October 28, 2010 | | Comments 0
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Who is running the care of the patient?

A friend of mine went into labor with her first child a few months ago and accounted that while she was receiving her epidural, the administering doctor and nurse were arguing over the proper way to insert it, and who was most fit for the job.  She described it as an “ego battle,” full of frustrated sighs, snide remarks, a few eye rolls, and what appeared to be a complete lack of attention to the fact that the patient was in the room, let alone on the receiving end of their needle.

Like any relationship, the one between physicians and nurses isn’t always smooth, but it’s definitely one that shapes many aspects of the healthcare environment.  Perhaps the most important one in this scenario: patient care.

The tension—particularly in my friend’s case—seems to revolve around who has the biggest impact on the care of the patient, and the role each party plays in decision-making. Physicians are the ones we often hand-select, book appointments with, and trust with the responsibility of our treatment. But nurses are the ones who manage our care, interact with us the most, keep us calm, and genuinely “take care” of us when we’re ill.

A recent blog post on NYTimes.com gives an account of the struggle that can occur when doctors and nurses disagree with each other, and asks whether the physician-patient relationship has more or less merit in making treatment decisions than the nurse-patient relationship.

The blog post says that because nurses spend so much more time with patients than doctors do, they have a different perspective on how the patient is really doing, often one doctors are unable to see, and a more intimate relationship with the patient.  This means that nurses should play a large role in decision-making. But, when nurses don’t have the authority to make certain care decisions, how do they ensure the patient is being properly treated?

I think the answer lies in good communication and collaboration between nurses and physicians to provide positive patient outcomes. When doctors and nurses don’t work in partnership —like the ones who treated my friend during her labor— it could seriously affect a patient’s recovery and add more stress to a their already vulnerable state. Physicians and nurses should view each other with mutual respect for the role each one plays in the recovery of a patient. Physicians are relied on for their expertise, even though they may not spend as much time at the patient’s side. Nurses may not have ultimate say, but they can have the responsibility of advocating for the patient to make sure they receive the best care possible, and the power to share information with all levels of medical staff to make sure good decisions are being made.

What do you think is the best way for nurses to make sure decisions are being made in the best interest of the patient?

Source: NYTimes.com

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Jaclyn Beck About the Author: Jaclyn is an Associate Editor at HCPro, Inc. She manages three monthly newsletters; Strategies for Nurse Managers, Briefings on Infection Control, and Briefings on Hospital Safety, and manages four ezines; AHAP Staff Challenge, Infection Control Weekly Monitor, Hospital Safety Connection, and Nurse Manager Weekly. She graduated from Gordon College in 2007 where she earned her bachelor's degree in Business.

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