5 ways to improve ER physician-nurse relationships

To improve on the ever-present physician-nurse tensions in the emergency department (ED), emergency medicine group CEP America stressed the importance of creating a collaborative ED management process.

The ED environment can be particularly stressful at high-volume and high-acuity times.

For example, an ER physician might be slow to accept help after several failed attempts at intubation or a chief nursing officer may decide to add bed capacity to a step-down unit without seeking input from the manager of the unit.

"In each of these examples, individuals are focusing heavily on themselves, not on the resources around them. In healthcare, we focus heavily on competence, as we should," wrote Gary L. Sculli, a registered nurse and clinical program developer, and David M. Sine, a member of The Joint Commission's Committee on Healthcare Safety, in an HCPro Staff Development Weekly article. "However, when we focus so much on individual competence and performance that we expect perfection, harshly judging the skill set of practitioners needing help in clinical situations, we do so at the patient's peril," they continued.

With support from on-site nurse directors, the emergency department can be a collaborative, mutually respectful environment, according to the white paper released today. CEP America pointed to the following strategies as best practices for developing and strengthening ED nurse-physician relationships:

1. Hold weekly medical director/nurse director meetings to discuss operational issues. Consider including administrators too.
2. Involve physicians at ED nursing staff meetings and include nurses at ED physician meetings.
3. Plan annual or biannual nurse-physician strategic planning retreats to discuss mid- and long-term issues.
4. Solicit nurse, ancillary personnel and interdisciplinary involvement in identifying and solving operational issues.
5. Develop a cross-disciplinary ED advisory group to address department issues.

For more information:
- check out the white paper (.pdf)
- see the HCPro Staff Development Weekly brief

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