Behind Every Great Physician is Excellent Nursing Care

A recent Press Ganey survey reports that nursing excellence improves the patient's perception of their care experience. Discover the connection here.

Behind Every Great Physician is Excellent Nursing Care

Have you ever considered that nursing excellence allows physicians to provide compassionate, patient-centered care? A recent study conducted by Press Ganey revealed that comprehensive nursing practice in high-performing hospitals creates high patient satisfaction rates for both nursing and physician delivered services.

What is the professional practice environment really like? It's free of disrespectful, rude, and disruptive behaviors between staff. Professional relationships don't focus on power or the abuse of it. This allows the work being done to center around the patient, and not on how one group is defending itself against the other. A healthy workforce also consists of effective communication, collaboration, and mutual respect.

Understanding the Nurse-Physician Connection

Ask any nurse, and frankly, any physician and they are likely to tell you that the relationships between nurses and physicians matter. Knowledge of the professional practice environment is critical to not only to collaboration but also to nurses’ recruitment and retention rates. The professional practice environment is where medical and nursing care happens. Depending on how the nurses and doctors feel about the workplace and their collaborative roles with one another impacts quality.

So is the professional practice environment really like? It’s free of disrespectful, rude, and disruptive behaviors between staff. There is no abuse of power or relationships between nurses and physicians and allows for work satisfaction for both professionals and quality patient care. It’s filled with communication, collaboration, and mutual respect.

Nursing Excellence Initiatives

The American Nurses Credentialing Center developed the Magnet Recognition Program for hospitals. It started in 1983 when they conducted a research study and identified 14 characteristics that made some organizations more able to recruit and retain nurses. Not only does the program require excellence, but it needs to be guided by a visionary nursing leader who supports, advocates, and practices nursing excellence.

The 14 characteristics of nursing excellence, according to the American Nurse Credentialing Center include:

  • Quality of Nursing Leadership
  • Organizational Structure
  • Management Style
  • Personnel Policies and Programs
  • Professional Models of Care
  • Quality of Care
  • Quality Improvement
  • Consultation and Resources
  • Autonomy
  • Community and the Healthcare Organization
  • Nurses as Teachers
  • Image of Nursing
  • Interdisciplinary Relationships
  • Professional Development

Nursing Excellence, Hospital Scores, and Physicians

Press Ganey's study explored the relationship between Magnet status and National Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. This standardized publicly reported survey looks at the patient's perspective on hospital care, including the environment and how well physicians, and nurses communicated with them during their care experience.

The Press Ganey survey found a connection between Magnet Status, which indicates nursing excellence, and higher patient ratings of their doctor’s skill, responsiveness, and bedside manner. While the difference appeared subtle in number, there was a meaningful difference in the patient’s perceptions. Out of 123 Press Ganey client hospitals, the survey found that 45 percent of those in the top quartile for engagement of physicians were also Magnet hospitals. Compare this to the 16 percent of bottom quartile facilities who also shared the Magnet designation, and you can see how nursing and physician care must be intertwined to deliver care that is perceived by the patient as having them in the center and being of the highest quality.

Improving Nurse-Physician Relationships

Considering that only about 8 percent of all hospital in the US achieve Magnet designation, we must find ways to enhance the nurse-physician relationship outside of this prestigious designation. Here are a few ways you can work on your relationship with the physicians in your facility to increase collaboration and positively impact patient outcomes.

Practice as a Team

While nurses spend far more time at the bedside than doctors, it’s critical that we remember that we each have a unique role in patient care. Share in the responsibility of patient outcomes with all staff members and work collaboratively.

Uphold Professionalism

When nurses uphold professionalism, the workplace runs smoothly. This includes simple things like getting to work on time, avoiding negativity, and working both autonomously and collaboratively.

Develop a Strong Sense of Advocacy

One of the pillars of nursing practice is to work as a patient advocate. You must learn to speak up for the patient and let the physician know your observations and thoughts about the patient’s condition. This can be difficult, depending on the type of relationship you have with the physician and other clinicians in the healthcare setting.

Practice Effective Communication

The ability to communicate with coworkers, including doctors, is critical to positive patient outcomes. You must learn to organize your thoughts before you pick up the phone. If you find yourself struggling to communicate concisely, check out a few different communication tools that can help you standardize your reports to the physicians and fellow nurses. Having a clear report can help the receiving clinician understand the patient’s needs better so that a comprehensive plan that addresses the most critical areas can be developed.

How do you feel about your relationship with the physicians in your facility? Do you think that you have a good relationship, built on mutual respect? We would also love to hear from nurses who work in magnet hospitals to learn how you feel about your ability to support physicians and how the two groups work together. Let us know what you think by commenting below.

Reference:

How Great Nursing Improves Doctors' Performance

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Melissa Mills

About Melissa Mills, BSN

Workforce Development Columnist

Melissa is a professor, medical writer, and business owner. She has been a nurse for over 20 years and enjoys combining her nursing knowledge and passion for the written word. She is available for writing, editing, and coaching services. You can see more of her work at www.melissamills.net.

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Specializes in Critical Care.

I work at a magnet facility, a large teaching hospital. I feel I have good relationships with medical staff, and enjoy getting to know residents on their various paths through training. Many nurses are either intimidated or have a “us vs them” attitude about physicians. If you learn to get to know each person as someone who is here to learn and provide great care, it makes life easier. We can learn from each other. Forming good relationships of trust (especially attendings who aren’t going anywhere), improves patient care: when I have something important I need to share, I am better able to make my thoughts known when I have a good working relationship with the physicians caring for the patient. I love the teaching hospital environment, and hope to spend my entire career being a part of it in some capacity.

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I also work in a Magnet, large teaching facility. I've worked in several as an RN or PCA/NA.

I will say, the relationship between physicians and nurses is very different in the OR than it is elsewhere. I recognize that some ORs are not fortunate, that some institutions still have abysmal working relationships in their ORs.

I have the best relationships with my physician colleagues working in the OR. The residents are all called by first names (or by some nickname), and if you've been there a while, perhaps the attendings are referred to by their first names too. The level of trust required in both directions is immense. I've seen our surgeons defend us relentlessly to patients/family members who think we're not qualified... I had one patient's parent who said I was not possibly old or smart enough to care for their child let alone be employed at all or have graduated from nursing school. This surgeon very politely disagreed, saying they would let me care for themself, their spouse, their mother or their children - without hesitation. Never would that have happened on the floor/ICU or in clinic.

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