Talking It Out: Improving Nurse-Physician Communication

Nurse-Physician Communication

Communication between nurses and physicians is arguably the most important link in the chain of patient care. Despite this, it can present challenges.

“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,” according to Cassandra Lee Flicek in MEDSURG Nursing.

Common Roadblocks to Nurse-Physician Communication

There are many different factors that can affect nurse-physician 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:

• Lack of openness and collaboration
• Frustration with a lack of professional respect
• Logistical challenges
• Language difficulties
• Nurse preparedness

Openness and Collaboration

In Dr. Tjia’s study, the communication impediment most frequently reported by nurses was feeling hurried by the physician or feeling that the physician was not listening to or interested in the information the nurse tried to convey. Such perceptions not only indicate that information is not being appropriately conveyed or received, but that nurses feel active discouragement regarding their assessments and views on patient care. This, in turn, can lead to a decreased chance of critical observations being voiced.

Professional Respect

Approximately 13 to 17 percent of nurse respondents to the study indicated a perceived lack of respect from physicians; 16 percent reported having been interrupted before they were finished communicating important information. Both physicians and nurses are vital to patient care; a breakdown of respect between the two can lead to a breakdown of trust, which negatively affects patient care.

Logistical Challenges

Simply finding a quiet place to communicate free of distractions proved difficult for a quarter of respondents. Nurses also reported not having time to communicate, and more than a fifth of respondents reported not being able to get in touch with a physician when one was needed.

Language Barriers

Nurses sometimes reported difficulty understanding physicians due to language barriers or accents. Jargon, too, was reported as a problem. These difficulties often prevented effective communication.

Nurse Preparedness

Some nurses felt uncomfortable determining what to report to the physician, and around a quarter of respondents indicated that they were afraid of interrupting or bothering the physician with their findings. Given that nurses spend a considerable amount of time with patients, their observations are essential to patient care and must be communicated.

Nurse-Physician Communication Impact on Patient Outcomes

The effects of poor communication on organizations are well-documented. A study by the Project Management Institute found that ineffective communication is the primary contributor to project failure one-third of the time and has a negative impact on project success more than half of the time. In a business environment, this can be catastrophic for the bottom line. In a medical environment, it can cost lives.

“Both safety and quality of care patients receive depend upon the quality of the practice environment where care is provided opens in new window,” says a study in The Online Journal of Issues in Nursing. According to that study, 55 percent of nurses surveyed indicated that physician behavior had an impact on their patient care decisions and that less experienced nurses were impacted more significantly than older, more experienced nurses.

Working on improving nurse-physician communication has a number of benefits opens in new window. Patient satisfaction tends to improve because patients see medical staff as professional and competent. This has a direct impact on quality of patient care and the patient’s likelihood of continuing self-care upon discharge. Team satisfaction also improves, which improves job satisfaction, reduces turnover and improves patient rapport. All of these factors have an effect on patient care, as well as the risk of malpractice.

Improving Nurse-Physician Communication

Improving communication between nurses and physicians has obvious benefits, but implementing such a change is easier said than done. Three important tools for improving communication are culture change, structured communication tools and supportive technology, according to Patient Safety & Quality Healthcare (PSQH).

Culture Change

PSQH calls culture change “the most fundamental intervention for improving nurse-physician communication.” Culture change starts at the top: Leaders must create an environment of open communication by modeling appropriate behavior, setting expectations and investing in support systems within the structure of the organization. Including both nurses and patient families in bedside rounds, emphasizing the fact that nurses and physicians are a team, familiarizing oneself with coworker preferences and fostering an environment of mutual respect are all ways to create a culture of open communication.

Structured Communication Tools

Using a structured communication tool, such as SBAR, can remove the guesswork from nurse-physician communication. SBAR stands for Situation, Background, Assessment and Recommendation. It provides a framework to facilitate easy organization and communication of information between physicians and nurses. By following an established procedure that everyone must respect and follow, expectations are set for communication. Nurses are able to more quickly and effectively prepare for conversations with physicians and are more equipped to communicate vital information in an organized way. A structured communication tool can also help overcome some language barriers, particularly when it comes to jargon.

Supportive Technology

Secure communication technology, such as email, text messaging or, most importantly, electronic health records (EHRs) are necessary to facilitate efficient communication. Writing a nurse-physician communication can often alleviate linguistic or accent-based barriers, and it also helps to ease time constraints by making communication asynchronous in nature. EHRs are vital communication tools, as they ensure that all parties have access to the same, up-to-date information about patients. This creates a shared foundation of knowledge that facilitates efficient communication.

Improving Your Nursing Communication Skills

Communication is key to success in the healthcare field, and education is an important component of good communication. An RN to BSN online from Rivier University prepares nurses not only for the clinical demands of the job, but also helps to improve their ability to communicate. Students learn in a convenient and flexible online environment that accommodates their work and personal schedules.