5 Tips for Nurses to Avoid Conflict with a Physician

By Stacey Mitchell on Thu, Jul 10, 2014

nurse-physician conflict

Our nursing jobs require us to speak with physicians about our patients. But how many of us have anxiety over calling the physician on behalf of our patients? All of us, at one time in our careers, have been nervous. Our palms itch while we recite in our head exactly what we would like from the MD. 

Relax! One of the most supportive things we do for our patients is having those crucial conversations with our MDs. Being a patient advocate does not need to put a strain on the nurse-physician relationship. After all, we are all on the same team.

But if the relationship you have with a particular physician is a strained one, then you are not alone. It comes with the territory. Here are some tips to improve the nurse-physician relationship:

  1. Use the SBAR (subjective, background, assessment, and recommendation) technique when communicating with a physician. This will allow a quick systematic approach to ultimately getting the orders you need to take care of your patients.

  2. Make sure you are communicating with the physician that is best trained to handle your request. Patients could have five different consultants on their case. So if you are calling a physician about post-op bleeding, make sure you call the surgeon. If you just need to adjust some medication orders call the generalist on the case, and so on and so forth.

  3. Ask a co-worker what they would do and say. Some nurses may have a better relationship with certain physicians than others. Ask around and get opinions from a more experienced nurse or maybe a nurse that has been in the system longer. 

  4. Keep your eye on the prize. Before you dial the number or stop him/her in the hall, you should already know the answer. Your suggestion should be exactly what orders you need. Physicians are not at the bedside so they need a gentle guide as to what and why you are requesting. 

  5. Chart it! Make sure you notate the call and the subject if orders were or were not received. It only takes one time for them to learn that you also know how to C.Y.A.

Do you have other tips to improve a nurse-physician relationship? ‚Äč



3 COMMENTS

Margaret Milam 5 months ago
How about for #1: You have a concern about your patient. It is not only "ok" to call the Doc but it is your obligation. Why is it put upon nurses to have a civil conversation with the Doc? After 40 yrs of critical care bedside nursing, in most cases I could write the order my patient needs myself. But, that is outside my scope of practice. So, Docs, be civil, give the order the patient needs and help the nurse care for the patient. And, nurses, when you have to call the Doc in the middle of the night...grow a pair.

Chris Forward 5 months ago
As an NP I'm on the receiving end of a lot of calls from home health RN's out in the field. I have a lot of respect for their experience. The main thing I ask is that you consider that I'm probably returning your call between patients, so have your facts organized and complete when we speak, paint a clear picture of what is going on with objective data, what may have been tried in the past and failed or worked, and what suggestions you are calling with. Having been an RN for 20 years first, I know just how knowledgeable these folks in the trenches are!

Anonymous 5 months ago
I was on a travel assignment 2 years ago in CT. I am from the South which means, I am used to having a bit of conversation with the doctor first. Well, I had a rude awakening when one of the first times I had to call the MD and I started the conversation by saying, "Good evening, doc, how are you?". He briskly answered "what is the purpose of your call?" - to which I thought was so rude as I clearly I was just trying to be polite and just establishing rapport. I was just shocked at how rude I was treated that I fumbled my words and really got embarrassed.

It's refreshing to be back home where you do get to know the physicians and you can actually have conversations with them without feeling like you are about to get your butt handed to you. IF I could re-do that conversation again, I would've stood up for myself a little bit more and said something sassier like, "Sir, I am not making a social call, I am calling on behalf of...", but instead, I stumbled and stuttered and frankly embarrassed myself.