Observations

How to Speak Physician

Approaching them, communicating with them and just plain making it work

Prior to becoming a nurse, my impression of the nurse-physician relationship was that physicians wrote the orders and nurses carried them out. Those orders were clear and concise, and everything was great!

Here’s the reality: Physicians do write orders, but nurses must make sure those orders are correct and appropriate for their patients. Nurses must ensure that patients aren’t allergic to the medications prescribed and that there are no contraindications. Nurses must also report critical lab values, relay patient questions/concerns and follow up on treatment plans.

Simply put, nurses are in frequent back-and-forth communication with physicians, often having to approach and interrupt them to make certain they have what they need to take care of patients. This can be very intimidating.

It took me a few years, but I finally established a plan of attack for achieving success in these interactions. Here they are:

Give them their due.

Physicians work hard to get where they’re at. So, regardless of whether you like them or not — or whether they’re a seasoned physician or one who’s brand new — address them appropriately and be respectful.

Be mindful of their personality and demeanor.

Are they easygoing, matter-of-fact or somewhere in the middle? Approach them accordingly.

Get to the point and take notes.

When you approach a physician, know exactly what you’re going to ask for or inform them about. If you need to go over several things, write them down — and write down the physician’s responses. It’s easy to get sidetracked and quite humiliating to repeat these conversations later while the physician stares at you like you belong in the zoo.

Always catch the physician in person if you can.

Physicians get frustrated if instead of approaching them when they’re making rounds and accessible, you page them when they’re on another floor or as they’re driving home to have dinner with their family.

Use the word “clarify” where possible.

Physicians have a lot on their plates; occasionally, they write orders that aren’t completely clear.  For example, suppose a physician writes an order for a dressing change, but you’re not sure what type of dressing change the physician wants. Instead of saying, “I don’t understand what you mean here,” say something like, “I just want to clarify your order for dressing changes on this patient. Do you want a basic wet-to-dry or did you have something else in mind?”  By framing your question as a clarification, you won’t come across as criticizing them for not writing a clear order. You’re just showing them you care enough about the patient (and about doing what the physician wants) to follow up and avoid confusion.

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Anticipate follow-up questions and have those answers ready.

For example, if you page a physician to inform them their patient’s blood pressure was elevated at 2 p.m., they’re more than likely going to ask you what the previous two blood pressures were. They’ll want to know if it has been trending up all day or if this was the first occurrence. Make sure you have those details at hand before you speak with the physician.

When absolutely necessary, stand your ground.

For example, if a physician ever tells you to do something outside your scope of practice, don’t do it! No one should be a doormat, and we all have times when we just can’t take it anymore. However, pick your battles wisely and fight them with the least amount of ammunition possible.


Nancy Congleton, RN, is a registered nurse and author of Autopsy of the NP: Dissecting the Nursing Profession Piece by Piece, released in August 2018. Learn more at www.nursenancyrn.com.


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