Medical Mistakes are ranked as the third deadliest condition, on that list are heart disease and cancer also. A BMJ study in 2016 found that 250,000 deaths each year are a result of medical Error. Unfortunately, most of the time this is human error that is resulted by miscommunication (Howley , 2018).
In this age of medical care, most facilities utilize multidisciplinary teams for patient care. As a patient you can see at least a dozen people in one day on a nursing floor each performing their own tasks. These could be doctors, nurses, nursing assistance, physical therapy…etc. Unfortunately, with all these people performing and focusing on their own plans of care this is where the issue of communication can become an issue. There is also the problem with how busy and the patient load of each could also play a factor in this poor communication (Howley , 2018). But that is only a tip of the iceberg.
Specifically, for doctors and nurses, we only see what our job is and how that needs to be performed. Doctors see themselves as “calling the shots” and having the most responsibility. They see it as they make all final decisions so there isn’t a true need to listen to the nurses. Nurses on the other hand, are the ones performing most of the bedside care and unfortunately do not always speak up. It is this hierarchical system between the two professions that is perceived as the biggest factor in the miscommunications in patient care. In a brighter light, there has been times where this imbalanced dynamic is pointed out and communication is improved (Howley , 2018).
This miscommunication is dominantly done during “hand-off” reports, this is where most of the information is misinterpreted or missed entirely. Another way this is done is buy bullying that happens frequently. One will blame the other for bad behavior or communications, usually the doctor being perceived as the bully, but this is a two-way street. For instance, there are nurses who bully residents due to being young and that is what they have dealt with from other doctors. It is an ongoing cycle (Howley , 2018).
In the U.S. we are a nation of many different nationalities and cultures. With this mix there is always going to be different ways of communication within those cultures and how those people face authority figures. Gender gaps can also play a part in these miscommunication issues. When looking at the nursing profession, they are typically dominated by females and physicians are usually male. However, no matter the reason, there needs to be an approach used before these individuals enter the workforce to improve these skills (Howley , 2018).
At UCLA they are taking the approach of interprofessional training groups. With these they are having Dentists, Nurses, and Doctors take classes together. This not only fosters the idea of communication, but this allows them to understand each discipline, what they do, and why they are important. The hope is that become more aware with each other and in return they build those lines of communication and trust resulting in fewer medical errors, at least those resulting from communication (Howley , 2018).
Introducing these different disciplines before they even enter the workforce could also change how current things are performed. For instance, physician rounds are usually just that between physicians. But with the idea of including all disciplines for rounds, nurses being the people that see the patients most often, there could be a more complete picture when rounds and decisions are made (Howley , 2018).
As for the patients, they need to act as advocates for themselves as well to be sure the correct information is out there for everyone. And if possible, have another family member to also be another ear for this information. They should also know their rights, such as, asking for other care team members if they feel there is a lack in their care in any way from those who are performing it now (Howley , 2018).
I chose this article from U.S. News, the article was published September 5th, 2018 and was retrieved from https://health.usnews.com/health-care/patient-advice/articles/2018-09-05/how-communications-issues-between-doctors-and-nurses-can-affect-your-health. As for the article itself I absolutely agree communication between disciplines needs to be improved in whatever way possible. As a nurse I have experienced these “bullying” issues from nurses alike. Just for example I have had an attending physician literally raise his voice to me and ask why I was contacting him and not the resident. Meanwhile, the patient was critical, and the resident was questioning themselves and were seeking more guidance. This was as a brand-new nurse on a post op transplant unit. So, to be able to seek out the guidance from the experienced nurses and physicians was something I felt I should be able to do.
I like the idea of including these individuals in certain classes together. This would help bring the idea of humanity to the table. The idea of one is not better than the other, that we each have a job to do it, though it maybe different, it is all to benefit the patient. These classes might help give confidence to those new nurses (I was one myself) that see the physician as the most knowledgeable and knew more than a nurse ever could, so their decisions were always best. Yes, of course physicians have much more education than nurses do, but that in no way makes all their decisions the best. And I have found that as a nurse we have much to offer in our assessments and findings as well. On the other hand, as mentioned, it could also give the physician an insight into the nursing discipline and how hard we work and dedicated we must be to earn our degree as well.
Unfortunately, we would have to change a whole culture that is formed in the medical field. Each of our disciplines have developed and become more skilled but, we still do not know how to appropriately communicate with each other. Hopefully, more education is done not only in these colleges, but even bringing everyone together for classes within the hospital unit could be beneficial. Getting to know each other on a more human level to me could be part of the answer to this issue. Overall, we need to remember this isn’t about any one of us personally, patients are being affected and we need to improve these outcomes.
Howley , E. K. (2018, September 5). How communication issues between Doctors and Nurses can affect your health. U.S. News. Retrieved from https://health.usnews.com/health-care/patient-advi…