Physician Communication

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Physician Communication
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Problems of the Nurse

• Doctors fail to respond in a timely manner
• Issues over orders
• Doctors can often be disrespectful to nurses

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Problems of the Doctor

• Little money in long term care medicine
• Nursing home is less of a priority than hospital
  and office work
• Nurses are perceived as disorganized and not
  having good assessment skills

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The Solution

• Fix your communication!!!

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Basic Ideas

• Ask for what you want
• Be concise but complete
• Be prepared for physician calls by having
  everything you need on the resident ready (chart,
  vitals, labs, etc.)
• Make rounds with doctors
• Be a resident advocate

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Improving Your Calls

• Dont apologize for calling
• Have what you need before you call
• Be concise and complete
• Think like a doctor make an educated guess about
  what you think the resident needs before you call
• Repeat back a summary of the conversation to the
  doctor

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Dealing with Dr. A-Hole

• Tell them you are putting them on speaker phone,
  and actually do it.
• Say You are being verbally abusive to me. I am
  hanging up. Please call back when you are
  calmer.

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SBAR

• Situation (current problem)
• Background (brief history)
• Assessment (whats wrong)
• Recommendation (what you would do)
• Now do some roleplaying!!

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Exercise 1

• Mr. Smith is a 72 year old man with COPD who is
  coughing up large amounts of thick green sputum.

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Exercise 2

• Ms. Jones is a 84 year old woman with vascular
  dementia who is newly incontinent of urine. The
  urine smells and she has a temp of 100.2 PO.

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Reading Recommendation

• Barholomew,Speak Your Truth Proven Strategies
  for Effective Nurse-Physican Communication.
  HCPro, 2004.