The relationship between nurses and physicians is known for being strained, with much of the strife being attributed to the nurse’s struggle to gain professional respect from doctors who view them as subordinates. This is reflected by an informal 2013 survey conducted by consulting firm Advisory Board, which found that 31% of the 1,289 respondents believed there are “too many unprofessional clashes” between nurses and doctors.
Often, though, the strain is due to errors in communication and a lack of empathy for each other’s roles and daily challenges, according to the American College of Healthcare Executives (ACHE). The troubles impact the nurses’ job satisfaction, healthcare facilities’ ability to retain employees and, most importantly, patient care outcomes.
A 2009 survey from the ACHE concluded that a “fundamental lack of respect between doctors and nurses is a problem that affects every aspect of their jobs. Staff morale, patient safety and public perception of the industry all suffer as a result.”
The survey asked questions of both doctors and nurses, 98% of whom said they had witnessed behavioral issues between doctors and nurses within the last year.
Advisory Board’s survey asked readers of its blog, “The Daily Briefing,” to measure whether they thought doctor-nurse relationships had improved. The survey found that 66% said nurse-physician relations are OK, involving a mix of collaboration and conflict, while 31% said relations are poor and involved too many unprofessional clashes. Only 3% said that relations are strong with a climate of mutual respect.
Enlarging that 3% involves improving communication. Doctors receive little or no formal leadership training, meaning many of them are managing teams for the first time. Additionally, many of them suffer burnout from their workload. Also, personal lives are often difficult to maintain in their line of work, which can add more stress.
A harmonious working relationship between nurses and doctors contributes to higher levels of nurse retention. This, in turn, improves patient outcomes as the staff becomes stronger as a team and is more invested in its work, according to an article on the Nurse Together website (www.nursetogether.com).
Creating this culture is easier said than done as the notorious riff between the two professions is nothing new. However, with nurses taking a more active role in the scope of practice, there has never been a more important time for the two sides to collaborate on patient care.
Here are some tips for nurses and doctors to help create an environment in which these important players in the healthcare system benefit from and feed off each other.
What Can Nurses Do to Improve the Relationship with Doctors?
- Respect the doctor’s time. Physicians bounce from one patient to the next and time is a precious commodity. It’s important that nurses help them maintain a certain level of efficiency. For example, do not start conversations with “I’m sorry to bother you.” Be prepared for rounds, anticipate problems ahead of time and always have a chart in hand when calling a physician.
- Communicate directly concerning behaviors that have a negative effect. Refrain from complaining about physicians to other staff members and instead confront them directly by speaking in private. If needed, get a manager for additional support.
- Be conscious of behaviors that affect the relationship. Nurses can have a big effect on the situation with their behavior while also noting the doctor’s. Thanking and acknowledging physicians with whom a good working relationship is present can go a long way, while identifying negative behaviors from doctors where a positive relationship is lacking can be an important step in making things better.
What Should Doctors Do?
- A little respect goes a long way. Using a nurse’s name can make a difference and if a physician does not know it, it can be useful to ask, as simply doing so is a form of recognition.
- Be considerate of the nurse-patient relationship. When walking into the room, doctors should respect the nurse’s interactions with the patient and the fact that the patient may be more comfortable with the nurse. Discuss the care plan for complicated cases directly with the nurse, as this helps doctors take full advantage of opportunities to educate nurses.
- Create a culture of inclusion. Inviting nurses on rounds and focusing on being a leader rather than a commander will make nurses more comfortable asking questions and sharing patient concerns without feeling inferior or troublesome.