Poor communication between doctors and nurses can lead to costly mistakes
One barrier to good communication is that the hospital hierarchy puts nurses at a power disadvantage, and many are afraid to speak the truth.
Communication breakdown among nurses and doctors is one of the primary reasons for patient care mistakes in the hospital. And since care quality is increasingly linked to reimbursement, those mistakes can be costly from both a health and financial perspective.
In a small pilot study, University of Michigan researchers learned about potential causes of these communication failures by recording interactions among nurses and doctors, and then having them watch and critique the footage together.
Several themes emerged to help explain the poor communication, and both nurses and physicians improved their communication styles, the authors said. Effective communication was defined as reaching a shared understanding.
One barrier to good communication is that the hospital hierarchy puts nurses at a power disadvantage, and many are afraid to speak the truth to doctors.
The recordings showed that nurses didn't directly request what they wanted or express their needs. They communicated indirectly, which confused physicians, who often ignored the nurses' requests and moved on to the next agenda item rather than ask for clarification.
The study also found that because doctors and nurses approach patient care from vastly different angles, achieving understanding isn't easy.
The authors said one interaction in particular really showcased the different approaches to patient care. A patient with mouth pain, caused by a fungal infection called thrush, couldn't swallow the pills she needed to get better. The physician wanted to prescribe more medication to treat the thrush, but the nurse -- who knew the patient well -- wanted to treat the patient with strong painkillers, as well.
The physician realized that pain was inhibiting the treatment, and that effective treatment would require addressing both the pain and the condition.
The recordings also showed that in good communication, the body language of each party mimicked the other. In strained relationships, body language wasn't in sync.
After being recorded, nurses and physicians watched and commented on the clips separately, and those comments were incorporated into the video. Finally, both parties watched the clip together.
Overall, the interactions were positive in the sense that there wasn't any contention, but there was room for improvement, and next the authors hope to record a larger group and use the videos as training tools to improve communication.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
