Journal Article

Review
Journal Article Review: Communicating with Doctors

Journal Article Review: Communicating with Doctors

Student: Gaganpreet Parmar
Student No: 823-073-598
Date Submitted: Tuesday, February 25, 2014
NURS 260: Practical Nursing Theory 2
Humber College ITAL

Journal Article
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Journal Article Review: Effective Communication
Communicate; it is what we do on a daily basis with individuals around us, letting them
realize our thoughts, feelings and demands. Yet, we fail to realize how essential communication
is throughout our everyday lives, especially within the healthcare system. Effective
communication between doctors and nurses is fundamental in providing high quality patientcentered care. The mutual interdependence is crucial in the physician-nurse relationship as
neither can work independently to accomplish the goal of supporting the patient achieve optimal
health. Continuously, ineffective communication between the two professions has increasingly
been a problem when providing care for patients. Adverse effects, and negative patient outcome
has been directly correlated to disconnect and poor communication between physicians and
nurses (Curtis, Tzannes, Rudge, 2011, p.13). Overall, three major factors within the nursephysician relationship which contribute to poor communication are the difference in nurse and
physician education, the presence of hierarchal relationships and time constrains.
Difference in Education
Nurses and physicians are disciplined and socialized with a strong professional identification;
therefore a deficiency of knowledge regarding team members of different professions is apparent
(Martin-Rodriguez, Beaulieu, DAmour, Ferrada-Videla, 2005, p.137). Due to the difference in
socialization limited knowledge about practices, responsibilities and skills is known about the
others profession, this can lead to disconnect between the physician and nurse. Furthermore, the
teaching of nurses has focused to a greater extent on the psychological and physical needs of the
patient to ensure a therapeutic environment- as a result nurses possess characteristics such as
nurturing and empathy (Curtis et al., 2011, p.16). Due to the nurses responsibilities of providing
this therapeutic environment/relationship for their patient less time is spent with the physician,

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which could potentially lead to miscommunication and conflict between the two (Curtis et al.,
2011, p.16). Continuously, I believe education is a factor that plays a role when nurses
communicate with physicians. Nurses are taught to create an atmosphere that is therapeutic for
their patients, promote health, and prevent disease by caring for sick individuals. The best
practice guidelines indicates that a therapeutic relationship between the nurse and patient is
central in helping the patient achieve optimal health (RNAO, 2002, p.11). Conversely, the
physicians role is to monitor a patients status and develop a diagnosis based on the patients
overall health. The roles and responsibilities a nurse has compared to a physician are different,
so when dealing with a patient the goals a nurse has compared to the goals a physician has
regarding the same patient are different. I believe in order to improve the communication
between the two professions being familiar with and understanding each others roles,
responsibilities and values are imperative.
Hierarchical Relationships
Ineffective communication between physicians and nurses can be related to the presence of
hierarchical relationships. Recent studies suggest nurses have difficulties voicing their concerns
for patients if it contradicts what the physician has said previously (Curtis et al., 2011, p.15). It
is important for nurses to voice their opinions and concerns for patients as participation, fairness,
and freedom of expression is essential for the development of good communication between the
nurse and physician (Martin-Rodriguez et al., 2005, p.139). Another study which involves nurses
suggests the existence of power imbalance plays a role in preventing collaboration with
physicians (Martin-Rodriguez et al., 2005, p.134). If a power imbalance exists individuals who
are at the end of the hierarchy believe that individuals at the top are unapproachable and they feel
uncomfortable discussing their concerns. I believe hierarchies within the healthcare system exist

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and they can have a negative impact on nurse-physician communication. Unfortunately, due to
hierarchies shared decision making and direct communication is not apparent (Martin-Rodriguez
et al, 2005, p.139). Nurses may withhold information regarding a patient or their opinions due to
fear of seeming incompetent or not wanting to correct a physician. Within a physician-nurse
relationship it is important to advocate for your patient even if it means contradicting what the
physician has said. If a nurse does not advocate for their patient they are not maintaining the
practice of the professional standards they must follow. If advocacy for the client does not occur
the nurses accountability, professional relationship and leadership is compromised as they are
not promoting the best possible care for the client, and they are neglecting to share their nursing
knowledge and expertise with their team members (CNO, 2002, p. 4). To prevent the
development of hierarchies it is important to promote openness and trust to encourage
communication.
Time Constraints
An increasing workload has been a problem for nurses and doctors as time and resources have
decreased. Due to the increasing complexity and acuity of patient conditions and an increase in
the aging population, a pressure on reducing hospital stays has been concentrated on (Curtis et
al., 2011, p.15). Due to time constraints and increased workload, a visible increase in lack of
motivation and energy for communicating has been noticed (Curtis et al., 2011, p.15). In order to
successfully communicate availability of time is needed. Time allows nurses and doctors to
discuss information, and develop interpersonal relationships (Martin-Rodriguez et al., 2005,
p.139). Having time also allows nurses and physicians to discuss the care of patients and reduces
patient errors. I believe that time is a factor that plays a role in physician-nurse communication.
In order to effectively communicate time is needed to discuss the patients condition and the way

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care is going to be carried out. In order to provide opportunities for nurses and physicians to
communicate proximity should be considered. If nurses and physicians work in close proximity
to each other collaboration is facilitated as it provides an opportunity to interact and work
together (Martin-Rodriguez et al., 2005, p.139). By promoting a work environment where nurses
and physicians regularly work within close proximity to each other their professional relationship
can develop. Nurses will be more willing to share their knowledge and promote the best possible
outcome for their patient (CNO, 2002, p. 12).
Conclusion
Overall, there are many barriers that promote ineffective communication between a nurse and
a physician. Some of these implications which lead to ineffective communication are the
difference in education between the nurse and physician, the presence of hierarchal relationships
in the healthcare field and time constraints. When poor communication occurs between a nurse
and a physician an adverse event can take place and it could result in a patient suffering due to
miscommunication between the physician and nurse. Communication between nurses and
physicians is crucial as it prevents errors when providing care for individuals and a sense of trust
and support is developed between the nurse and physician.

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Reference List
College of Nurses of Ontario. (CNO). (2002). Professional standards, Revised 2002.
http://www.cno.org/Global/docs/prac/41006_ProfStds.pdf

Curtis, K., Tzannes, A., & Rudge, T. (2011). How to talk to doctors - a guide for effective
communication. International Nursing Review, 58(1), 13-20.
Registered Nurses Association of Ontario. (RNOA). (2006). Establishing Therapeutic
Relationships. http://rnao.ca/sites/rnao-ca/files/Establishing_Therapeutic_Relationships.pdf
San Martin-Rodriguez, L., Beaulieu, M., D'Amour, D., & Ferrada-Videla, M. (2005). The
determinants of successful collaboration: a review of theoretical and empirical studies, 132-147.