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Challenges in the working relationship between professional nurses and clinical associates in selected district hospitals in South Africa

Emmah M. Mokoena
Tinda Rabie
Antoinette du Preez


Background: Clinical associates were introduced in South Africa to address physician
shortages in healthcare. Professional relationships between physicians and professional nurses
(PNs) have been widely researched, but none specifically between the new cadre of clinical
associates and PNs.
Aim: This study aimed to understand the professional working relationship between PNs and
clinical associates.
Setting: Selected district hospitals within Mpumalanga Province, South Africa.
Method: A qualitative descriptive design was used. Professional nurses were purposely
sampled, and an all-inclusive sampling method was used for clinical associates in selected
district hospitals within Mpumalanga Province, South Africa. Twelve (N = 12) semi-structured,
individual interviews (PNs n = 6; clinical associates n = 6) guided by an interview guide were
conducted in English. The interviews were audio recorded and transcribed verbatim by an
independent transcriptionist. Tesch’s eight steps of data analysis were employed to analyse the
data. An independent co-coder assisted with data analysis.
Results: This study yielded four themes: (1) professional relationship defined, (2) professional
relationship characteristics, (3) professional challenges applicable to both PNs and clinical
associates and (4) personal professional challenges applicable to clinical associates only.
Conclusion: This study demonstrated that the professional relationships between PNs and
clinical associates are affected by various challenges, which could be resolved within the
department through in-service training and good communication.
Contribution: This is one of the first studies that highlight the professional relationship
challenges between PNs and clinical associates.

Journal Identifiers

eISSN: 2071-9736
print ISSN: 1025-9848