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Addressing the Disrespect Disconnect

Joe Cantlupe, for HealthLeaders Media, February 13, 2012
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"I do believe nurses and physicians are on two different pages when it comes to communication," Kadlick adds. "Time is a commodity for physicians today. When they present to do rounds, they want to have pertinent data given to them. Nurses have a tendency to give a very detailed report, more than what a physician may want to hear; hence, the physician may interrupt, seem to be abrupt, even rude at times."

When confronted as being rude or disrespectful, a physician often would be "truly taken aback, as they do not see it this way," Kadlick says. Referring to reports of alleged abuse, Kadlick says she believes that "while there are validated incidents of true disrespect for nurses by physicians, these incidents are minimal."

As health systems improve care coordination and increase the roles of nurse navigators, Kadlick says she expects the communication between nurses and doctors to get better.

"I do see it improving on the acute care level, with care coordinators working with primary care physicians," Kadlick says. "As you add care coordinators and change the delivery models, you will see registered nurses more at the bedside than tied to the computer, and the communication will be getting better. You have more advanced nurse practitioners popping up in the acute care settings. We are getting there, but still moving at a snail's pace.

"Physicians have acknowledged how important it is to have that mid-level provider to help them with their greatest commodity—time," Kadlick says.

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3 comments on "Addressing the Disrespect Disconnect"


CENotredame (2/15/2012 at 2:45 PM)
Actually, in my > 35 year career as a nurse I have experienced this first hand and have been verbally abused on a daily basis in one job as an educater because the physician did not want me there. Also, I have had a resident speak very disrespectfully to me, in a very non emergent sistuation, as though entitled to do so, although I was at the time old enough to be her mother. I have witnessed physician disrespect towards nurses, and sometimes nusres being unkind and disespectful towards residents, throughout my career so commonly, that the numbers sied by nurse leaders seem rediulously low. My feelings about this have been more affected by my experiences as a patient with significant medical problems as I have seen the limitations that physicians and the medical model bring to the table Nonetheless I have had very rwarding working relationships with physicians as well and found that the team approach really benefitted our patients

ed (2/15/2012 at 2:44 AM)
Quite an interesting article in that the article only appears to address the level of disrespect the nurses may feel. However, I think it is safe to say that the contrary also occurs and I wonder how many physicians feel they are disrespected by nurses. Unfortunately, as far as I know the treatment of physicians, especially in training, by nurses are rarely examined. When it comes to the perception of blame, I certainly do feel that physicians have played a part as they do make the ultimate decisions regarding patient care. I am not sure what to make of the perception that nurses do not share some of the blame for our current health care system, as they appear to be an integral part. Ultimately, improved communication will likely lead to improved healthcare delivery, but I am not sure if performing a one-sided, possibly biased survey is contributing to the solution.

Sue Wintz (2/14/2012 at 9:15 AM)
Thank you for bringing this important topic out into the open. As a board certified professional chaplain, I have worked closely with both physicians and nurses and agree that there is a 'disconnect' that impedes communication. As the article pointed out, it's not only the MDs and RNs that contribute to this, but many other influences, including the organizational culture. Coordinated care and a multidisciplinary approach are the key, however the barriers often set up within the culture can impede this and must be addressed. Professional chaplains are often the overlooked resource by many organizations. Our expertise is communication, not only in assessing patient/family beliefs and values to incorporate them into the plan of care (which increases satisfaction), but also within the team. Often chaplains facilitate communication between members of the team, including physicians and nurses. To increase the overall success of communication in healthcare delivery, organizations would do well to bring all members of the team to the table to talk openly about solutions. This means not only the organizational leaders. The voices of those who do the bedside care - the physicians, nurses, professional chaplains and other disciplines, need to be heard and respected. Together solutions to this issue can be addressed.