Building Collegial Nurse-Physician Relationships - OR Today
Collaborative nurse–physician relationships lead to better patient and organizational outcomes such as decreased length of stay and net reduction in treatment. Opportunities for improving communication between physicians and nurses pop up every day. You find them in the irate doctor who belittles a. The literature indicates that collaboration between nurses and physicians has become more sophisticated as these relationships have become collegial in.
And the patient also benefits because they receive the best care. You find them in the irate doctor who belittles a nurse right in front of her patient, or in the physician who refuses to call nurses by name. It is during these unfortunate events that the nurse can learn to curb this behavior. Addressing the conflict and uniting under a zero-tolerance policy for disruptive behavior and verbal abuse is paramount.
Yet there are many other strategies that a staff nurse can adopt, as well to foster better communication and collaboration between nurses and physicians. Have your nurses begin by utilizing the following tips: Understand that the difference in your roles may cause confusion. Reinforce your role in patient care.
Strategies for collaborative nurse-physician relationships
Use the progress notes to identify concisely the problems you addressed on your shift, the progress made, and the plan of care. Education is key to gaining knowledge and respect. Further your education in any way possible-from pursuing a bachelor's degree to pursuing a master's degree. Take advantage of certification courses in your specialty. Request assertiveness training workshops at your institution. Sponsor a conference by nurses and physicians. Turn physician complaints about nursing knowledge deficits into inservices.
Use the vast knowledge of the experienced professionals around you to raise your level of knowledge. Perform a root-cause analysis whenever there is an unplanned outcome, and include both physicians and nurses on the team Knox and Simpson ; LeTourneau Ask for what you want. If you feel strongly that the physician needs to see a patient, say so.
You don't have to have a diagnosis because you are not the doctor.
Insist physicians call you by name. Be prepared for telephone calls by having the chart, labs, and recent vital signs in your hand if there is a change in patient status.
Round with a physician whenever possible.
Nurse-Physician Relationships in Hospitals: 20 Nurses Tell Their Story
In addition, when physicians, administrators, and representatives from other professional departments were interviewed, they were asked to rate the quality of interdisciplinary interactions on a scale of 1 to 10 with the following benchmarks provided: Ratings ranged from 4 to 10, with a mean of 8.
No significant rating differences were found between physicians mean, 8. In situations in which therapists had a continuous and regular presence eg, on orthopedic, rehabilitation, or critical care unitsinterdisciplinary interactions were reported to be particularly collaborative, almost collegial. When therapists provided care on a large number of units, the ratings of quality of interdisciplinary interactions were lower.
A medical director demonstrates this feature in his orientation session with residents: Nurses are our colleagues. Best-case scenario is that they overlap with you. They not only are an extension of you, they also have unique and skills, knowledge, and talents that the patient needs.
If you work collaboratively with nurses, patient outcomes will be better and you can trust that they will do and see that patients get what they need.
Summary When synthesizing results from several studies over time, the information may become overwhelming, suggesting the need for a summary. In the preceding section on the status of nurse-physician relationships on clinical units in hospitals and comparison of these relationships between magnet and comparison hospitals over time, the following major points are evidenced: Nurses in magnet hospitals consistently report higher quality unit nurse-physician relationships than do nurses in comparison hospitals.
These percentages have remained fairly constant for 4 years.
Comparison hospitals in the sample gained some ground with respect to the quality of nurse-physician relationships reported on their units. Specialized units, particularly critical care units, report better unit nurse-physician relationships than do nonspecialized medical-surgical units. Evidence of improved quality in interdisciplinary interactions and relationships is increasing.
Collegial and collaborative nurse-physician relationships predominate on clinical units in Magnet hospitals. Intensive care units and other specialized units score higher in nurse-physician relationships than do less specialized units. Clinical nurses can improve relationships with physicians and quality of patient care by participating in interdisciplinary collaborative patient rounds, resolving conflict constructively, performing competently, and demonstrating self-confidence.
Patient care is not about what is best for the physician or most convenient for the nurse, or what advances research; it is about what is best for the patient. All aspects of care must be examined from the framework of the patient. Policies related to conflict resolution must be in place so that everyone knows what they are and how to proceed. Many interviewees proclaimed that a policy of no tolerance or abuse of any kind must be in place, even if never or seldom used.
It also reflects the culture of the organization. Definitive steps must be taken to reverse this trend.
The first step in constructive conflict resolution is to get the conflicting parties to talk with one another. As a staff nurse explained, If there is a problem with the physician, then you go directly to the physician first.
The best place to resolve conflict is with the person. If a physician has a problem with a nurse, the same expectation holds. In either case, the situation is pursued in accordance with the defined process until a satisfactory conclusion is reached. Effective and constructive conflict resolution can also be done on a unit basis.
In a unit operations or other interdisciplinary meeting, staff nurses and others can initiate a general discussion on approaches and best practices to use in handling disagreements, conflicts, and differences of opinion.NURSES versus PHYSICIANS calling in sick
Seek guidance from peers on how they approach situations that involve difficult interactions. Planned deliberative action is often successful in altering relationships. Many ICUs, particularly medical ICUs and other specialized units such as oncology, rehabilitation, trauma, and stroke units, have such rounds well established.
Nurses, managers and physicians report that such rounds may be difficult for many reasons: The best practice of regular, interactive interdisciplinary patient rounds is facilitated when a medical director or physician such as a hospitalist or an intensivist is designated as responsible for the medical practice of the unit.
One community hospital that participated in the nurse-physician structure-identification study 10 devised a plan to make interdisciplinary patient rounds truly effective and beneficial. Every 2 or 3 months, the practice designated 1 member of their group to be the medical director for the unit, responsible for conducting interdisciplinary collaborative patient rounds and communicating results and information to the appropriate practice physician.
Nurses reported that this method worked quite well. It is the responsibility of all professionals to attend and participate in such rounds. By making evidence-based, thoughtful recommendations, nurses are not only helping the patient but building the cornerstones of future collegial, collaborative practice.
Competent performance and self-confidence are the keys to both collaborative nurse-physician relationships and to clinical autonomy.
All nurses have the responsibility for developing, maintaining, and increasing their level of competent performance, not only in technical skills but also in the other competency domains.
In the preceding article in this series, 37 the structures and best practices related to autonomous practice were described. Many of these overlap. The structures and practices with particular relevance for clinical nurses were presented in this and in the preceding article.
Nurse-physician relationships of any kind are forged by the day-to-day interactions on the clinical unit and can be shaped by staff nurses.