in sickness and in health physician-nurse collaboration karen e. johnson, md associate professor of...
TRANSCRIPT
In Sickness and In HealthPhysician-Nurse Collaboration
Karen E. Johnson, MD
Associate Professor of Pediatrics
Baylor College of Medicine
Physician-Nurse Collaboration
Objectives:
1) Recall factors that predict retention of RNs
2) Understand how physician-nurse relationships affect this
3) Describe ways/efforts to improve this professional relationship
Physician-Nurse Collaboration
• “burnout”• “engagement”
• “job satisfaction”• “retention”
Physician-Nurse Collaboration
Conceptual Framework for Predicting Nurse Retention
Sawatzky JA, Enns CL. Exploring the key predictors of retention in emergency nurses. J Nurs Manag. 2012 Jul;20(5):696-707.
Van Bogaert et al. 2009, Wieck et al. 2010, Cowan et al. 2008, Rafferty et al. 2001
Physician-Nurse Collaboration
Impacts many issues:
including-• Job satisfaction/intention to leave• Patient outcomes, including LOS• Nursing engagement
Autonomy plays a central role in this collaboration!!!!!!!
Coombs & Ersser 2004
Physician-Nurse Collaboration
“Power and authority have traditionally been used to preserve the dominance or hegemony of the medical profession in health care decision-making over other team members”
Clough J, Forum, May 2008 Vol 26 Number 2 p1-2
Physician-Nurse Collaboration
Fundamental to:
1) improved outcomes
2) error and risk reduction
3) optimum care/patient satisfaction
Physician-Nurse Collaboration
Current “pressures” for MD/RN:
1) financial concerns
2) technology(i.e. EMR)
3) “pipeline” shortages of both
Pauly B, Varcoe C, Storch J, Newton L. Registered nurses' perceptions of moral distress and ethical climate. Nurs Ethics. 2009 Sep;16(5):561-73.
Physician-Nurse Collaboration
Puntillo KA, McAdam JL. Communication between physicians and nurses as a target for improving end-of-life care in the intensive care unit: challenges and opportunities for moving forward. Crit Care Med. 2006 Nov;34(11 Suppl):S337.
Physician-Nurse Collaboration
Physician-Nurse Collaboration
• COMMUNICATION!!!!!!
• COMMUNICATION!!!!!!
• COMMUNICATION!!!!!!
Physician-Nurse Collaboration
Puntillo KA, McAdam JL. Communication between physicians and nurses as a target for improving end-of-life care in the intensive care unit: challenges and opportunities for moving forward. Crit Care Med. 2006 Nov;34(11 Suppl):S333.
Physician-Nurse Collaboration
??What can be done about this??
Competent performance and self confidence are the keys to clinical autonomy/collaborative working relations!!
Sawatzky JA, Enns CL. Exploring the key predictors of retention in emergency nurses. J Nurs Manag. 2012 Jul;20(5):696-707.
Physician-Nurse Collaboration
• Expertise
• Autonomy
• Responsibility
• Interdependence
• Deliberation
• Dialogue
Physician-Nurse Collaboration
Successful collaboration =• Cooperation +• Shared responsibility +• Jointly formulate/carry out patient care
plans +• Open communication +• Mutual respect