Behaving Collaboratively and Getting Along: A Classical Grounded Theory of Certified Nurse Midwives Collaborating With Physicians in U.S. Hospitals



Journal Title

Journal ISSN

Volume Title



This dissertation is a classical grounded theory study that examines how certified nurse midwives perceive their collaborative role as they work with physicians in U.S. hospitals. The most common reason for hospitalization in the U.S. is birth and care of the newborn (Levit, Wier, Stranges, Ryan, & Elixhauser, 2009). Although the majority of women and their newborns are healthy, maternity care costs in the U.S. are staggering (Johantgen, Fountain, Zangaro, Newhouse, Hutt, & White, 2012). Collaboration within maternity healthcare teams may positively impact healthcare economics (Downe, Finlayson, & Fleming, 2010). Classical grounded theory methodology was used in the current study; it is a rigorous method suitable for exploring the processes of human social phenomenon (Glaser & Strauss, 1967). Classical grounded theory methodology is focused on the data which reveals the participants’ main concern. The participants’ main concern is discovered using Glaser’s (1978) constant comparative method. How participants resolve their main concern forms the basis for the basic social process/core category and subcategories. The links between the subcategories form the basis for the generation of substantive grounded theory. The most important finding of the current study is the discovery of the behaving collaboratively basic social process. This basic social process with its subcategories of holding, adjusting, and releasing fits the real life experiences of certified nurse midwives who work with physicians in U.S. hospitals. Certified nurse midwives in the current study perceived behaving collaboratively as a problematic experience and their main concern as getting along with their physician colleagues. The certified nurse midwives were able to resolve the problematic experience of behaving collaboratively through the phases of the subcategories which ultimately resulted in the generation of a substantive theory of getting along. Substantive theories explain the main concern of a specific group, in a specific setting, and predict the consequences of the modifiable conditions. Although the substantive theory of getting along described in this dissertation relates only to the certified nurse midwives who participated in the study, getting along has potential for the generation of formal grounded theory.