25
In Sickness and In Health Physician-Nurse Collaboration Karen E. Johnson, MD Associate Professor of Pediatrics Baylor College of Medicine
In Sickness and In HealthPhysician-Nurse Collaboration
Karen E. Johnson, MDAssociate Professor of PediatricsBaylor College of Medicine
Physician-Nurse Collaboration
Objectives:1) Recall factors that predict retention of RNs2) Understand how physician-nurse
relationships affect this3) Describe ways/efforts to improve this
professional relationship
Physician-Nurse Collaboration
• “burnout”• “engagement”
• “job satisfaction”• “retention”
Physician-Nurse Collaboration
Conceptual Framework for Predicting Nurse Retention
Sawatzky JA, Enns CL. Exploring the key predictors of retention in emergency nurses. J Nurs Manag. 2012 Jul;20(5):696-707.
Van Bogaert et al. 2009, Wieck et al. 2010, Cowan et al. 2008, Rafferty et al. 2001
Physician-Nurse Collaboration
Impacts many issues: including-• Job satisfaction/intention to leave• Patient outcomes, including LOS• Nursing engagement
Autonomy plays a central role in this collaboration!!!!!!!
Coombs & Ersser 2004
Physician-Nurse Collaboration
“Power and authority have traditionally been used to preserve the dominance or hegemony of the medical profession in health care decision-making over other team members”
Clough J, Forum, May 2008 Vol 26 Number 2 p1-2
Physician-Nurse Collaboration
Fundamental to:1) improved outcomes2) error and risk reduction3) optimum care/patient satisfaction
Physician-Nurse Collaboration
Current “pressures” for MD/RN:1) financial concerns2) technology(i.e. EMR)3) “pipeline” shortages of both
Pauly B, Varcoe C, Storch J, Newton L. Registered nurses' perceptions of moral distress and ethical climate. Nurs Ethics. 2009 Sep;16(5):561-73.
Physician-Nurse Collaboration
Puntillo KA, McAdam JL. Communication between physicians and nurses as a target for improving end-of-life care in the intensive care unit: challenges and opportunities for moving forward. Crit Care Med. 2006 Nov;34(11 Suppl):S337.
Physician-Nurse Collaboration
Physician-Nurse Collaboration
• COMMUNICATION!!!!!!
• COMMUNICATION!!!!!!
• COMMUNICATION!!!!!!
Physician-Nurse Collaboration
Puntillo KA, McAdam JL. Communication between physicians and nurses as a target for improving end-of-life care in the intensive care unit: challenges and opportunities for moving forward. Crit Care Med. 2006 Nov;34(11 Suppl):S333.
Physician-Nurse Collaboration
??What can be done about this??
Competent performance and self confidence are the keys to clinical autonomy/collaborative working relations!!
Sawatzky JA, Enns CL. Exploring the key predictors of retention in emergency nurses. J Nurs Manag. 2012 Jul;20(5):696-707.
Physician-Nurse Collaboration
• Expertise
• Autonomy
• Responsibility
• Interdependence
• Deliberation
• Dialogue
Physician-Nurse Collaboration
Successful collaboration =• Cooperation +• Shared responsibility +• Jointly formulate/carry out patient care
plans +• Open communication +• Mutual respect
