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Curtis, K., & Tzannes, A. (2011). How to talk to doctors a guide for effective communication.
International Nursing Review, 58(1), 13-20.
Ruwangi Wadugodapitiya
822665063
February 26, 2014
NURS 260: Nursing Theory
Professor: Franklin Gorospe
Humber College ITAL

Introduction
In the health care system, there are many different professions involved in patient care.
Therefore, communication is vital to maintain efficiency and safety for the client. Curtis and
Tzannes (2011) have provided a guide for nurses to contribute effectively to nurse-physician
communication. This article is highly beneficial for people who lack confidence when speaking
to people of seniority. It provides strategies that will aid in diminishing the fears, and increasing
competency when it comes to nurse-physician communication. This confidence stems from
being prepared with the information, as well as being aware of all the barriers that may arise
during a conversation with the doctor. Organization of data also aids in being prepared and also
facilitates communication inevitably increasing the efficiency of the conversation. Lastly, being
assertive is important to help validate the nurses opinions and establish competence. This will in
the end ensure productivity and will benefit the client immensely.
Body
When it comes to communicating with a doctor, preparation is a key factor. This includes
mental preparation as well as having all documentation and data readily available. It is important
to reflect on ones current emotional state in order to identify how the communication process
can be affected. Being aware of barriers such as tiredness, or certain emotions will help reassess
the approach of the conversation (Curtis & Tzannes, 2011). Before making the call to the doctor,
the purpose of the conversation should be established. For example, the doctor may be needed
for urgency, clarification or if the nurse is simply reporting on any changes or concerns. It is also
essential to get a hold of the right doctor to avoid wasting time. The purpose of communicating
with the doctor is not always just to present information, but to also provide relative data to

deliberate and come to a conclusion (Curtis & Tzannes, 2011). In order to have a strong flow of
communication and to get the maximum input from the doctor, all findings such as vitals, tests
and patient observations should be ready to discuss (De Meester, Verspuy, Monsieurs, & Van
Bogaert, 2013). I believe the preparation stage plays a huge role in building up the nurses
confidence to carry out nurse-physician communication. It will ensure that I have all the data
required to back up a case and carry out the task in an efficient manner.
Along with being prepared for communication with a doctor, it is also essential that all the
necessary information is organized. Another implication that Curtis and Tzannes (2011) suggest
is structuring the data prepared for communication. This will outline the message to be delivered;
ultimately reducing the amount of errors in communication by ensuring that certain details are
not left out. When carrying out nurse-physician communication, a tool that is widely used is
ISBAR. This consists of an introduction, stating the situation, background, assessment and
recommendations to the doctor. The purpose of this ISBAR is to improve clarity of nursephysician communication regarding an alteration in the patients current status (Curtis and
Tzannes 2011). This implementation also makes it easier for the physician to contribute
effectively and aids the process of communication. It gives both parties a foundation to discuss
and come to a conclusion to resolve patients needs. Client safety is the main goal of nurses
(College of Nurses Ontario, 2002). Therefore, the communication between nurses and doctors
should be efficient in order to maintain the stability of the client. According to De Meester,
Verspuy, Monsieurs and Van Bogaert (2013), there is a direct relationship when it comes to
ISBAR and the decline of unexpected deaths. Critical thinking along with ISBAR ultimately
achieves the College of Nurses Ontarios (CNO) standard of practice of client safety.

Nurse-physician communication can be very intimidating, especially for nurses. As health

care providers, the scope of practice is very different for both fields; thus, it can lead to egotistic
or passive behaviour. While being respectful of the chain of command, it is important to keep in
mind that nurses opinions are also valid, and they are capable of questioning a doctor in regards
to maintaining patient safety. Curtis and Tzannes (2011) provide a process of graded
assertiveness, to help feel more confident when speaking to someone that is more experienced.
This includes, stating the problem using an I statement, providing possible solutions, asking for
further clarification and demanding a response. Nurses are hesitant to make calls to the doctor
because of the lack of confidence, or fear of being perceived as incompetent. (De Meester,
Verspuy, Monsieurs, & Van Bogaert, 2013). Being passive to doctors commands puts the client
at risk (Johnson & Kring, 2012). I believe that nurses not only should follow orders, but should
always be critically thinking and doing a thorough analysis in order to prevent error. Client
safety should be prioritized over lack of confidence or ego (Curtis & Tzannes, 2011). In the end,
it is a nurses duty to discuss concerns with the primary health care provider in order to resolve
the problem (College of Nurses Ontario, 2009). I can be a passive person, so when it comes to
nurse-physician communication, it is important that I implement these strategies to help build up
my confidence and to carry out the process with efficiency.
Conclusion
Communication between health care team members is crucial to provide the best care for each
client. Even though there are barriers, it is important to remember that the client is the main
priority, and communication needs to be clear in order to be productive. There are many
approaches to nurse-physician communication. The ones mentioned were preparation,
organization, and assertiveness. From the article, I learned the importance of being confident and

ready before calling the doctor. I can be shy, so these strategies will help me in the future to be
more confident by having all the data gathered and organized, using ISBAR efficiently, and
being assertive. By implementing these strategies, nurses will have more respect and will have
more self-confidence. This will, in return, be very beneficial for the clients because they will be
getting the care they need, when they need it.

References
College of Nurses of Ontario. (2002). Professional Standards. Toronto: Author.
College of Nurses of Ontario. (2009). Practice Guideline: Disagreeing With the Plan of Care.
Toronto.
Curtis, K., & Tzannes, A. (2011). How to talk to doctors a guide for effective communication.
International Nursing Review, 58(1), 13-20.
De Meester, K.,Verspuy, M., Monsieurs, K.G., & Van Bogaert, P. (2013). SBAR improves
nurse-physician communication and reduces unexpected death: a pre and post
intervention study. Resuscitation
Johnson, S. & Kring, D. (2012). Nurses' perceptions of nurse-physician relationships: medicalsurgical vs. intensive care. Medsurg Nursing.