How are nurses’ individual and their colleagues’ diversity factors associated with their cooperation behaviors in teams? - Results of an online factorial survey

BACKGROUND: Diversity within nursing teams in Germany increases due to staff shortages, nurse migration and the current academization of the profession. Little is known about how nurse’s own diversity factors and those of team members impact nurse’s perception and behavior in team situations. This study examines if and how nurses differentiate in the assessment of their colleagues’ nursing abilities in basic care, i.e. patient’s personal hygiene and treatment care, i.e. the set-up of an infusion, as well as their willingness to swap shifts with colleagues. METHODS: A quasi-experimental, cross-sectional study with a factorial online survey with fictional case studies (vignettes) was conducted at two healthcare organizations in 2023 in a major city in Germany. Nurses ( > = 18 years) working in hospitals or nursing homes were eligible to participate. Associations of diversity factors, i.e., gender, age, migration background, and qualification, on the participant and vignette level on perceived competences and willingness to cooperate were analysed via multi-level fixed effects models. RESULTS: N = 684 nurses participated (76% female; mean age: 44.2 years; 88% born in Germany; 75% completed vocational training). Colleagues’ competency in patient’s personal hygiene was rated higher by respondents born in Germany (β = 0.42, p=.002; vs. foreign-born), when fictional colleagues were from Germany (β = 0.26, p<.001) or France (β = 0.09, p=.01; vs. China) and had completed vocational training (β = 0.06, p=.02; vs. a university degree). Competency in inserting infusions was rated higher by respondents born in Germany (β = 0.59, p=.002; vs. foreign-born), when fictional colleagues were from Germany (β = 0.33, p<.001) or France (β = 0.21, p<.001; vs. China) and when one worked together for months (β=-0.44, p<.001; vs. days). Willingness to swap shifts was affected by the length of collaboration (β=-0.09, p<.001) and their fictional colleagues’ age (β=-0.07, p=.02). CONCLUSIONS: How nurses perceive their colleagues’ competences tended to be associated with their own and the other person’s migration background, while willingness to cooperate was affected by length of collaboration and colleagues’ age. However, limited generalizability of the findings applies due to our highly selective sample. Improving the onboarding process of new nurses in teams, and providing the time and space for professional exchange at work might improve mutual trust and teamwork in nursing. CLINICAL TRIAL NUMBER: Not applicable.