iceteastock – Fotolia.com
In this article on Canada.com, a professor of nursing named Laurie Gottleib examines the role that nurses have in educating doctors.
She points to the combination of theoretical and practical knowledge that nurses possess, as well as their tendency to be much more accessible than senior doctors. Nurses frequently point out the warning signs of a patient’s deterioration to medical interns and residents, correct their misinterpretations of signs and symptoms, suggest diagnoses, and anticipate when and how to intervene. In this recent post about the “July Effect,” for example, a nurse recounts how she had to convince a new young doctor that his patient was in dire need of more pain medication.
Gottleib says that physicians are often grateful for this sort of guidance, yet nurses are not usually given credit for their role in doctors’ education.
Knowledgeable nurses protect the system in countless ways, not least by ensuring that physicians have the most up-to-date and salient information about their patients so they can make medical judgments and take appropriate action.
They are people who have committed themselves to nursing as a career and have selected workplaces that value nursing. Experience working in one place or with one group of patients is required to develop expertise and intuitive know-how – a key to reading the signs correctly and predicting which patients are in trouble.
Two decades of research have exposed the deleterious effects of devaluing and undermining nurses and nursing. The cost has been high in terms of nurse burnout and patient morbidity and mortality.
Research has also revealed the conditions needed to retain professional nurses. When nurses are recognized and respected for their expertise and given status, resources and opportunities to function autonomously within their scope of practice, they stay in the profession. The most intriguing finding in this research is that the most consistent predictor of nurse satisfaction and good personal health (i.e. a low burnout rate) is positive professional relationships with doctors. When doctors partner with nurses and there is clear communication between them, patients’ needs are met.
Within the McGill university and hospital network these lessons have been heeded. For example, there has been ongoing dialogue within McGill’s Faculty of Medicine and School of Nursing about how to improve inter-professional education. (This discussion extends to physical and occupational therapists and speech therapists.) At the Jewish General Hospital, nurse-physician partnership is the organization’s managerial structure in all matters of patient care.
These are important beginning steps for restoring the health-care system and a healthy nursing workforce. We are still recovering from the effects of the recent past, when Quebec’s nursing operations were dismantled and the nursing workforce was left not adequately prepared for today’s health-care challenges.
In the next decade we need to continue to build a workforce of front-line nurses who are well educated, knowledgeable, skilled, compassionate and committed to nursing as a career. Quebec nurses took this step themselves when they voted at this year’s meeting of the Ordre des infirmières et infirmiers du Québec to make university education a basic requirement for entry into the profession.
Employers need to continue to create workplaces where nurses are given support to practise to the full extent of their training, and where physician-nurse partnership is the governance structure. Physicians need to treat nurses as respected and valued partners, not as subordinates. Nurses need to embrace these new opportunities and become accountable for their practice. And governments need to dedicate resources to support innovative nursing roles that complement those of doctors and other health professionals to meet the complex needs of patients and their families.
When this happens, the health-care system will be transformed and quality, safe patient-and family-focused care will follow.