Tensions and Opportunities in Nurse, Midwife, and Peer Worker Collaborations in Healthcare Delivery: A Scoping Review and Narrative Synthesis

Abstract

Aim

To explore the published literature on nurse/midwife and peer worker collaborations in healthcare services.

Design

Scoping review and narrative synthesis.

Methods

The framework proposed by Levac et al. was used. PubMed, CINAHL, MEDLINE, Scopus, and Embase databases were systematically searched, and results uploaded to Covidence for screening against inclusion criteria. A critical narrative synthesis of included studies was conducted, guided by Popay et al.

Results

Sixteen studies from five countries met the inclusion criteria. They examined peer worker and nurse/midwife collaboration across diverse settings including cancer, HIV, mental health, and community services. Findings indicated that nurse/midwives and peer workers valued the distinct forms of expertise they contributed, which enhanced care. Tensions in collaboration related to clinical dominance and control in hierarchical structures, challenges navigating scope and role boundaries, and mistaken notions of what constitutes ‘successful’ peer work. Peer workers and nurses/midwives could be ‘close strangers’ with little opportunity to build genuine rapport.

Conclusion

Successful collaboration requires attention to power dynamics within healthcare cultures and opportunities to connect and understand each other's disciplinary expertise. Identifying strategies to optimise partnership and mobilise collective strengths has the potential to further enhance care.

Implications for the Profession/Patient Care

Peer worker or ‘lived experience’ roles within healthcare services have rapidly expanded. Our study highlights the benefits of peer worker and nurse/midwife collaborations and areas that require attention, including recognition of peer worker and nurse/midwife roles and responsibilities in the healthcare setting and effective integration of peer workers into existing healthcare teams. Importantly, strategies should be developed to address disparate power dynamics between nursing/midwifery staff and peer workers as these impact workforce relations and capability. Addressing these key areas will strengthen collaboration between nurses/midwives and peer workers, improve healthcare provision, and ultimately benefit service users.

Impact

This study highlights the tensions arising when nurses/midwives and peer workers carry out duties alongside each other, as well as factors that can promote effective collaboration. Successful collaboration in healthcare necessitates addressing power differentials, fostering mutual understanding, and providing the tools, training, and inclusive environments needed for nurses/midwives and peer workers to work together effectively.

Reporting Method

This scoping review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) extension for scoping reviews.

Patient or Public Contribution

Our authorship team includes experts with experience in peer work and supervision of peer workers, and designing and implementing peer-led interventions within health and community service settings.