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Improving Doctor Nurse Partnership

In order to provide the best possible patient care, all members of the healthcare team must work in a collaborative manner. Physicians and Nurses are at the forefront of providing care, so their partnership is imperative.

Nurses and Physicians can both improve their partnership by trying a few of these tips provided by fellow Nurses and Doctors.

Brian Secemsky, M.D. lists a few things Physicians can do to advance communication between them and Nurses.

  • Know the name of Nurse you are working with, take time to meet him or her face to face.
  • Involve nurses in bedside rounds if they are available to do so. If the nurses are busy at this time, a two-minute phone call to the nurse after seeing the patient will make the patient’s plan for the day run that much smoother.
  • Always inform Nurses as soon as possible if any of these patient objectives are modified or reversed. This includes any new imaging, lab work and any other new insights to the patient’s goals of care. FYI: Signing an order is not sufficient communication. Call the nurse or swing by the nurse’s station on your way to the patient bedside to relay this information.
  • The greatest challenge and the ultimate goal is to create a friendly and personal environment where nurses and doctors are able to question each other’s decision-making without fearing an angry or defensive response. Even the greatest nurses and best-trained physicians make mistakes. In order to mitigate these potential medical errors, nurses and doctors must obtain a level of communication where it is okay to question a medical decision or provide productive feedback on any aspect of patient care.

An article from Jacksonville University provides tips for Nurses.

  • Respect the doctor’s time. Physicians bounce from one patient to the next and time is a precious commodity. It’s important that nurses help them maintain a certain level of efficiency. For example, do not start conversations with “I’m sorry to bother you.” Be prepared for rounds, anticipate problems ahead of time and always have a chart in hand when calling a physician.
  • Communicate directly concerning behaviors that have a negative effect. Refrain from complaining about physicians to other staff members and instead confront them directly by speaking in private. If needed, get a manager for additional support.
  • Be conscious of behaviors that affect the relationship. Nurses can have a big effect on the situation with their behavior while also noting the doctor’s. Thanking and acknowledging physicians with whom a good working relationship is present can go a long way, while identifying negative behaviors from doctors where a positive relationship is lacking can be an important step in making things better.

An ANA article shares successful examples of Nurse/Physician collaboration.

  • Every year the Intensive Care Unit of a large metropolitan hospital hosts a conference in which topics are selected by a physician and nurse who pair off to research best practice. Each team then speaks for 20 minutes, with the physician talking about his or her role in managing the disease, and then the nurse speaking specifically to nursing interventions. The conference is a sell-out every year.
  • Another hospital hosts an annual Nurse-Physician Summit in each department. Prior to the summit, physicians get together and discuss the top five things they would like nurses to change in order to deliver the most optimal quality care. At the same time, nurses meet and list their top five issues involving physicians. At a luncheon attended by both groups, a facilitator reveals the results of these surveys. The survey results are always a surprise and bridge a critical communication gap in understanding each other’s roles.
  • After returning from the annual Nurse-Physician Summit, four orthopedic physicians avidly discussed their newly perceived role in creating a supportive climate. They composed a survey they asked every nurse to fill out regarding each surgeon, with ratings on a 1-to-5 Likert scale on approachability, patient complaints, and professionalism. The results were eye-opening for both groups. Neither realized how subliminal attitudes and beliefs were affecting their everyday behaviors.
  • Both physicians and nurses in a department survey each other annually by asking the person they work with the most frequently for specific feedback: “What do you like that I do well?” and “What would you like to see more of?”

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