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K. Curtis & A. Tzannes

How to talk to doctors a guide for effective communication
2011 The authors, International Nursing Review 2011 International Council of Nurses

Submitted By: Jessica Marbil

Student Number: 820-532-752
Submission Date: February, 28th 2014
Submitted To: Tamiza Kassam

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In the health care field, members of the team are generally busy and facilities seem
overloaded and crowded. In an environment such as a hospital, clinic, or retirement home, one
may find it difficult to find the time and place to be able to communicate with other health care
professionals. Effective communication between healthcare professionals plays a big role
relating to patients outcome and nurses satisfaction.
Poor communication between nurses and physicians can result in passive aggressive
behaviour, bitterness, and truancy. It can cause conflict and stress between healthcare
professionals and result in adverse events. In any event, nurses and physicians both have a
common goal; that goal is to provide optimal health care. Poor communication between health
care professionals can result in an unfavourable patient outcome. In the article, How to talk to
doctors a guide for effective communication written by K. Curtis, it focuses on methods and
guides to enable effective communication between nurses and physicians.
The article introduces factors that influence poor communication between healthcare
professionals such as levels of hierarchy and relationships, increasing workload resulting in less
time for communication, language barriers, and the emotional labour of nurses. Aside from these
barriers, the article establishes methods of how to effectively communicate with staff members
and increase nurse satisfaction.
Three nursing implications this article has for nursing practice are personal consideration,
preparation and structure. Personal consideration focuses how personal emotions can interfere
with how you speak and tolerate others. It is important to understand the perspective of others
and yourself, this can help guide how you will approach the conversation and help avoid any
conflict. By having a clear approach and direction to the conversation it will result in effective

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communication between sender and receiver. Although one may have a different opinion, it is
vital to remember that there is a common goal between the nurse and physician or other team
member (Curtis & Tzannes, 2011). For this reason, learning how to control anxiety levels and
realising any negative emotions during the conversation, the goal of advancing patients care will
be achieved.
Additionally, preparation is in important concept to learn when communicating with
physicians. By preparing what will be said to the physician, it will allow the speaker to gather
thoughts and develop a more confident tone which will build professional respect. Also, by
organizing your thoughts the speaker will be able to determine what information the physician
will require such as lab, or any other test results. The speaker will be able to classify if the call is
urgent, or if the issue is able to wait until the doctors next scheduled round (Curtis & Tzannes,
2011). This will eliminate wasting your time, and the physicians time.
Furthermore, having an organized structured approach between the sender and receiver
will ensure that important information will not be missed and allows the doctor to make
informed clinical decisions. Similar to preparation, it minimizes the risk of communication error
(Curtis & Tzannes, 2011). A method used to improve communication between nurses and
physicians is a structured method known as Introduction, Situation, Background, Assessment,
and Recommendation (ISBAR). This method is an excellent way to communicate with
physicians when change of patient status or condition is needed to be reported in a timely
manner. ISBAR creates a shared expectation between the nurse and physician of the information
being shared.

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In the same way, another method used as an effective way to communicate between
nurses and physicians is Situation, Task, Intent, Concern, and Calibrate (STICC). Using the
STICC methods requires feedback from the physician. When calibration comes into play it
allows both physicians and nurses to have input in the clients condition and discuss what further
steps need to be carried out. STICC advances the understanding by maintaining back and forth
communication between the sender and receiver (Manojlovich, Antonakos, & Ronis, 2009).
One factor that causes barriers to effective communication between nurses and physicians
is the subject of hierarchy. Although health care has adapted much over time, there have been
reports of nurses who are too afraid to voice their concerns or opinions because they fear the
criticism or any rebuttal the doctor may have. Curtis (2011) has noted that nurses who have had
previously been bullied or felt defensive communicating with other healthcare workers, are left
with unexpressed thoughts and emotions and avoid any further collaboration.
As was previously stated, poor communication between nurses and physicians can have a
direct or indirect correlation with patient outcomes. What I have learned from reading this article
is that it is fundamental for nurses and physicians to have good communication and good
therapeutic relationships. CNO practice guidelines notes that a healthy workplace is an
environment in which nurses can safely identify conflict and implement systems for its
management. By fostering methods to improve nurse and physician communication, it will
ensure that conflicts do not negatively affect client health outcomes (College of Nurses of
Ontario, 2009).
The knowledge I believe that will enable me to improve my nursing practice from
reading this article is using the communication method of I-S-B-A-R. Not only is this method of

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communication highly effective, but it also allows healthcare professionals to immediately
initiate communication and to receive a swift response from the receiver. Communication is
more effective when the receiver and sender accurately perceive the meaning of each others
messages (Potter & Perry, 2014). I think this will help improve my nursing practice because
members of the health care field need to work at a rapid paste; yet, still have adequate
communication. From this article I have learned that communication is a powerful therapeutic
tool that is used by health care professionals and many others to help achieve positive health care
outcomes.
Curtis article reflects my role as a student nurse because it provides guidance on how to
overcome communication barriers between nurses and physicians. As a nursing student it is my
responsibility to know how to effectively communicate with not just clients and their families,
but it is important to have communication between physicians and any other colleagues. In such
active working environment, specifically in any health care facility, it is necessary that
communication between the sender and receiver is done quickly and efficiently (Potter & Perry,
2014). In turn, effective communication between health care professionals contributes the
ultimate health care and safety for clients.
Lastly, this article has helped me develop a greater understanding about the importance of
verbal communication. With effective open communication, positive levels of staff satisfaction
are present. By addressing the three implementations: personal consideration, preparation and
structure, nurses are able to adequately and efficiently implement verbal communication with
physicians. It is important to keep in mind that although conflict may occur during
communication with health care professionals, they must collaborate to achieve a common goal
and that is to give the best possible client care.

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In conclusion, I have learned how to communicate effectively with colleagues using the
ISBAR method. Also, prior bad experiences communicating with other health care workers can
result in absenteeism. Although nurses often are afraid to speak to physicians and do not voice
their opinions, using protocol methods such as ISBAR or STICC gives nurses the ability to feel
that they are able to speak to doctors without receiving criticism for their input. By using these
communication methods it ensures important information will not be missed resulting in
communication error. Overall, Curtis article provides an excellent guide to achieve nurse-doctor
communication.

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References
Curtis, K., & Tzannes, A. (2011). How to talk to doctors- a guide for effective communication.
Internal Nursing Review, 13-20.
Guidelines, C. p. (2009, June 05). Conflict Prevention and Management. Retrieved from College
of Nurses of Ontario: http://www.cno.org/Global/docs/prac/47004_conflict_prev.pdf
Manojlovich, M., Antonakos, C., & Ronis, D. (2009). Intensive Care Units, Communication
Between Nurses And Physicians, And Patient's Outcomes. American Journal of Critical
Care, 21-30.
Potter, P., & Perry, A. (2014). Canadian Fundamentals of Nursing. Toronto: Elsevier Mosby.