In Sickness and In Health Physician-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 Jul;20(5):

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!!!!!!! Van Bogaert et al. 2009, Wieck et al. 2010, Cowan et al. 2008, Rafferty et al. 2001

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” Coombs & Ersser 2004

Physician-Nurse Collaboration Fundamental to: 1)improved outcomes 2)error and risk reduction 3)optimum care/patient satisfaction Clough J, Forum, May 2008 Vol 26 Number 2 p1-2

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 Sep;16(5): 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 Nov;34(11 Suppl):S337. Physician-Nurse Collaboration

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 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 Jul;20(5):

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