Poor communication between doctors, nurses puts patients at risk

Care mistakes in the hospital often happen due to communication breakdowns between nurses and doctors, according to a recent study from University of Michigan researchers.

The pilot study looked at potential causes of communication failures by recording interactions between nurses and doctors, who then watched and critiqued the footage together. The UM researchers following physicians and nurses at Michigan Medicine, concluding that video could be used as a training tool for improving communication.

The recordings found that nurses weren’t explicit in their communication with doctors, from not directly requesting what they wanted or needed. The hospital hierarchy that puts nurses at a power disadvantage was found to be one barrier to good communication, with many who are afraid to speak the truth to doctors, according to Milisa Manojlovich, a UM professor of nursing and a researchers of the pilot study.

Understanding between doctors and nurses was also divided because they approach care differently, the study found.

For example, a patient with mouth pain cause by a fungal infection couldn’t swallow the pills she needed to get better. While the doctor wanted to treat the patient with more medicine, the nurse wanted to treat the patient with painkillers, as well, so the patient could swallow the pills.

“The physician realized that the pain was inhibiting the treatment, and treating the pain, as well as the condition, would solve the problem,” Manojlovich explained.

The study also found that body language tended to mimic communication. Doctors and nurses mimicked each other when they had good communication, but they weren’t in sync in strained relationships.

Reviewing the footage was beneficial for both physicians and nurses to recognize and see opportunities to improve their communication behavior. The study was published in the British Medical Journal in July.

“One physician said, ‘I didn’t give the nurse a chance to answer,’ and this physician had a habit of doing that and recognized it,” Manojlovich said. “She was one of the champions of the study.”