5 Tips for Communicating With Doctors...

Communication is the cornerstone of patient care.

We communicate continually with patients, nursing colleagues, other healthcare providers.

We communicate verbally, through body language, on paper, by computer, or through text messages and email.

Of all nursing communications, those with physicians can be the most important, and the most problematic, because physicians are often off-site, depending on our communication to tell them exactly what is happening.

Here are five tips to help ensure your nurse-to-physician communication is clear, concise, and  gets your point across so your patient gets what they need.

1. Know what you want to accomplish.

Make a list of what you want to talk about before you make the call to the physician. If there are multiple issues, prioritize them. The physician may be taking call and not know the patient, so know what you want to accomplish with the communication.  Are you reporting a change in a patient’s condition? Do you need an order? A change in medication?

2. Collect your data

Have everything at hand before you call. Get a recent set of vital signs, including intake/output. Have the chart, including lab results and the medication record in front of you. You will need to know a brief history of the patient, and you will need to anticipate questions, especially if speaking to an on-call physician. Be ready.

3. Be clear and concise

By now we’ve all know about the SBAR style of communication: Situation-Background-Assessment-Recommendation.  Let me tell you, this is a godsend for communicating in healthcare.

Basically, it’s (a) here’s what’s we have, (b) here’s how it started, (c) here’s what I believe is happening and (d) here’s what I’d like (or like you) to do about it.

Short. To the point. Direct. Let’s roll. You have no choice but to be direct and concise using this method.

4.  Stay focused.

Sometimes physicians are not receptive to receiving a call. They may be preoccupied. It may be the middle of the night and you waking them up from a sound sleep. You may have interrupted a sports broadcast, their dinner, or they just aren’t happy to be called about “work” right at that moment. They might get angry. They might yell, or bring out the sarcasm so thick it can be sliced.

Tough. Don’t get caught up in their tone or behavior, or respond to it. This is why you make a list of what you need to discuss, so you are not flustered. Do not apologize for calling or “interrupting” or act in any way subservient. You are not doing anything wrong. Speak clearly and state what you need using SBAR. Repeat any orders back to the physician. If they hang up on you before you can do that, document this on clearly on the chart.

(Lest anyone think I am being overly dramatic in my examples,  I have been personally yelled at for interrupting football games and dinner. I have been hung up on before I’ve been able to repeat verbal orders. After waiting until 7 am to call a surgeon, he screamed at me for waking him at 7 am. This is a reality for nurses.)

5. Document everything.

This step is obvious, and is for your protection and for the physician’s, also. Document the time, what was communicated, what was ordered and what was done. 

One last note – if something significant occurs on the night shift that does not require a call to the physician, but you feel should be communicated to the physician, consider calling them before you leave and speaking to them directly. Your insight and direct observations are things that can get lost in the translation in reports or in notes left on charts. By directly communicating, you can ensure the physician knows exactly what you saw, and the plan behind your nursing interventions.

In summation, communicating with doctors can be easier and more productive if you know what you want to say, are organized before you begin the conversation, communicate clearly and concisely, stay focused on the goal of the communication, and document clearly all aspects of the communication.