It's been shown that the nurse-physician relationship has an impact on patient outcomes in intensive care, and it has been cited as a factor in nurse staffing turnover. In a small pilot study, 10 nurse and physician leaders (including nurse managers, physician directors, and unit leaders, such clinical nurse specialists) from two ICUs at different hospitals, one a small specialized unit and the other a larger medical-surgical unit, participated in an educational program to promote leadership skills, teamwork, and "collaborative communication," which was defined as shared "responsibility for problem solving, conflict management, decision making, communication, and coordination."

After a baseline evaluation of communication skills and perceptions of ICU outcomes (including the "technical quality of care," the ability to meet families' needs, and cohesion within the work group), participants attended several training sessions, amounting to approximately 23 hours over an eight-month period. Postintervention evaluations showed that all participants communicated better and reported increased satisfaction with their communication and leadership skills. And at six months, staff nurses on the units perceived better collaboration and problem solving on the units and reported a decrease in personal stress.

Boyle DK, Kochinda C. J Nurs Adm 2004;34(2):60-70.