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Running Head: IMPROVING PATIENT CENTERED CARE THROUGH

COMMUNICATION 1

Improving Patient Centered Care Through Communication


William Clements
Writing for Work

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Introduction:
Have you ever been a patient in a hospital? More specifically, have you
ever had to stay in a hospital overnight? If the answer is yes, then you
probably remember seeing multiple different healthcare providers in your
room. Every single healthcare provider that enters your room performs a job
that can affect the patients health as well as how the other healthcare
personnel does their job. The three primary groups of healthcare personnel
are doctors/physicians, nurses, and unlicensed assistive personnel.
Communication between all three of these professions is vital for multiple
reasons such as providing patient-centered care, reducing errors, and
running an efficient floor to minimize stress and overworking of the
healthcare providers.
Problem:
The main reason medical errors exist is a lack of communication.
Communication between all healthcare professionals is vital and promotes
patient-centered care, reduction of medical errors, and reducing the stress
level that exists on the floor.
Purpose:
The purpose of this paper is to outline exactly what the different
healthcare providers are responsible for in terms of patient care, as well as
list ways to minimize lack of communication between the healthcare
providers.
Discussion:

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An important part of interprofessional communication is knowing the
responsibilities and roles of all three professions. In my personal experience,
this has always lead to improved care of the patient. Knowing what my
specific role is keeps me from performing an action twice and keeps me from
wasting the time it takes to perform the task. For example, as a nurse, if I
give a bedbath to someone who has already received a bath earlier, the time
spent giving that bath could have been used to assist another patient.
Unlicensed assistive personnel have the smallest number of
responsibilities. These responsibilities include providing the patient with fresh
linens, helping the patient to take a shower, giving the patient a bed bath if
they are not able to shower normally, and change the patients briefs
whenever they are soiled. Although they have few responsibilities, most
nurses agree that it is probably impossible to deliver nursing care without
the proverbial extra set of hands (nursingworld.org, 2001).
The nurse only has a handful of responsibilities, but the responsibilities
require many tasks to be done. According to the American Nurses
Association (2016), the main responsibilities are to provide patient-centered
care, be an advocate for the patient, and carry out the care plan designed by
the doctor/physician. Some of the many tasks that are involved in the
responsibilities include mediation between the patient and the patients
family, mediation between the patient and the doctor, providing medications
when the patient needs them, and assessing the patient for any changes in
their condition.

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Nurses and doctors have equally important and similar roles, however
they are slightly different. Doctors have the most power in the medical field
and according to the University of Texas at Austin, the physician is trained
to provide leadership in developing and supervising the patients overall
healthcare plan.Their primary jobs are to diagnose the patient and to come
up with a care plan designed for the patient to restore them to normal health
in as little time as possible. To do this, they must take a detailed medical
history and perform a detailed assessment of the patient to ensure they treat
the correct disease process. Doctors must also provide adequate teaching to
the patient, the patients family members, and support staff to ensure they
have knowledge of how to complete the tasks required by the patient to
heal.
According to recent studies, medical errors are a major cause of death
in the United States accounting for almost one hundred thousand deaths
annually. Reports also show that poor communication among healthcare
professionals is one of the most common causes of patient care errors
(Lancaster, 2015). For anyone entering a hospital, this should an alarming
statistic. In the findings of Lancasters study, she describes how for the most
part, doctors, nurses, and unlicensed assistive personnel operate as
separate healthcare providers who barely speak to each other.(Lancaster,
2015)
Communication is part of everything a healthcare professional does.
Doctors communicate with nurses, nurses communicate with unlicensed

