Providing the best possible healthcare to patients requires the skills and expertise of many different healthcare providers. The cornerstones of the healthcare team are the physicians and nurses who coordinate and lead the professionals who manage the many aspects of each patient's care. In orthopaedic nursing we have a saying that goes "behind every orthopaedic surgeon there are three nurses" I would venture to go further and say there are several orthopaedic nurses who fulfill varying roles in various settings such as the operating room, orthopaedic unit, outpatient office, preadmission unit, and postanesthesia recovery unit to name just a few.
Collaboration among caregivers is something that I believe orthopaedics does better than many other groups. For those who do not work in orthopaedics, trepidation and fear of working with orthopaedic surgeons quickly consumes the less knowledgeable. This stigma is present but can be overcome when professionals work together.
Collaboration among nurses and physicians is one of the most important interactions in the healthcare setting today. Disch, Beilman, and Ingbar (2001) define collaboration as the joint decision making between different groups who share ownership and responsibility for decisions and outcomes. The ability to understand that two parties will have two perspectives and possibly two ways to achieve the optimal care for the patient, allows the clinicians the opportunity to share these perspectives and develop the plan of care that is appropriate for the patient.
The often cited early work of Benner (1984) revealed that the relationship between the physician and nurse was an important factor in the ability to provide good patient care. In addition, collaborative relationships helped to create an environment that fostered high staff morale. Not only do the patients benefit from the collaborative relationship between physicians and nurses, but both the nurses and physicians benefit too. What could be better than colleagues who respect and trust each other to make the right assessments and decisions regarding an individual patient? I am sure you have heard the statement "I am really glad you are taking care of my patient tonight. I know she will be in good hands" or made the statement "I am so glad you are on call because I know you will answer my page if I need you for Mr. Smith."
Research backs up the notion that when nurses and physicians utilize a collaborative model to provide patient care, the outcomes of that care are better than when the physician provider did not utilize that practice model. (Jackson, Long, & Swartz, 2003). Research also demonstrates that poor relationships can be detrimental to patient care. Espin and Lingard (2001) looked at errors in the perioperative setting and found that in an environment where relationships between physicians and nurses were not collaborative, the rate of errors was higher.
Nurse physician collaboration has occurred for decades in different forms. An environment where nurses and physicians work together is better for patients, nurses, and physicians. Fostering a collaborative environment is a goal that we all should promote. Demonstrating how nurses and physicians work well together will become evident to all involved and improve patient care.
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