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Working with HCPs at the Bedside

*Original post released on 2/16/2022

In any healthcare setting, it can be a challenge to work with some healthcare providers…regardless of whether or not you are a new grad nurse. In this article, I want to take time to discuss some suggestions and tips you can implement or utilize when working with healthcare providers of different specialties. Hopefully this article affords you some insight, especially if you are a new nurse or are anticipating graduation, on ways to ease your interactions and improve the interdisciplinary approach to your patients’ care. Without further ado, let’s dive in!

It is in your best interest as your patient’s nurse and care coordinator to be aware of which healthcare professionals (HCPs) are assigned to your patient’s case. These can include (but are not limited to) specialty consultants, respiratory therapy (RT), physical therapy (PT), occupational therapy (OT), speech therapy (ST), case management, etc. Know their names, contact information, and the coverage of that specialty when applicable. Why? Knowing the HCPs’ names and contact information is useful in case there’s an emergency, you need to report critical labs or request new orders, and during updates provided in rounds. Knowing their names can go a long way in conveying a friendly attitude that sets the tone for the rest of your shift that day and possibly your remaining shifts that week. Be sure to know who your admitting physician is for your patient and always make time to notify them of an admission or discharge out of courtesy and to obtain the necessary orders.

Get used to taking advantage of the time your HCPs are present on the unit, in person! If the professional is unfamiliar to you, make time to introduce yourself and obtain their contact information should something arise with the patient. Save their contact information in your phone, on a notebook, in a clipboard, etc. for future reference. Provide them with updates, ask questions, and make clarifications about the plan of care as indicated. While they’re present on the unit, take advantage of the incredible asset and resource you have available to you to improve your patient’s situation.

Take time to learn the providers’ individual preferences, typical orders, and parameters in which to notify them. This is especially true and important if you work the night shift when providers are typically unavailable during certain time frames. Some providers are very insistent about being notified or called for every single order, whereas others are content if you enter that tylenol 325 mg order for a 1-3 pain level in the middle of the night. You’ll have to get a feel for their reaction to situations like this over time, but knowing their preferences can save you both time and headache.

Treat your HCPs how you would like to be treated. This seems like such a common sense tidbit of information, but it can go a long way in fostering a mutually beneficial professional relationship. When reaching out to a HCP for communication purposes, ensure that you are direct, to the point, and use SBAR technique. This means you should be taking the following approach in every conversation: discuss the current situation at hand, provide background information that may be helpful to know, your collected assessment data related to the situation, and your overall recommendation. For example: “Hello, Dr. XYZ. This is Andra calling from ABC Hospital in the ICU. I have your patient, Ms. X, in room 1. She is having difficulty maintaining MAPs above 65. Over the past hour her systolic BPs have been dropping steadily, but her other vitals remain stable. Would you like to see if she is fluid responsive with her BPs before starting vasopressor therapy?”

When making contact with a HCP, try your best to cluster updates and questions for them. If it is possible to wait until the provider is there in person, do so. If a phone call must be made because it’s the night shift or the situation becomes urgent, attempt to see if anyone else on the unit might need to speak with that same provider. Make sure you’re asking questions and seeking clarification whenever necessary. This includes inquiring about their approach to the patient’s plan of care. Asking questions helps you understand the provider better, their approach to the plan of care for the patient in question as well as subsequent patients, and it may help you understand their specialty better.

On a different note, you need to be a guard to your patients’ rooms regarding any HCP. It doesn’t matter how much education the person has or what their specialty or license declares them to be. Anytime a person enters your patient’s room, you should be clarifying who they are, what they want and/or need, if they’ve done anything with or to the patient or their equipment settings, etc. Make sure you know your IV, tube feed, and respiratory equipment settings so you can verify the accuracy every single time someone enters or leaves your room. You are directly responsible for ensuring that patient’s care during your shift, so make every attempt to lessen your liability risk.

If you’ve received new orders or saw new orders entered into the system, double check them for accuracy. If something sounds too good to be true or seems incorrect, question it. Just because a HCP may have a higher title and/or more education than you does not mean they cannot make mistakes just as easily as you might. If you need to seek clarification about an order, it may catch any potential mistakes or at the very least, the provider may be able to help you understand their rationale for the order.

Consider having updates ready to go every four hour mark during your shift (Ex: 8 am, 12 pm, and 4 pm). Some providers make their rounds at odd times, when you least expect them, so this can help you anticipate any surprises. If you are able to provide them with overnight updates, recent changes in condition, and an end of shift update, you’ll be golden. If you consistently are on top of updates whenever they round, they’ll make note of this and remember you in a good light…which will only make your life easier and help you get what you need for your patient quicker. Lastly, always place the safety and advocation for your patients at highest priority. If this means confronting or calling out a HCP to ensure a change in behavior is made, do it. As long as the patient benefits from those interactions, you are being the best nurse possible for them.

Hopefully the tips and suggestions discussed in this article prove useful for your everyday practice as a bedside nurse. Other healthcare providers are not the enemy. When we can all work together in a harmonious manner, not only does it make the work lighter and less stressful but the patient benefits considerably as well. That’s the ultimate goal in our profession, to improve the health and wellbeing of our patients. Keep these considerations in mind and get on the good side of those HCPs you work with!

Until next time, happy studying!

Andra Alyse

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