OVERVIEW: Effective nurse-physician communication is essential to care, especially that of older ... more OVERVIEW: Effective nurse-physician communication is essential to care, especially that of older adults, who often have comorbidities that can lead to frequent moves between care settings. This article examines the current state of nursephysician communication and presents suggestions on how to improve it, including developing relationships, defining communication strategies, and packaging information for clarity. A nurse's messages left on a physician's answering machine receive no reply. A physician angrily tells a nurse that he isn't responsible for a patient, even though he was the admitting physician. A nurse can't read a physician's order, but not wanting to bother her, she doesn't call the physician for clarification. A physician refuses to hear a nurse's opinion, even though it's apparent that the nurse clearly knows the subject. At the heart of each of these circumstances-and many more like them-is poor communication. Deficient communication among providers creates the conditions for acrimony, frustration, and distrust that can lead to inferior care and a greater risk of error. As dramatist Bertolt Brecht wrote, "Society cannot share a common communication system so long as it is split into warring factions." 1 In health care, nowhere is this split more evident than in communication between nurses and physicians. But can this change? Can the two factions unite? Clearly, nurses and physicians have a common goal: to provide care. And many of these patients are at least 65 years old, a population Mezey and Scholder have referred to as "hospitals' 'core business.'" 2 Older adults have more diagnoses, take more medications, have higher degrees of functional and cognitive impairment, and are more likely to report their health status as "poor" than are younger patients. 3, 4 Older patients are also hospitalized more frequently, which creates greater opportunity for loss of critical information as patients move from one setting to another. 4 Better communication among providers can be a tremendous boon to older patients and their families; thus, improved nurse-physician communication is not only a remedy for diminished job satisfaction, it's also an elixir for improving care. NURSE-PHYSICIAN COMMUNICATION: IN THE LITERATURE Several studies have examined nurses' and physicians' perceptions of the quality of their interactions. In one, designed to "assess communication and collaboration," researchers surveyed 67 primary care providers affiliated with Brigham and Women's Hospital in Boston and 820 home care clinicians (nurses and physical therapists) affiliated with eight regional agencies. 5 Forty-seven percent of primary care providers and 74% of home care clinicians reported satisfaction with
The Mount Sinai journal of medicine, New York, 2005
Recent data have shown that medical students do not receive adequate exposure to the practice of ... more Recent data have shown that medical students do not receive adequate exposure to the practice of home care. The number of homebound people is expected to increase, and health care services for these patients will need to expand. A one-week didactic and clinical curriculum was designed and implemented by four nurse practitioners in the Visiting Doctors Program, to provide home care exposure to medical students. The program stresses the medical, psychosocial and palliative aspects of patient care. The students evaluated both the nurse practitioners and the program favorably, using a five-point Likert scale. Role modeling and professionalism were noted to be of value to the students, and bear further study in the context of medical school curricula for home care.
OVERVIEW: Effective nurse-physician communication is essential to care, especially that of older ... more OVERVIEW: Effective nurse-physician communication is essential to care, especially that of older adults, who often have comorbidities that can lead to frequent moves between care settings. This article examines the current state of nursephysician communication and presents suggestions on how to improve it, including developing relationships, defining communication strategies, and packaging information for clarity. A nurse's messages left on a physician's answering machine receive no reply. A physician angrily tells a nurse that he isn't responsible for a patient, even though he was the admitting physician. A nurse can't read a physician's order, but not wanting to bother her, she doesn't call the physician for clarification. A physician refuses to hear a nurse's opinion, even though it's apparent that the nurse clearly knows the subject. At the heart of each of these circumstances-and many more like them-is poor communication. Deficient communication among providers creates the conditions for acrimony, frustration, and distrust that can lead to inferior care and a greater risk of error. As dramatist Bertolt Brecht wrote, "Society cannot share a common communication system so long as it is split into warring factions." 1 In health care, nowhere is this split more evident than in communication between nurses and physicians. But can this change? Can the two factions unite? Clearly, nurses and physicians have a common goal: to provide care. And many of these patients are at least 65 years old, a population Mezey and Scholder have referred to as "hospitals' 'core business.'" 2 Older adults have more diagnoses, take more medications, have higher degrees of functional and cognitive impairment, and are more likely to report their health status as "poor" than are younger patients. 3, 4 Older patients are also hospitalized more frequently, which creates greater opportunity for loss of critical information as patients move from one setting to another. 4 Better communication among providers can be a tremendous boon to older patients and their families; thus, improved nurse-physician communication is not only a remedy for diminished job satisfaction, it's also an elixir for improving care. NURSE-PHYSICIAN COMMUNICATION: IN THE LITERATURE Several studies have examined nurses' and physicians' perceptions of the quality of their interactions. In one, designed to "assess communication and collaboration," researchers surveyed 67 primary care providers affiliated with Brigham and Women's Hospital in Boston and 820 home care clinicians (nurses and physical therapists) affiliated with eight regional agencies. 5 Forty-seven percent of primary care providers and 74% of home care clinicians reported satisfaction with
The Mount Sinai journal of medicine, New York, 2005
Recent data have shown that medical students do not receive adequate exposure to the practice of ... more Recent data have shown that medical students do not receive adequate exposure to the practice of home care. The number of homebound people is expected to increase, and health care services for these patients will need to expand. A one-week didactic and clinical curriculum was designed and implemented by four nurse practitioners in the Visiting Doctors Program, to provide home care exposure to medical students. The program stresses the medical, psychosocial and palliative aspects of patient care. The students evaluated both the nurse practitioners and the program favorably, using a five-point Likert scale. Role modeling and professionalism were noted to be of value to the students, and bear further study in the context of medical school curricula for home care.
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