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assistive personnel, and doctors, nurses, and unlicensed assistive personnel
all communicate with the patient. The doctors main role in communication is
to discuss treatment options with the patient and the nurse. As a doctor, it is
important to be able to communicate effectively with the patient. Being able
to provide explanations of treatment options in a way that is easily
understandable helps the patient to know what is best for them, as well as
what is required of them to help promote a speedy recovery. This is called
patient education, or the process of influencing behavior and producing the
changes in knowledge, attitudes, and skills necessary to maintain and
improve health (AAFP. 2000).
While discussing treatment options with the patient is mandatory,
discussing treatment options with the nurse is not mandatory, however, can
give the doctor a perspective that he may have overlooked. This not only
provides patient-centered care, but also makes the nurse feel as if their
opinion matters, promoting a healthy working relationship. In a recent
discussion with a med student, he stated that nurses really know their stuff,
and any doctor that does not consult with the patients nurse should consider
a different profession.
Nurses eat, sleep, and breathe communication. Communication
between the nurse and doctor is vital because the nurse needs to know what
the doctor is thinking in terms of treatment plans. Nurses also learn to help
the doctor by providing solutions disguised as suggestions. For example, a

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nurse might say What do you think about running a specific test? to which
the doctor will often agree.
Nurses must also communicate with the unlicensed assistive
personnel. Communication is limited, but it is important for the UAP to notify
the nurse of any changes it skin integrity as well as bowel function. If this
communication does not exist, the nurse might find an elevated lab value
caused by something such as a pressure sore, but because they arent aware
of it, they might try to provide a treatment unneeded by a patient.
Lastly, nurses must communicate with the patient. A large portion of
patient-centered care is asking the patient for information such as what their
pain level is, what their mental state is, and how they learn best. Often,
nurses will be administering medications and the patient will ask what a
medication is and may also say Ive never seen that pill before. This could be
an indication that a medication error has occurred.
Communication is one of the biggest problems in nursing, however, it
is often caused by only one thing; ego. Doctors have the greatest tendency
to big dog the other professions. A lot of them think that they dont need
second opinions because they went to school for a longer period of time
than nurses. This type of thinking usually ends with the doctor belittling a
nurse, leading to a poor nurse-doctor relationship. Ultimately, it affects the
care of the patient. While it is true that doctors have the most education, the
nurse is the one at a patients bedside and monitors how the treatment is
going.

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Nurses also have a tendency to think they are right, regardless of what
the physician says. Nurses have a lot more experience in the actual
implementation of treatments, and have more knowledge of how the
treatment will affect the patient because of their knowledge from assisting
the patient.
Nurses also have a tendency to not appreciate the unlicensed assistive
personnel. It is often rare for the nurse to talk with the UAP, but care begins
with them. If UAPs dont perform their job, it can lead to serious medical
problems such as pressure sores and poor hygiene. Pressure sores are
caused by pressure on a portion of the body for an extended period of time
that leads to breakdown of the skin. Pressure sores along with poor hygiene,
can lead to more infections that will prolong the healing process and alter
the care of the patient.
Conclusion:
To conclude, how do we minimize this problem? The first way is to have
trust. Trusting the other professions to complete their jobs is essential to
running an efficient floor. Without trust, the floor would be a madhouse
because everyone would try to correct everyone elses mistakes.
The second way is to engage with the coworkers. Doctors, nurses, and
unlicensed assistive personnel all agree that how something is said is just as
important as what is being said. Just talking with the other professions
increases efficiency in the workplace, by understanding how your co workers

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operate. Talking to them also promotes good relationships that can lead to a
building of trust.
Communication in any workplace is essential to running any business,
and is even more important in any healthcare setting. Whether it is
interprofessional, or between the professional and the patient,
communication affects patient care.

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References
American Nurses Association. 2016.
http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/ToolsYou-Need/RNsAPNs.html.
Lancaster, Gwendolyn. 2015. Interdisciplinary Communication and
Collaboration Among Physicians, Nurses, and Unlicensed Assistive
Personnel
University of Texas at Austin Interprofessional Education.
http://www.healthipe.org/healthcare-roles/physician
American Nurses Association. 2001.
http://ana.nursingworld.org/mods/archive/mod311/cerm202.htm
AAFP. Am Fam Physician. 2000.
http://www.aafp.org/afp/2000/1001/p1712.html