A 2013 survey examined the working relationship between doctors and nurses, and the responses were fairly disheartening. 66% of the healthcare professionals polled said that nurse-doctor interactions were “just okay” with a mix of collaboration and conflict, while 31% considered these relationships altogether “poor”. Only 3% of those polled felt that the nurse-doctor dynamic is “strong”.
What’s causing problems between nurses and doctors, and how can these professionals improve their relationships? We’re taking a closer look at the most common issues — and offering up some potential solutions.
What Constitutes a Strong Nurse-Doctor Relationship?
In a peer-reviewed article published in OJIN: The Online Journal of Issues in Nursing, nurses and doctors were asked what constitutes a strong nurse-doctor relationship. Both professions identified “civility, courtesy, and respect” as the primary factors that determine the quality of their interactions.
The following behaviors were deemed important by both doctors and nurses:
- Treats me with civility, courtesy and dignity
- Works to solves problems without hostility or verbal abuse
- Listens when I am speaking
- Never intentionally ridicules embarrasses or harasses
- Asks me questions
- Answers my questions
5 Types of Nurse-Doctor Relationships
In a report published by CRITICAL CARE NURSE, 20,000 nurses were interviewed about their professional interactions with physicians. Five primary types of relationships were identified:
- Collegial Relationships: Doctors and nurses are considered equals and treat each other with mutual respect.
- Collaborative Relationships: Doctors and nurses work together toward common goals and listen to one another’s input, but doctors are given more authority.
- Student-Teacher Relationships: In this dynamic, either the nurse or the physician can assume the role of the teacher (particularly when nurses have specific clinical experience outside of the attending physician’s specialty).
- Friendly Stranger Relationships: Doctors and nurses interact with one another in a formal fashion, and they seldom ask each other for input or discuss orders.
- Hostile/Adversarial Relationships: These interactions involve general disrespect, angry outbursts, belittling, verbal abuse and threats.
Common Problems Between Nurses and Doctors
Some of the more common issues between doctors and nurses include the following:
- Doctors are oftentimes more focused on the diagnosis rather than the patient as an individual, whereas nurses are generally more tuned in to the emotional and social factors that affect patient care.
- Nurses typically spend more time with patients, and this can lead to disagreements with attending physicians regarding treatment plans.
- Busy healthcare settings require quick (and oftentimes less efficient) communication between doctors and nurses.
- Nurses are still seen by many facilities, patients and doctors as subordinates.
- Because of this imbalance, nurses may feel hesitant to speak up in care plan meetings or provide helpful suggestions to doctors. Similarly, doctors may ignore the insight nurses have to offer. Either of these can have a negative impact on patient care.
- Eliminate the hierarchy.
Sure, physicians deserve respect. So do nurses.
Both of these healthcare professionals play vital roles in patient care, and both can learn from one another. Their relationship should be collaborative, and nurses should never be treated as inferiors.
- Have protocols in place for conflict.
Conflicts and disagreements are bound to happen in any workplace, and healthcare facilities are no exception to the rule. Facilities should have proper procedures in place to address these difficult situations so that nurses and doctors know exactly how to handle anything from a minor interpersonal issue to a major disagreement regarding a patient’s treatment plan.
- Establish team training’s.
One of the more common mistakes that facilities make regarding nurse-doctor interactions is creating a professional hierarchy rather than establishing nurses and doctors as colleagues and peers. An easy solution for this is conducting regular team training’s where doctors and nurses are on equal ground.
Ultimately, each and every healthcare worker comes to the table with a different set of unique experiences, skills and perspectives. Everyone can learn from others, and collaborative team training’s encourage a more synergistic work environment.
- Focus on patient care.
It’s essential to work in an atmosphere where patient care is paramount. A patient-centered culture is a must for positive treatment outcomes, and this is a great rule of thumb to keep in mind when working with all of your colleagues. Interdisciplinary partnerships are the best way to address a patient’s holistic needs in the most comprehensive way possible, so never assume that you can’t offer insight (or receive constructive criticism).
If you think that a different treatment plan is optimal for a patient’s needs, speak your mind. If you’re a doctor who receives a suggestion from a nurse, listen to the idea without feeling threatened. Check your ego or insecurity at the door, and take proper care of the patients who need you.
- Speak with confidence.
It’s not uncommon for nurses to feel hesitant about second-guessing a doctor’s decision or discussing alternative options with an attending physician. Remember that a nurse’s voice is no less important than a doctor’s, and the best way to underscore this point is by respecting yourself.
Give yourself permission to say what you think in a professional manner. When you treat yourself as an equal, others will follow suit.
- Address conflicts with each other first.
It may seem easier to voice your disdain with a specific doctor or nurse to your co-workers, but that will only breed negativity and make you appear unprofessional. Instead, take your concerns to that person directly (albeit professionally).
If you feel that someone has disrespected you or made a decision that’s not best for the patient, then it’s perfectly fine to address your viewpoint with that person. In busy healthcare settings, these types of issues are often directly related to miscommunication or job stress. Confronting these differences head-on establishes doctors and nurses as equals, and facilities are wise to encourage this approach as the first step in conflict resolution.
- Expect professionalism.
Would you ever speak down to a colleague or belittle another healthcare professional? Then don’t accept that treatment from anyone else. It’s one thing to have a respectful disagreement, and it’s quite another to be yelled at, humiliated or verbally abused. This type of behavior is completely out of bounds and is never an acceptable response to conflict. Healthcare facilities should have clear and firm boundaries in place regarding professional interactions, and cruelty should never be tolerated regardless of a person’s professional credentials.
How are the nurse-doctor relationships at your facility, and what tips do you have to improve the overall dynamic between these two healthcare professions? Keep the conversation going in the comments!