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Expert spotlight: Curb disruptive behavior at your facility

Nurse Leader Weekly, September 22, 2008

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This week, expert Kathleen Bartholomew, RC, RN, MN, lends some advice on how to prevent disruptive behavior from occurring in the healthcare setting.

Q: Is there any advice I can pass off to my nurses to curb disruptive behavior between nurses and physicians at our facility?

A: Addressing conflict and uniting under a zero-tolerance policy for disruptive behavior and verbal abuse is paramount. Yet there are many other strategies that a staff nurse can adopt as well to foster better communication and collaboration between nurses and physicians. To promote collaborative relationships at your facility, reinforce the following to your nursing staff:

1. Understand that the difference in nurse and physician roles may cause confusion, but emphasize your role in patient care. Use the progress notes to identify concisely the problems you addressed on your shift, the progress made, and the plan of care.
2. Perform a root-cause analysis whenever there is an unplanned outcome, including both physicians and nurses on the team.
3. Ask for what you want. If you strongly feel that the physician needs to see a patient, say so. You don't have to have a diagnosis because you are not the doctor.
4. Be prepared for telephone calls by having the chart, labs, and recent vital signs in your hand if there is a change in patient status.
5. Round with physicians whenever possible. If staffing is tight on the unit, take turns. There is no better way to learn what a physician is looking for, to clarify nursing's role, and to offer input.

Editor's note: Do you have a question for our experts? Email your queries to editor kmucci@hcpro.com and see your name in print next week! In the meantime, head over to our Web site and view a growing collection of advice from our experts.

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