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When Facilities Promote Excellent Nursing, the Whole Healthcare Team Improves

Many patients believe top-notch care depends their physicians, but in collaborative treatment settings, nurses have a much greater impact than they might think. For example, it’s been well-documented that high-quality nursing lowers mortality rates, improves patient outcomes overall and even boosts revenue.

Now, research published in Harvard Business Review indicates that facilities actively promoting excellent nursing through magnet programs and other similar initiatives have higher patient-satisfaction ratings for their physicians, as well.

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To get a sense of the association between nursing and physicians’ care, the authors looked at hospitals that have achieved the “Magnet” designation through the American Nurses Credentialing Center, part of the American Nurses Association. The Magnet Recognition Program judges hospitals based on qualities such as nursing leadership, organizational structure, professional development, autonomy for nurses, interdisciplinary relationships and more. Fewer than 10 percent of U.S. hospitals have earned this status.

The authors also combed through these facilities’ HCAHPS patient satisfaction survey scores and Press Ganey’s database of over 2,000 healthcare organizations. The most significant findings include:

  • Patients at Magnet hospitals were more likely to recommend their treatment facility than those at non-magnet hospitals.
  • Patients believed physicians at Magnet hospitals were more concerned about the their questions or worries than those at non-magnets. (Researchers use this metric to assess physicians’ courtesy and respect, listening and explaining.)
  • Patients at Magnet hospitals gave their physicians’ higher approval ratings for “time spent with you” and “skill of the physician” than those at non-magnets.
  • About 45 percent of hospitals in the top quartile for physician engagement were Magnet hospitals, compared to only 16 percent in the bottom quartile.

Because receiving a Magnet designation requires the hospital to excel all around, the results aren’t exactly shocking. But it does show that prioritizing nurses’ autonomy, relationships and leadership prompts a ripple effect across all staff, regardless of their title or education.

Tips for Communicating with Physicians as a Nurse

Regardless of whether you work for a Magnet hospital, communicating with physicians can be intimidating, especially for new nurses. Below are some tips to make the interaction better for both of you.

Be prepared. Know what you want to discuss with the physician and what you hope to gain from talking to him or her. Making lists can be helpful.

Trying to decide whether to call at all? Try this litmus test from the Daily Nurse: What would you want the nurse to do if the patient was your family member or friend?

Collect your data ahead of time. For starters, know the patient’s diagnosis, allergies and what medications they’re taking. And be ready to present their latest labs and vitals.

Confidence is key. If you’re in person, make eye contact and stand up tall. Also, try to avoid apologizing for calling. It’s part of your job, not to mention physicians don’t feel obligated to apologize when they call nurses. If you receive attitude, try not to get caught up in it.

Be as concise as possible. Try sticking to the Situation-Background-Assessment-Recommendation style of communication. Break down what has happened, how you believe it started, what’s happening now and what you’d like to do or what you need help with.

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Focus on your patient’s needs. Ultimately, you’re seeking a physician’s assistance because you want to give your patient the best care possible. If you don’t speak up, then you could be putting your patient at risk.

In some circumstances, you also may considering calling the physician at the end of a shift to talk about a treatment decision you made even if it didn’t require a call. Charts don’t always tell the full story.

Document the communication. As much as possible, write down the time of the interaction, what was said and what was done. And if the physician acts inappropriately, such as by being condescending or demeaning, don’t hesitate to report the behavior.

How Great Nursing Improves Doctors’ Performance, Harvard Business Review.

Last updated on 10/3/19.

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