Setting the stage...
Nurses and doctors have been having power struggles in the Operating Room lately causing the quality of care to be impacted as well as leading to short staffing from nurses calling out at the last minute. Frustration has resulted in a hallway shouting match between a nurse and a surgical resident...one left crying, the other left angry and refusing to work with the other again.
In come the Nurse Manager and Medical Director of the OR...neither was aware of the extent of the problem but both must work together to fix the tension and work relations!
"Do two walk together unless they have agreed to meet?" -Amos 3:3 ESV
MAKING A PLAN TO COME TOGETHER AND FIX THE PROBLEM AT HAND...a round table meeting will be called and ground rules will be set...NO BLAMING, STATE FACTS and PERCEPTIONS in a NEUTRAL TONE, LISTEN TO ONE ANOTHER in order to LEARN...
Together, nurses and physicians need to sit down and discuss what it is that each wants from the collegial relationship and they must think about how they should behave in order to achieve the common goal of having a smooth running, high quality unit. It is not about blaming the other side or winning the battle...it is about mutual respect for the strengths of each discipline and the mutual commitment to achieving the common goal. (Patterson, Grenny, McMillan, & Switzler, 2012).
The nurse manager and medical officer have agreed to start out with a good CUS ...Concern, Uncomfortable, Safety! (Agency for Healthcare and Research Quality, 2014)
As the manager I am Concerned about the negativity between the doctors and nurses...I am Uncomfortable that people do not feel welcome and happy with their work environment...and the Safety of our patient care is at risk...We need to fix this!
Some possible interventions to improve Nurse-Physician collegial relations: walk a day in the other persons shoes - have a day where nurses and doctors shadow one another in order to gather a better appreciation for what it is the other side does; initiate a change of shift multidisciplinary huddle - the nurses and doctors are expected to attend and briefly talk about the day and what went well and what did not; plan team building exercises between nurses and physicians - something as simple as high fives or thumbs up when passing in the hallway goes a long way in building interdisciplinary morale.
The Nurse Manager and Medical Officer must present a united front and be open and available to hear concerns while at the same time setting the clear expectation that this workplace negativity will not be allowed to continue.
"From whom the whole body, joined and held together by every joint with which it is equipped, when each part is working properly, makes the body grow so that it builds itself up in love." -Ephesians 4:16 ESV-
Agency for Healthcare and Research Quality (2014). Appendix. Example of the SBAR and CUS Tools. Agency for Healthcare Research and Quality, Rockville, MD. retrieved from http://www.ahrq.gov/professionals/systems/long-term-care/resources/facilities/ptsafety/ltcmod2ap.html
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial Conversations: Tools for Talking When Stakes Are High (2nd ed.). New York, NY: McGraw-Hill.
The Holy Bible ESV: English Standard Version: containing the Old and New Testaments. (2007). Wheaton, IL: Crossway Bibles.