Date of Award

May 2014

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Karen Morin

Committee Members

Nancy Burrell, Julie Darmody, Rachel Schiffman, Michelle Simpson


Collegiality, Missed Nursing Care, Nursing Work Environment, Peer Relationships, Practice Environment


The practice environment of nurses has received attention in recent time related to a heightened awareness of the need for improved patient safety and an anticipated return of a nursing shortage. Existing literature has identified the presence and negative outcomes of unhealthy peer relationships among nurses, however; positive peer relationships (collegial) have received little attention in nursing research. This descriptive correlational study used data obtained through online survey methodology to describe the current state of collegiality among staff nurses working in the hospital setting and the relationship collegiality has to the nursing practice environment and missed nursing care.

Collegiality levels were measured using the Survey of Collegial Communication (SCC). The overall mean score on the SCC was 3.2. The SCC is made up of eight components with the following mean scores: Confidence/Trust (3.24), Teamwork (3.49), Open Communication (3.26), Mutual Help (3.49), Mutual Support (3.13), Creativity (2.95), Freedom from Threat (2.79), and Friendliness and Enjoyment (3.34). The total scores on the SCC ranged from 40-196 with a mean of 128. No significant differences among personal and workplace characteristics and levels of collegiality were found. Collegiality among nurses and perceptions of the nursing practice environment were significantly correlated (r = .59, n = 525, p < .01). Additionally, all components of the collegiality and all factors of the nursing practice environment were significantly correlated. Regression analysis was used to determine factors within the nursing work environment that may serve as predictors of missed nursing care. The model that best fit the data included; (1) Nursing Foundations of Quality Care, (2) Staffing and Resource adequacy, (3) Collegiality, (4) Nurse Manager Ability, Leadership and Support (5) Nurse Participation in Hospital Affairs as predictors of missed nursing care. This model explained 35% of the variance in missed nursing care. The path model presented in this study was found to be significant and a good fit for the data. This model presents the nursing practice environment as a predictor of missed nursing care with the collegiality partially mediating that relationship.

This study is the first large study to assess collegiality among bedside staff nurses, thus, these findings serve to establish a baseline for levels of collegiality among nurses. Major findings from this study indicate collegiality influences missed nursing care, as do other factors traditionally defined to make up the nursing practice environment. Thus, including the assessment of collegiality when assessing the nursing practice environment in future research is suggested.

Included in

Nursing Commons