Nurses and Physicians: A Symbiotic Relationship…
One of our top goals (actually our highest priority) is to provide safe patient care. This focus is across the board no matter your education or clinical training. I’d like to believe that we are all striving for positive patient outcomes.
Ongoing and effective communication among everyone on the interdisciplinary team is critical to provide continuity of care to our patients. Let’s also not forget about keeping up the communication with family members. Oh the interesting and helpful nuggets of information a provider can find out just by speaking with our patient’s family.
I actually wanted to share an article on Huffington Post that was written by a resident Physician Brian Secemsky, M.D., Doctors and Nurses: A Relationship in the Works. In the article Brian mentions some very key areas that include both communication and understanding when it comes to the working relationship with physicians and nurses. I would say that most if not all of us are aware of the communication breakdown that occurs, and this ultimately impacts the outcomes of our patients and our professional relationships with each other. A few solutions from Brian:
“Step 1: Involve nurses in bedside rounds if they are available to do so. Period. 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.
Step 2: Always inform nurses as soon as possible if any of these patient objectives are modified or reversed. This includes any new imaging, labwork 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.
Step 3: 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.”
These are very clear and concise solutions wouldn’t you say?
A quote from the “understanding” portion of this article:
“…Basic understanding of what nurses are meant to do on the job can jumpstart an effective relationship with the care team that you work with. For instance, a lot of physicians forget that, like doctors, nurses care for multiple patients at a time. Thus, do not expect specific patient care tasks to get done the minute something is ordered on the computer or paper chart. (Remember, if a plan needs to be carried out “stat,” a simple phone call to the nurse relaying this information can get things moving that much faster.)
I have also found that doctors tend to underestimate the clinical training that many nurses carry via years on the job and/or through advanced education. Engaging them on their thoughts of the patient case as well as getting their angle on how the patient is reacting to your choice of medical interventions will most certainly improve patient care. This undoubtedly rings true for brand new deer-in-the-headlight physicians like myself.
The education and clinical training statement is spot on. I won’t necessarily speak from the physician’s standpoint since I am a nurse, but I can say without a doubt that nurses require a higher level of knowledge and understanding about the patient populations that we work with. Ongoing skills assessments and training are both part of my practice. Physicians and nurses are caring for more patients, and they typically have multiple issues with a higher level of acuity to address. This of course puts a huge strain on our practices, so we obviously need to streamline our processes in how we deliver our care. Making these investments in communication and understanding on the front end will certainly help our delivery of care on the back end.
This was great timing on this particular article seeing as Keith and I are interviewing Dr. Victoria Rich, Chief Nurse Executive and Associate Executive Director at the University of Pennsylvania Medical Center. Just a small piece from her bio:
Dr. Rich is the co-leader and innovator with the Chief Medical Officer, Patrick J. Brennan, MD in the development of the PENN Medicine Blueprint for Quality and Patient Safety. This strategic initiative has created an interdisciplinary model of care in which a physician, nurse manager and quality coordinator provide unit leadership.
You’ll of course have to listen in to hear more, but I certainly hope to discuss these two points from the Huffington Post article and encourage our listeners to either weigh in here by posting comments/questions, or of course listen in live Monday night at 7PM MST and call in to speak with us: (347) 308-8064.
Brian, I did enjoy your article and look forward to hearing more as you take on a higher level of responsibility in your career. I encourage you to listen in tomorrow evening (or archived) as I am sure we’ll be discussing your article. Also, would you be interested or know of another doc who would like to be on our show? You wouldn’t be the first physician that we’ve had on. We like to keep an open dialogue around here.