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如何与医生沟通——有效沟通指南。

How to talk to doctors--a guide for effective communication.

机构信息

Trauma, St George Hospital, Sydney, Australia.

出版信息

Int Nurs Rev. 2011 Mar;58(1):13-20. doi: 10.1111/j.1466-7657.2010.00847.x. Epub 2011 Jan 9.

DOI:10.1111/j.1466-7657.2010.00847.x
PMID:21281287
Abstract

BACKGROUND

Nurses and doctors undertake segregated and distinct preparation for clinical practice, yet are expected to communicate effectively with each other in the workplace. Most healthcare facilities have policies relating to written communication, but guidelines for verbal communication, which is used most in times of uncertainty and urgency, are generally less regulated. Poor communication and communication overload are shown to have a direct correlation with patient outcomes, adverse events and stressors among healthcare professionals. We suggest a guide for more effective verbal communication between nurses and doctors.

METHODS

We perform an integrated review of the extensive literature that identifies specific problems that contribute to ineffective communication between a doctor and nurse. We discuss these in five themes in the modern clinical context including intensification of workload, workforce mobility, differing perceptions, language use and heuristics. To combat these, we provide a four point practical guide to arm the nurse clinician with effective tools to ensure a satisfactory exchange of information in the context of patient advocacy.

CONCLUSIONS

The guide assists in overcoming the discussed barriers by creating a premise for fostering communication, understanding each clinician's information needs in a mutually respectful manner, especially in the context of uncertainty. We recommend that a shared mental model regarding communication in health be adopted at tertiary institutions offering pre-registration nursing and medical training and techniques and be woven into respective curriculum design.

摘要

背景

护士和医生在临床实践前接受的准备工作是分开且不同的,但他们在工作场所中需要有效地相互沟通。大多数医疗机构都有关于书面交流的政策,但对于在不确定和紧急情况下使用最多的口头交流,一般的指导方针则较少受到监管。沟通不畅和沟通负担过重与患者的治疗结果、医疗专业人员的不良事件和压力因素有直接关联。我们建议制定一份护士和医生之间更有效的口头沟通指南。

方法

我们对大量文献进行了综合回顾,确定了导致医生和护士之间沟通不畅的具体问题。我们在现代临床环境中围绕五个主题讨论了这些问题,包括工作负荷的加剧、劳动力的流动性、不同的看法、语言使用和启发式。为了应对这些问题,我们提供了四点实用指南,为护士临床医生提供有效的工具,以确保在患者权益倡导的背景下,信息交换令人满意。

结论

该指南通过为促进沟通创造前提,以相互尊重的方式理解每个临床医生的信息需求,特别是在不确定的情况下,从而有助于克服所讨论的障碍。我们建议在提供护理和医疗预注册培训的高等教育机构中采用关于健康沟通的共同心理模型,并将其纳入各自的课程设计中。

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