clinical innovations, asking rurses for help -Twenty Clinical Innovations to Build Patient-Doctor Trust: Third of aA Series

On Physicians Asking Nurses for Help in Building Patient Trust

Today’s blog is elemental. My message is this:

Busy doctors should rely more on observant nurses to help increase productivity, save time, and build patient trust.

In The Successful Physician: A Productivity Handbook for Physicians (Aspen Publications, 1998), Dr. Marshall O. Zaslove, a Napa Valley psychiatrist nationally known for his productivity seminars for overburdened doctors, says practitioners would be happier and more productive and have more trusting relationships with patients if they would simply listen to office nurses, follow their advice, and respect their judgments. Nurses, he believes, are potent messengers of patient trust.

Doctors, according to Zaslove, don’t give nurses opportunities during a busy day to help because they don’t consult the nurses. Doctors don’t listen to nurses, he says. This lack of attention frustrates nurses. That is why nurses are heard to say. “He just doesn’t listen!” “He doesn’t know how to work as a team.” “He doesn’t respect us.” “He’s not working safe.” “He refuses to accept our help.” When nurses voice these feelings, they are indicating doctors may be too arrogant, myopic, money-hungry, or afflicted with tunnel vision to listen.

Doctors, maintains Zaslove, should step back, listen, and ask nurses: “How could I do this better?” Can you help me do it better?” “Should you be doing this rather than me?” “Am I missing something here?” “Am I being arrogant?” ”Am I scheduling too many patients?” “How do you think we can better address his patient’s problems? “How we better build this patient’s trust?”

Zaslove advocates teamwork to build trust. In From Chaos to Care (Perseus Publishing, 2002), David Lawrence, MD. Chairman emeritus, Kaiser Permanente, refers to the “promise of team-based medicine” to achieve competence and trust. Teamwork can be applied to small practices as well as large ones. Building trust requires clear communication by doctors with patients -- and with nurses. Zaslove advises doctors to step back, stop, look, listen carefully to nurses, trust them.. Nurses are on their side and the side of patients. We –doctors, nurses, and patients – are all of us in this together, and it will take all of our talents, knowledge, and trust to make it work.

Patients trust nurses. Patients find nurses approachable, easy to talk to, and nurturing. Patients share with nurses intimate details they don’t share with doctors. Patient trust of nurses is a simple, irrefutable, unarguable, universal fact.

The power of nurse trust by patients has not been lost on health care organizations. Nurse trust is why hospitals have had such great success with “Ask a Nurse” programs.; why American Healthways, other chronic disease firms, health plans, hospitals, and health systems vigorously recruit nurses and why nurses are more in demand than any other job category in America..

There are not enough nurses to go around. There may never be. Nurses have medical knowledge, speak the medical language, understand disease, and are emphatic listeners and caregivers. They are an indespensible and irreplaceable asset and resource.

My wife, a nurse, says the foregoing should be accepted with absolute certitude as a self-evident truth.