Healthcare News and Trends
9 Ways Physicians Can Effectively Collaborate with Nurses
May 07, 2019
By
Debra Wood, contributor
Much
has changed during the last 40 years, including an understanding of the importance
of physicians and nurses working together, using a team-based approach to
improve patient care.
“The
relationship between nurses and physicians is vital to the well-being and
outcomes for patients and their families,” said Linda Cassidy, MSN, EdM, RN,
CCNS, CCRN-K, strategic advocacy manager at the American Association of
Critical-Care Nurses (AACN). “Additionally, there is ample evidence spanning
decades that supports the importance of nurse–physician collaboration and
patient outcomes.”
A study
published in Critical Care Nurse in
2015 found collaborative relationships between physicians and nurses decreased
rates of healthcare-associated infections in critical care, she explained.
Cassidy
noted that team-based care and physician and nurse partnerships are part of a
healthy work environment, which can influence patient outcomes and the quality
of care delivered across the care continuum.
To that
end, here are some tips and reminders for physicians to work effectively with
nurses and build strong patient care teams.
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Nine
Ways Doctors Can Improve Collaboration with Nurses
1. Build trust and partnership
“Building
trust and partnership between clinicians, whether physicians and nurses or
allied health professionals, is really important today,” said Tracy Duberman,
PhD, MPH, FACFE, founder, president and CEO of The Leadership Development Group
in New York.
Duberman
described a “trust cycle.” First, everyone must put the patient in the center
and remember the goal, then work on finding common ground, having
conversations, sharing collective wisdom, and building trust.
“If we
start from understanding each other and what value each of you brings to the
reason we are here, hence the patient in the middle, it can help to have an open
dialogue,” Duberman said.
2. Keep communication open
“Collaboration
requires an equal, nonhierarchical partnership between the nurse and physician
grounded in open communication, trust and mutual respect,” Cassidy said. “Both
nurses’ and physicians’ unique contributions to patient care must be valued and
solicited.”
3. Round together
Rounding
together helps in providing team-based care and patient perceptions of
cooperation. It leads to better handoffs and increased patient satisfaction,
Duberman said. Rounds can be time-intensive, she added. A quick scripted review
about the patient’s status helps make the rounds go more quickly.
Researchers at Penn State
College of Medicine in Hershey, Pennsylvania, studied interprofessional
rounding and found the use of scripts and staff support was associated with
more team-based rounding.
4. Involve mid-level providers
Improving
collaboration among physicians, nurses and other medical providers is “an
excellent opportunity for mid-level providers to get involved in a process, so
that physicians can focus more on clinical decision making and allow some of
the legwork to be done by their mid-level providers,” said Alejandro Badia, MD,
a board-certified hand and upper extremity orthopedic surgeon with Badia Hand
to Shoulder Center in Doral, Florida. “This can be the group that perhaps most
interacts with nurses who are the first line of actual patient care.”
5. Build a collaborative culture
Collaboration
begins at the top of an organization and should be carried through and modeled
by everyone.
“Achieving
effective nurse–physician collaboration requires a focused effort that is
supported throughout the healthcare organization,” Cassidy said. “A culture of
collaboration must be the expectation and role modeled by leaders. All must be held
accountable for assuring that true collaboration is the norm.”
Duberman
described an effective coaching model to help foster physician and nurse
partnerships. It requires active listening, asking questions about the topic,
challenging assumptions and giving feedback. Ask to help you understand,
without being judgmental.
6. Participate in team training
All
members of the health care team training together, perhaps in a simulation lab,
can help ensure better teamwork when a crisis situation develops. A 2011 Mayo
Clinic study found enhanced patient-care decision making and greater physician–nurse
collaboration when the professionals participated in high-fidelity simulation
training.
7. Use mobile communication
Badia noted
that there is “an absolute need to increase the use of mobile communication
between physicians and nurses, which is done in many sectors outside of health
care, but we need to catch up in this area. Physicians are now communicating
through their smart phones to a great extent, but I believe more of this needs
to be done with nursing colleagues.”
8. Contain the urge to yell
Yelling
at a nurse, because the nurse disturbed your dinner or sleep with a report of a
change in a patient’s condition, is a good way to shut down collaboration. The
next time a patient has a change in status, that nurse may hold off calling,
which could harm the patient.
Nurses
should effectively communicate the situation, using standard tools and be
prepared to answer questions by having all of the facts at hand.
Controlling
your speech volume and tone is important in other situations, as well. Both
sides need to learn “to effectively resolve conflicts that naturally occur in
complex environments such as healthcare,” Cassidy advised.
9. Recognize diversity as good
A
difference of opinions is helpful when doctors and nurses work together.
“You
usually come up with better solutions when you ask lots of people for input,”
Duberman said.
“Remember
the mission, vision and values,” Duberman advised. “If you go back to that, it
creates a better environment to work in.”
Related:
5
Things Doctors Can Learn from Nurses
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