Communication is the foundation of excellent patient care. Whether it is nurse-to-nurse, nurse-to-manager, nurse-to-patient, or nurse-to-physician, each form has a tremendous impact on healthcare everyday. What type of communication stresses you out most? Well, according to last week’s poll on stressedoutnurses.com, nurse-to-physician communication is at the front of your minds. A whopping 64% stress most about dealing with docs, with nurse-to-manager communication running a distant second at 16%.

Here’s a little snippet of help. This excerpt from HCPro’s “Speak Your Truth: Proven Strategies for Effective Nurse-Physician Communication,” by Kathleen Bartholomew, RN, MN, will provide some insight into this difficult issue . . .

Promoting effective nurse-to-physician communication can only be achieved if nurses address conflict and unite under a zero-tolerance policy for disruptive behavior and verbal abuse. There are many strategies that staff nurses can adopt to foster better communication and collaboration between nurses and physicians:

1. Understand that the difference in your roles may cause confusion. Reinforce your role in patient care. Use progress notes to identify concisely the problems you addressed on your shift, the progress made, and the plan of care. Remember, be brief. Use SOAP (subject, observation, assessment, plan) charting.
2. 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.
3. 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.
4. Insist that physicians call you by name.
5. 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.
6. Round with physicians whenever possible. If staffing is tight on the unit, take turns. There is no better way to learn what a physician is looking for, to clarify nursing’s role, and to offer input.
7. Remind coworkers and physicians that you are all on the same team.
8. Advocate for the patient. Keep the patient as the main focus of conversation. Advocate for a formalized collaborative practice model.
9. Take personal responsibility for working out any negative relationships that you may have with a physician. Always take these conversations off the floor. Ask for manager support, if needed. Nurses report that they are often surprised that simply stating how a behavior makes them feel to a physician will heal the situation. Raising awareness of the problem and maintaining boundaries in this way is critical.
10. Acknowledge positive behavior and relationships. If there are physicians with whom you enjoy working, send thank you notes and list specific reasons why you enjoy working with them. Send copies of the notes to the medical staffing office.

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