Iranian Physicians' Perspectives Regarding Nurse-Physician Professional Communication: Implications for Nurses

Nurses' care coordination competence in mechanically ventilated patients in intensive care units: a cross-sectional study

BACKGROUND

The intensive care unit (ICU) is crucial in treating severely ill patients, particularly those requiring mechanical ventilation. Nurses are essential for coordinating care and addressing any gaps within the ICU team. This study aimed to evaluate the care coordination competency of nurses in Iranian ICUs, specifically about mechanically ventilated patients.

METHODS

A descriptive cross-sectional study was conducted at Guilan University of Medical Science from September to December 2022, involving 211 ICU nurses selected through convenience sampling. The Nurses' Coordination Competency Scale (NCCCS) and a demographic information form were used. Statistical analyses were conducted using SPSS version 16, including Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression analysis, with a significance level set at 0.05.

RESULTS

The mean score on the NCCCS for nurses was 3.41 out of 5. The multivariable analysis identified key factors influencing coordination competency, including a Master of Science in Nursing (MSN) degree (b = 0.891, P < 0.001), prior ICU experience (b = 0.080, P < 0.001), and fixed shift employment (b = 0.500, P = 0.011) scored higher on the NCCCS. Conversely, those in commitment-type positions had lower scores than those in standard roles (b=-0.690, P < 0.001).

CONCLUSION

The study found that Iranian ICU nurses demonstrated high competency in coordinating care for mechanically ventilated patients. However, they must improve teamwork, align their understanding of patient care needs, and enhance team cohesion through training and advanced technologies.

The development of a research-based interprofessional communication behaviors repository in healthcare education: A systematic review

Interprofessional communication is crucial for patient care, yet there is a dearth of comprehensive assessment tools essential to train and assess healthcare students. While the Interprofessional Educational Collaborative framework (IPEC) outlines eight sub-competencies, it lacks detailed behavioral indicators. This study aimed to create a repository of interprofessional communication behaviors to complement the IPEC sub-competencies. From 12,448 articles, 55 were selected and thematically analyzed with NVivo18®. We identified 230 interprofessional communication behaviors, organized into 10 themes and 61 sub-themes, aligning with the IPEC sub-competencies. This comprehensive repository could be foundational for developing interprofessional communication assessment tools in healthcare education and aiding healthcare institutions in improving interprofessional communication practices.

Do nurses participate in end-of-life decision making?

BACKGROUND

To explore how Jordanian nurses participate in the end-of-life (EoL) decision-making process.

METHODS

Interviews with 10 patients and family caregivers, and focus group discussions with seven healthcare professionals (HCPs), were conducted. Interviews were audio-recorded, transcribed and analysed following inductive thematic analysis.

FINDINGS

The participants agreed that nurses are not fully engaged and did not have a direct role in the EoL decision-making process. However, the participants highlighted that 'nurses bridge the gaps in the decision-making process', where nurses act as mediators to facilitate the decision-making process. Lastly, nurses were viewed as 'nurturers and supporters during the journey of the patient's illness'; they were always available to answer their questions, offer help and advise when necessary during palliative referral and throughout the illness.

CONCLUSIONS

Although nurses did not directly participate in EoL decisions, they have several vital contributions that need to be rearranged into structured decisional coaching.

Interprofessional communication in the hospital setting : a systematic review of the qualitative literature

Communication plays a key role in the provision of safe patient care, and miscommunication in healthcare can lead to avoidable patient harm or mortality. Interprofessional communication (IPCom) can be challenging due to differences in training, education and roles between healthcare professions. The aim of this systematic review was to synthesize the qualitative evidence regarding healthcare providers' perceptions of interprofessional communication in the hospital setting. Four databases (PubMed, CINAHL, Web of Science, and Embase) were searched for studies that met the inclusion criteria. Eighteen studies were identified as suitable for inclusion in the review and were examined using thematic synthesis. Thematic synthesis led to the development of five descriptive themes: 1) 'Hierarchy", 2) "Interprofessional Ethos," 3) "Healthcare Environment," 4) "Personal Factors" and 5) "Methods of Communication," and two overarching analytical themes: "Barriers to Communication" and "Facilitators to Communication." Personal factors, such as strong interprofessional relationships, were found to be important facilitators to IPCom, while organizational factors, such as challenging and hierarchical working environments, were found to pose barriers to IPCom.

