Dialogue: a potential strategy for building healthy physician relationships.Managed care and technology are forcing hospitals to move beyond their traditional walls to provide health care. Outpatient services continue to grow, new models of care are being developed, and demands continue for quality care and decreased cost. These changes result in stress for all health care providers, including physicians. These changes are taking their toll on the personal and professional lives of physicians.
Nursing leaders are frequently at the center of these healthcare conflicts: These leaders are expected to recognize these conflicts, solve problems, and promote a healthy working environment. If we lived in a perfect world, work such as that used in this article might not be needed.
Dziabis and Lant (1998) discussed the importance of healthy relationships and provided strategies for increasing the potential for successful partnerships with our physician colleagues. According to these authors, building healthy relationships begins with open and honest dialogue about who we are personally and professionally. Defining "who we are" creates opportunity for colleagues to explore their need for security, safety, and acceptance and, yes, even love.
One of the most compelling aspects of this article is the authors' belief that dialogue is sadly lacking among nurse leaders and physicians and that dialogue may provide creative energy for our lives and our organizations. Building healthy relationships with physician must be viewed as a process and not an event, a process that demands commitment and time. The factors Dziabis and Lant (1998) consider crucial for building these relationships are listed in the accompanying table and briefly discussed in the following sections. The focus of this article is on nurse leaders working to better develop healthy relationships with physicians.
Listen to the stories
Learning how to listen to someone tell their story is essential to create profound relationships. An effective way is to visualize the story as if you are filming a movie and try to capture the passion. Passion is the soul of who we are. As we listen to physicians 'tell their story' of the difficulty they are experiencing navigating the rapidity with which they are expected to see patients, we grasp a greater understanding: Nurses also grapple with rapid patient turnover.
Nurture partnerships and set boundaries
Professional organizations may provide confusing models of what healthy work environments should look like for physicians and nurses. As nurse leaders 'listen to physician colleagues' stories', they are nurturing their relationships and they can begin to shape their practices together within mutually determined and respected boundaries.
Adults want control over their personal and professional lives. The authors point out that control needs often come from perceptions of how we thought things were or should have been. Unhappiness and stress can come from experiences that are vastly different than our expectations. For many physicians, today's health care delivery system is not what they thought it would be. The authors do not excuse inappropriate behavior when physicians are stressed over their lack of control. Rather, they stress learning new skills to build healthy relationships, such as skills integral to dialogue.
In summary, these authors' belief that dialogue is strategy to build healthy physician relationship was a breath of fresh air, so to speak. Dialogue is crucial for nurse and physician leaders to reach shared meaning about the importance of healthy relationships and strategies to promote partnerships.
Dziabis, S., & Lant, T. (1998). Building partnerships with physicians: Moving outside the walls of the hospital. Nursing Administration Quarterly, 22(3), 1-5.
Table: Factors to Promote Healthy Physician Relationships * Listen to the stories of physicians and nurses as partners and people * Tell your story * Nurture the partnership * Set boundaries * Encourage healthy living * Help providers regain control * Build new skills
Bea Jaye Warlick, BSN, RN, Integris Health, Henry G. Bennett Fertility Institute, and Betty Kupperschmidt, EdD, RN, Director, Nursing Administration Program, OUHSC College of Nursing. Member Region 2, ONA