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Journal&Article&Review:&How&to&Talk&to&Doctors&&A&Guide&for&Effective&Communication&
Natasha&English&
Humber&College&
NURS&150&
Vasanthy&Harnanan&
March&6th,&2015&
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Proper and effective communication is an integral part of nursing and successful patient
care. Without communication you would be unable to successfully collaborate with team
members and other health care providers, nor would patients be informed of what was happening
with their care. Curtis and Tzannes (2011) not only describe the importance of effective doctornurse communication, but reasons for communication breakdown, and ways to make it effective.
There are three key points they discussed. The first is that ineffective communication between
doctors and nurses can have an impact on both patients and health care provider, and that there
are several barriers to communication. The second key point is the notion that practicing and
being exposed to doctor-nurse communication should begin during school. This is so that when
they enter the workforce they are able to easily begin the healthy working relationship. The last
key point is that doctors and nurses must develop and work at effective communication
strategies. The article presents four ways which have proven to be successful. I selected this
article because regardless of my chosen field of practice, communication with doctors will
always be a necessary component. I wanted to explore the challenges and information presented
so I can apply it to my expanding knowledge of nursing skills. However beyond just applying the
knowledge I want to be able to understand the impact of effective and ineffective communication
so I can provide the best nursing care possible.
The first implication the article has for nursing practice is that excellent patient care is
reliant on proper communication between doctors and nurses. Curtis, Tzannes, and Rudge (2011)
state, Poor communication and communication overload has a direct correlation with patient
outcomes, adverse events, transfer delays, and length of stay. I strongly agree with the point the
authors make because without effectively speaking to doctors the amount or quality of
information that needs to be shared can be limited. For example a nurse is in direct patient

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contact often and he or she is constantly assessing the patient in many different ways. If there is
ineffective communication the nurse may not be able to share her opinion of the patient situation,
which may lead to a negative outcome if it is apparent to the nurse that the patient needs different
care than what is ordered by the doctor.
Related to this discussion is barriers to communication. One of the most important ones in my
opinion is prior experiences of judgement, bullying, and defensiveness and how they can impact
the nurse. Poor relationships among members of the health care team can negatively affect the
delivery of care. For example, workplace bullying can erode a nurses confidence and
compromise her/his ability to foster therapeutic relationships with clients (CNO, 2009, 5). I
believe this is extremely important to nursing because when a nurse is feeling like his or her
nursing skills are not up to the required standard they are unable to provide care with the
confidence required. This impact of ineffective communication is something that I did not
consider before examining the article, but seems to be one that could be the most important when
looking at the effects on a full spectrum. It involves the patient, the nurse as an individual, and
the nurses career.
Another implication that the article discusses is that nurses must take it upon themselves
to remedy communication issues and break through the barriers. While the most effective
communication relies on the cooperation of both doctors and nurses, nurses have the ability to
use specific techniques that will improve communication breakdown. Curtis, Tzannes, and
Rudge (2011) list the following techniques: personal considerations, preparation, structure, and
graded assertiveness. Personal considerations examines a nurses emotional status and how it
affects those around them. Preparation includes mentally preparing for contact with a doctor
before it happens. Structure is using a standard and structured approach when contacting a doctor

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in order to give all the necessary information. Graded assertiveness is a technique which allows
the nurse to escalate a concern when there is differing of opinions, by being firm and taking
working steps to resolve the issue.
I believe that structure is the most important communication technique because it allows you to
mentally and physically prepare before making contact with the doctor, and allows you to gather,
complete, and organize your information. I believe that being trained and knowledgeable about
this technique will improve nursing practice greatly because when you use this technique, you
dont leave the doctor with any reason to doubt your ability, and this use of effective
communication in turn could build confidence. As a student, I have learned the structure
technique and this reinforces my opinion that it is extremely effective especially for someone
who is learning or building communication skills.
There are also several other techniques and skills that the nurse can use to establish and maintain
proper and effective professional relationships. These skills tie in with everything discussed in
the article. For example, using a wide range of communication and interpersonal skills to
effectively establish and maintain collegial relationships; demonstrating knowledge of and
respect for each
others roles, knowledge, expertise and unique contribution to the health care team; sharing
knowledge with others to promote the best possible outcomes for clients; developing networks to
share knowledge of best practices; and demonstrating effective conflict-resolution skills (CNO,
2002, 12)
The last implication is that working on doctor-nurse communication while still in the
school setting can increase the rate of effective communication in the workplace. This is an
implication that directly affects my nursing practice as a student and currently has the most

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impact for me. Incorporating how to communicate effectively into the curriculum is something
that I feel would be extremely important. When I enter the clinical setting and workplace, I want
to feel prepared and confident in my abilities to interact with doctors. Before reading the article I
would not have considered this to be an important topic to be integrated into the program,
however after learning of the outcomes of poor communication, it seems to be an obvious
solution to increasing effectiveness. Curtis, Tzannes, and Rudge (2011) discuss the issue of
seeing doctors and nurses as a hierarchical relationship which refers to more traditional roles.
This mindset is one of the barriers for communication since believing that one is above the other
can impede the willingness to be open and honest. This fits well into the notion that doctor nurse
communication should be taught in school. I believe this because if we are taught about
collaborative care and working with doctors, the belief that there is a hierarchical relationship
could be lessened. McKay & Narashimhan (2012) also promote the importance of incorporating
this into the school settings: Inter-professional education programmes should encourage mutual
intergroup differentiation to promote positive attitude change through acknowledgement of each
groups valued identity on specific dimensions. This could achieve the reduction of negative
stereotypes and provide a synergistic approach to the patient.
While this article confirmed the way I thought about communication between doctors and
nurses, it has really impacted how I view about the importance of it. The key points discussed
were things that I had considered but did not put much emphasis on understanding the
consequences should they be absent. I think the realization of the importance is critical to my
role as a student nurse because this is the time that Im still learning and shaping my skills and
development. I feel as though it is easier to incorporate the points discussed into my nursing
practice now, than if I was well into my career.

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In conclusion I can safely say that the focus of a nurse is on providing the best care
possible to the patients. It is apparent that communication between doctors and nurses plays an
incredibly large role on how successful patient care is. Prior to reading the articles and resources
I understood the importance, however I did not consider the many manifestations it can have,
and the impact on all involved. I truly believe that communication is a topic that should be
engrained into doctors and nurses from the moment they enter school and continue throughout
their careers. Focusing on effective skills and attitudes can only have a positive impact on the
medical profession. By examining this article I believe I now have a good understanding on the
importance of communication with doctors and how to foster a working environment.
Furthermore, how to encourage and advocate for effective communication in the workplace
between my future colleagues and the doctors we will be working with.

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References
Curtis, K., Tzannes, A., & Rudge, T. (2011). How to talk to doctors a guide for effective
communication. International Nursing Review, 58, 13-20.
McKay, K A., & Narashimhan, S. (2012). Bridging the gap between doctors and nurses. Journal
of Nursing Education and Practice 2(4), 52-55.
The College of Nurses of Ontario. (2009). Practice guidelines: conflict prevention and
management. Retrieved from http://www.cno.org
The College of Nurses of Ontario. (2002). Standard guidelines: professional standards.
Retrieved from http://www.cno.org