Examining the views of operating room nurses and physicians on the relationship between professional values and professional communication

Purpose

Professional communication and professional values are two basic concepts in operating rooms and should be studied more closely in view of the nature of work and the high circulation of patients in operating rooms.

Methods

The present work is a descriptive-analytic study with a cross-sectional design. The sample was 603 operating room physicians and personnel selected from the public hospitals of Shiraz. The data collection instruments were the 41-item professional communication questionnaire and the 26-item professional values scale.

Results

The results showed that the operating room nurses and physicians perceived the status of professional communication and professional values to be satisfactory. As for professional communication, the participants’ perception of the domains of mutual respect and trust (p ≤ 0.001), teamwork (p ≤ 0.001), ethical competence (p ≤ 0.017), and workplace conflicts (p ≤ 0.001) was significant. As for professional values, only the dimension of care (p ≤ 0.016) was perceived to be significant. Moreover, a significant positive relationship was found to exist between professional communication and professional values (p ≤ 0.001).

Conclusion

Considering the significance of the concept of professional communication and its connection with professional values, it is recommended that operating room personnel and physicians receive systematic education about professional communication and the harms of destructive attitudes as part of their academic education and afterwards.

Caring to Nurses in a Hospital Setting: Meanings Unveiled by Photography

BACKGROUND AND PURPOSE

Care represents a human need and as a fundamental component of the social practice of nursing it should be reified in interpersonal relationships and in patients' biopsychosociocultural needs, thus requiring thinking on a regular basis. This study aims to analyze the senses and meanings of the caring process experienced by nurses in a hospital setting.

METHODS

Qualitative research oriented by Symbolic Interactionism as the theoretical framework. The data were collected through photography and by semi-structured interviews with 16 nurses from a University Hospital of Northeastern Brazil. After a narrative analysis, four representative themes were perceived.

RESULTS

The nurses' perception of caring was related to building relationships based upon complicity, solidarity, care, love, and technico-scientific competence but also upon the work overload and working conditions and difficulty to deal with human emotions and feelings of suffering, which are exposed and perceived in the social interacting process.

IMPLICATIONS FOR PRACTICE

The senses and meanings of caring converge into a rupture of the nurses' regular and crystallized actions. That assumes a critical and reflexive review of ways of interacting with the patient, family, and environment. It is necessary that nurses choose communicative strategies, such as photography, that can unfold feelings and emotions which are essential requirements in the process and in the evaluation of care in a hospitalization setting.

General phenomenon and communication experience of physician and nurse in night shift communication: A qualitative study

AIM

This paper explored the general phenomenon and psychological experience of the special background communication in night shift medical staff and provides better reference for night shift communication between doctors and nurses.

BACKGROUND

Physician-nurse communication has always been an important agenda for health care work and an important concept in nursing theory. During night shifts, effective doctor and nurse communication can enhance mutual trust, provide timely and appropriate medical services to patients, reduce adverse events and enhance patient safety.

DESIGN

A qualitative study was conducted.

METHODS

Husserl's descriptive phenomenology method and semi-structured in-depth interviews were used to collect data from 8 nurses and 5 doctors. Colaizzi's method was used to analyse data using MAXQDA 12. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed (see Appendix S1).

RESULTS

Three themes were extracted after sorting out and refining: the need to achieve goals in night-time physician-nurse communication; obstacles in night-time physician-nurse communication; and relationship culture in night-time physician-nurse communication.

CONCLUSION

Attention should be paid to the particularity of night shift and efficiency of achieving the goal of communication between doctors and nurses on night shift, and the hidden obstacles behind communication between doctors and nurses. Managers should pay attention to the cultural construction of night shift communication in the system, form a good night shift communication process and regularly train doctors' and nurses' related communication skills. And they should also study relationship culture rationally to improve the communication efficiency of night shift.

IMPLICATIONS FOR NURSING MANAGEMENT

The experiences described in this study contribute to a better understanding of obstacles hidden behind night shift physician-nurse communication. This also provides valuable information to professional managers who develop good doctor-nurse relationship culture.