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I am a new nurse manager on my unit and am wondering how I can improve communication and understanding between the physicians and my staff.

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Opportunities for improving communication between physicians and nurses pop up every day. You find them in the irate physician who belittles a nurse right in front of his or her patient, or in the physician who refuses to call nurses by name. It is during these unfortunate events that the chance to speak your truth arises.

Garner administration support: Administrators need to ensure that hospital systems are in place to support and foster good nurse-physician relationships. Organizations that don't provide affirmative and continuous administrative support should expect to fail. Cooperation and collaboration start with the messages sent by our leaders and by seeing the process in action.

Create a zero-tolerance policy: A policy defines unacceptable behavior and its consequences, and it provides a much-needed support structure for nurses. However, a lone policy has proven not to be a deterrent to abuse unless it is followed and supported by both staff and administration. If there is no policy in place, advocate for one to be adopted—and that it be zero-tolerance.

Use your name as a powerful equalizer: Make sure that the physicians with whom you work frequently know your name. Daily communication should be mandatory—not optional—and calling someone by his or her name is a basic sign of respect. Therefore, introduce yourself to physicians, and if they forget your name, reintroduce yourself.

Take advantage of formalized collaborative models: Collaborative governance models are based on building internal and external respect. They provide a structure for a working partnership that supports physicians and nurses both personally and professionally.

Build community: Community is the optimal setting for bonding and, thus, patient safety. To form a safe working environment, the atmosphere on the unit must be psychologically safe. Fear of being judged or ridiculed must be replaced by compassion, understanding, and belonging. Rather than trying to ignore the fact that we are human, both nurses and physicians should acknowledge their humanness.

Kathleen Bartholomew, RN, MN

(March 2010)