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Blog spotlight: Set the tone for nurse-physician collegiality

Nurse Leader Weekly, March 23, 2009

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This week, Kathleen Bartholomew, RC, RN, MN, discusses how nurse managers can create collaborative relationships in their unit:

Imagine that a nurse has come to you complaining about a physician who talked to him or her rudely and arrogantly. The nurse feels humiliated. The very next day, you see this physician on the unit. What do you do?

It is vital that nurse managers model zero tolerance for any kind of disruptive, intimidating, or verbally abusive behavior. Research shows that 1-3% of physicians are disruptive, yet this group causes exponentially devastating effects on morale, retention, and patient safety (Rosenstein & O'Daniel, 2005). Managers must take the necessary actions to demonstrate to nurses and physicians the standard of acceptable behavior and set the tone for collegiality on the unit. Nothing is more powerful than staff witnessing a manager approaching a disruptive physician and saying, "Can I speak to you for a minute in my office?"

Also, few professionals—not even busy physicians—will refuse a minute of their time. So asking a physician if you can talk to him or her for just a minute will likely be well received.

There are other measures you can take to ensure these conversations go smoothly:

• Find a private place (e.g., a conference room) where you can sit down.
• Always take potentially emotionally conversations off the floor.
• Make excellent eye contact and be direct.
• State what you know, and never judge the situation. For instance, if you say, "Excuse me, I understand that you had an interaction with one of my nurses that left (him or her) feeling devalued and unappreciated," you avoid direct accusation.

Reference:
Rosenstein, A., & O'Daniel, M. (2005). Disruptive Behavior and Clinical Outcomes: Perceptions of Nurses and Physicians. American Journal of Nursing. 105(1)

Read more about improving nurse-physician collaboration.

What are some other strategies managers can use to create collegial relationships on their unit?

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