By Ayodele Nwosu
Published on May 12th, 2014
The most important issue with nursing today is the physicians’ lack of communication with nurses. There are many examples but I will pick one to discuss.
This can be a very touchy subject to bring up but I think it’s a very important one to discuss. When I graduated nursing school, I didn’t’ know what to expect at my first job. I would often find myself looking at my patient assignment for the day and have many questions about their plan of care. The plan of care is the most important thing to the patient because this is telling them what’s next and why. Nurses are with the patient 24/7 and they are the ones who are constantly answering questions and discussing the plan of care with the patient. For example, as a nurse I see a patient has an x-ray order for their left shoulder, however, the patient came in with COPD exacerbation. The nurse who gave me report has no clue why this was ordered. I then look through the doctor’s notes to see if I can figure out why they are having this done. Unfortunately, this xray is not mentioned in any notes. My next option is to ask the patient. The patient gives me a confused look and says “I don’t know”, then “why don’t you know, how come tests are being ordered for me and no one can tell me why.” The patient becomes very upset and then refuses the test. Finally, I must call the doctor to make them aware of the situation. I get yelled at on the phone for calling and then hung up on. The rest of my shift with this patient is very difficult because the patient deems me as an incompetent nurse.
As a nurse, we are constantly reviewing the doctors’ orders and making sure it makes sense for the patient. Even doctors make mistakes and put in wrong orders for the wrong patient. Maybe this test was placed mistakenly or maybe the doctor has a reason. Due to the lack of communication, both the nurse and patient have no clue. The sad part is that all of this could have been avoided if the physician communicated with the RN what the plan of care was and why.
I have been to many hospitals and have seen this particular problem at each one. Nurses are guessing why this is being done and what will probably happen next. Physicians are required to see their patients every day. If they let the nurse know they are going into see patient Jane Doe, that nurse would have the opportunity to discuss with the patient and the doctor the plan of care. I was at a hospital that was trying to enforce this policy and it was great. It saved the nurses and doctors time as it resulted in less pages for the doctors and it gave the nurses a concrete plan to reinforce to the patient when questions came up after the doctor left.
“READ MY NOTE, IT’S IN THERE!” says the doctor. The problem is, I can’t read your note because the hand writing is awful. Second of all, just like doctors are always so busy, so are nurses. We don’t have time to sit down and go through every note from every doctor to hopefully find the information we are looking for. It would probably take the doctor 10-20 seconds to pick up the phone and call the nurse’s phone and her/him know he is going into see the patient now. The doctor doesn’t need to wait around for the nurse, the nurse will meet him there as soon as possible. Having the doctor, nurse, and patient all together at once would help eliminate most of this communication barrier.
