Chapter 1: How It All Started – The Scope of the Problem
What’s the Problem?
Big Problems
Moral distress
For your patients
For your coworkers
Burnout
Work environment
Decreased job satisfaction
Retention
Patient safety
Impact of Disruptive Behavior on Patient Care
Staffing levels
Factors Affecting Today’s Nurses and Physicians
Physicians
Nurses
Conclusion
Chapter 2: Reasons for Poor Communication
Discovering Why We Can’t Play Nice
The Oppression Theory
Power Play
Sexuality as a Mirror for Power
Asserting Their Dominance
History: Why Jane Is Silent
Game Over
Chapter 3: Key Stakeholders
Patients
What’s Our Problem?
Physicians
Traditionalists and Baby Boomers
Generation X
The Physician’s Point of View
Female Physicians
Nurses
The Agony
Powerlessness
The Ecstasy
Caring
Boundaries
Adaptability
A Healing Environment
Nurse Managers
The Manager’s Experience
Conclusion
Chapter 4: Checking the Emotional Pulse of Work Relationships
Part I: Taking the Pulse of Nurse-Physician Relationships
Collegial Relationships
Collaborative Relationships
Teacher-Student Relationships
Friendly Stranger Relationships
Hostile Relationships
Relationship Tips
Part II: Taking the Pulse of the Physicians
Part III: Taking Your Own Pulse
Fear and Uncertainty
Maintaining Our Boundaries
What Would Jane Do?
A Story of Courage and Confrontation
What Will Jane Do?
Chapter 5: Breakdowns and Opportunities
Breakdowns in Communication
Disagreements Over Discharge Orders
Disagreements Over Treatment Decisions
Incidents of Disruptive Physician Behavior
Telephone Trouble
The SBAR Tool for Preventing Breakdowns
Opportunities for Improvement
Garner Administrative Support
Create a Zero-Tolerance Policy
Provide Assertiveness Training
Use Your Name as a Powerful Equalizer
Take Advantage of Formalized Collaborative Models
Build Community
Strategies for Collaborative Relationships
Home Runs!
Chapter 6: A Manager’s Quest to Create Collegial Relationships
The Power of a Name
Use Social Events as Networking Opportunities
The Great Fruit War: Conquering with Humor
Nursing Through a New Lens
A Meeting of the Minds
Creative Strategies
Educational Opportunities
Just What the Doctor Ordered: A Physician’s Prescription for Transforming Our Culture
‘Aunt Jane’
Setting the Standard
Role Modeling
Conclusion: Not So ‘Pleasantville’
Chapter 7: Leadership’s Role – Creating and Sustaining Healthy Nurse-Physician Relationships
Perceptions vs. Reality
Individual Response: One Bad Apple
Process for Guiding Interventions
Single Unprofessional Incident
Apparent Pattern of Behavior
Authority Intervention
Disciplinary Intervention
System Response: “Spoils the Whole Bunch”
Start Here: Roadmap to Success
Board and Senior Leadership Commitment
Set a Standard of Behavior/Code of Conduct
Code of Conduct: Education and Integration
From Theory to Practice
Create a Reporting or Surveillance Process
The Rest of the Bell Curve
Increase Social Capital
Increase Nurse Educational Level
Seek ANCC Magnet Recognition Program® Status
Conflict Resolution Skills
Hold the Vision