amongst physicians than nurses. Their theory had social system underpinnings:

The other way that hierarchy plays into IPC is that it is reflected in the core ingredient of mutual respect. Specific examples were previously noted in that section.

The other social factor was brought to light during discussion with the NorWest Community Health Centre. Understanding the problems of marginalized people is obviously integral to patient centred care, and the NorWest Community Health Centre understands that well. Unfortunately society in general may not share this understanding (perhaps because marginalized people don’t have as much of a voice) and this likely impacts on the funding for the significant health concerns of this segment of the population.

Return to the IPC Model

…physicians are at the top of the totem pole. They don’t have to prove anything to anybody. They know who they are and everyone knows who they are. Nurses have that hierarchy where they always were reporting to the physicians, and now with this new model they are almost fighting to find their role, what they are supposed to do. I find in our project we find the most resistance from NP and/or nurses. And I think there has almost been this…they are trying to find their role now and the role is so less defined that we are starting to see a resistance from them for this IP. You are not seeing this with the physicians where you would expect to see it from, and you are not seeing it from the other allied health professionals, you are actually seeing it from the nursing.

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I wish that society would understand the problems that marginalized people have, the suffering that they have and that one human is equal to one human and they are human beings that require caring and services. Wish everyone could understand what our staff understands, so then we wouldn’t have to justify our existence…then our people would be OK because we would get more services and all that other stuff would happen.

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