Communication is the key to collaborative and efficient workflow in any industry. Collaboration is a critical task in healthcare since a single patient is cared for by multiple people including technicians, nurses, physicians, and doctors. Clear, efficient communication is imperative in healthcare because a single error can lead to serious consequences for the patient.
Nurse and Physician Communication
Communication between a nurse and a physician is an extremely important link in the chain of patient care. However, there are still many challenges in this era of technological advancement. The dilemma is aptly summarized by Cassandra Lee Flicek in MEDSURG Nursing:
“The lack of co-educational experiences involving the two professions possibly leads to a lack of understanding of what each profession contributes to the interdisciplinary team, and complicates communication between nurses and physicians.”
Common Challenges in Nurse-Physician Communication
Several factors affect nurse-physical communication. A study by Dr. Jennifer Tjia et al in the Journal of Patient Safety found that the most common impediments to communication between nurses and physicians are:
- Language barriers
- Nurse preparedness
- Logistical problems
- Frustration with a lack of professional respect
- Lack of collaboration and openness
Language Barriers
Nurses reported difficulty in understanding physicians due to language difficulties or accents. Jargon is also an issue. These problems prevent effective communication.
Nurse Preparedness
Some nurses felt uncomfortable in deciding what to report to the physician and almost 1/3rd of respondents said they were afraid of bothering the physician with their observations. Since nurses spend a lot of time with the patients, their observations are critical to patient care and should be communicated.
Logistical Problems
Finding a quiet place to communicate without distractions has been proven difficult for 1/3rd of the respondents of the study. Nurses also claimed to not having time to communicate. 1/5th of the respondents claimed they were not able to get in touch with the physician when they needed to.
Lack of Professional Respect
In the study, around 17% of nurse respondents and their answers indicated a perceived lack of respect from physicians. 16% also reported being interrupted before they finish imparting information. Both physicians and nurses are important links in patient care and a breakdown of respect between these two can cause a breakdown of trust which adversely affects patient care.
Lack of Collaboration and Openness
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Impact of Nurse-Physician Communication on Patient Outcomes
The impact of poor communication on organizations around the world is well documented. This study found out that poor communication is one of the main reasons why a project fails one-third of the time and has a major negative impact on project success more than 50% of the time. In a business environment this can be devastating for the profits. In a medical environment, it can cost precious lives. According to a study in The Online Journal of Issues in Nursing both safety and quality of care patients receive depend upon the quality of the practice environment where care is provided. The study also found that 55% of nurses surveyed indicated that physician behavior impacted patient care decisions and that less experienced nurses were affected more than the more experienced ones.
If nurse-physician communication is improved, it can have several benefits. Patient satisfaction also improved as patients see medical staff being competent and professional. This impacts the quality of the patient care. Medical team satisfaction also improves leading to job satisfaction which reduces turnover. All of these factors have an impact on patient care.
Strategies to Improve Nurse-Physician Communication
Improving communication between nurses and physicians has lots of obvious benefits but implementing this change is difficult. According to Patient Safety & Quality Healthcare (PSQH) there are three important tools for improving communication. These are:
- Culture Change
- Structured Communication Tools
- Supportive Technology
Culture Change
PSQH calls this factor as the most fundamental intervention for improving nurse-physician communication. Culture change begins from the top: leaders need to create an environment of open communication by displaying approachable behaviors, setting expectations, and investing in support systems in the organizational structure. If patient families and nurses are both included in bedside rounds, it emphasizes that physicians and nurses are a team and fosters an environment of mutual respect that goes a long way to create a culture of open communication.
Structured Communication Tools
Using a structured communication tool like SBAR can remove any doubt of guesswork from nurse-physician communication. SBAR stands for Situation, Background, Assessment, and Recommendation. It gives a framework that facilitates the easy organization and giving of information between nurses and physicians. By following an established procedure that everyone needs to follow and respect, expectations can be set for communication. Nurses can quickly and effectively prepare for an impromptu conversation with physicians and will be able to communicate important information in an organized method. A structured communication tool can also aid in overcoming some language barriers, when it comes to medical jargon.
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Supported Technology
Secure communication technology like electronic health records (EHRs) and telehealth can facilitate efficient, quick, and effective communication. Writing a nurse-physician communication can eliminate accent based and linguistic barriers while also easing time constraints by making communication asynchronous. EHRs are important communication tools as these ensure all parties have updated information about patients. It creates a shared foundation of knowledge for effective communication.
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