NEW YORK NURSE: May 2009
Q.: Can a physician tell me what I should or should not say to a patient or family members?
A.: Registered professional nurses practice under their own licenses and are responsible for their own practice. Nevertheless, this is an interesting and not uncommon question (Center for Nursing Advocacy, 2009). The most direct answer is “No!” – physicians cannot dictate what nurses say. However, we must look further into this question because there are deeper issues involved.
The real issues are two-fold: professional autonomy and collaboration (Kirchhoff & Beckstrand, 2000). In general, physicians focus on the medical aspects of a situation while nurses function as patient advocates. Both professions have autonomy and the shared goal of providing good care. Problems arise when the perspectives and roles conflict and mutually respectful collaboration is lacking (Hojat et al., 2001).
The complementary roles of nurses and physicians can be facilitated and supported through interdisciplinary collaboration (Hojat et al., 2001). This can be fostered through cultural changes such as multi-professional rounds and ongoing dialogue (concerning ethical and intervention issues) among members of the healthcare team. All of these things will indeed help patients, their families, and nurses to reach their respective, and often similar, goals.
Center for Nursing Advocacy (2009). Q: Are you sure nurses are autonomous? Retrieved 3/23/09 from http://www.nursing advocacy.org/faq/autonomy.html
Hojat, M., Nasca, T.J., Cohen, M. J.M., Fields, S.K., Rattner, S.L. et al. (2001). Attitudes toward physician-nurse collaboration: A cross-cultural study of male and female physicians and nursing in the United States and Mexico. Nursing Research. 50. 123-128.
Kirchhoff, K.T., & Beckstrand, R.L. (2000). Critical care nurses: Perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients. American Journal of Critical Care, 9, 96-105.
Norton, S.A., & Talerico, K.A. (2000). Facilitating end-of-life decision-making: Strategies for communicating and assessing. Journal of Gerontological Nursing, September, p. 6-13.