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A manager’s quest to create collegial relationships with physicians

Nurse Leader Weekly, January 23, 2006

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Setting the standard

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

The day after Lucille spoke with the manager, Dr. Wyte came to the floor and the secretary paged the manager regarding his arrival. "Dr. Wyte," she said, "can I talk to you for just a minute?" He nodded, and she opened the conference room door. "I understand that you had an interaction with Lucille yesterday that left her feeling devalued and insignificant."

He paused for a moment and then said, "I'm sorry. Will you tell her I'm sorry?"

"It would be better if you told her yourself," suggested the manager. "She is just down the hall."

Few professionals-not even busy physicians-will refuse a minute of their time. Perhaps that's why asking "Can I talk to you for just a minute?" was well received by Dr. Wyte. There are other things you should do to ensure that such conversations go smoothly:

• Find a private place (e.g., a conference room) where you can sit down.

• Always take potentially emotional 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 yesterday you had an interaction with one of my nurses that left her feeling devalued and unappreciated," you avoid direct accusation.

In this case, the doctor apologized but then asked the manager to "please apologize to the nurse for him." Don't accept the job as emissary of apologies. The standard of etiquette for apologizing was set in kindergarten-apologies are given directly to the person who has been offended by the offender.

By her actions, this manager demonstrated to both physicians and nurses the standard of acceptable behavior on the unit. Two-thirds of hospitals have approved standards detailing acceptable behavior, but nurses continue to report disruptive behavior in these institutions and do not find the standards to be helpful because they are not enforced. Therefore, although it is an excellent idea to lobby for behavioral standards, standards alone do not stop disruptive behavior-they are only as valuable as the nurses who use them.

Editor's note: The above excerpt was taken from HCPro Inc.'s best-selling book Speak Your Truth: Proven Strategies for Effective Nurse-Physician Communication by Kathleen Bartholomew, RN, MN. Go to www.hcmarketplace.com for more information.

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