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A few of my nurses have been disaggreeing with our physicians over treatment decisions for patients. What is some advice I can give them?

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How nurses and physicians communicate about treatment depends on the relationship. If it is collaborative, speaking up and sharing concerns is appreciated and is often an opportunity for both parties to learn something new. If it is neutral or negative, it is more difficult for nurses to make themselves heard. In either case, if they disagree with a treatment decision, they should base their actions on the safety of--or danger to--the patient.

If the patient's life is in danger, tell them to take action by following the chain of command: manager, chief of practice, medical director, etc. In general, there is more danger for the patient in keeping quiet than in sharing concerns and if their concerns are not warranted, then at the very least, they can learn something--and the physician usually does too.

-Kathleen Bartholomew, RN, BS