Note from Mindy: I welcome Amy Kramer, Healthcare Sector Strategist at Maritz, for her second post. With Amy’s 10 years of experience in the healthcare industry, ranging from pharmacy, hospitals, managed care, and pharmaceuticals, Amy’s thoughts are both detailed and contain real-world applications. Enjoy!

We all know nurses and physicians as the direct respondents to our care as patients. Whether we’re in a doctor’s office, or in the hospital, everyone is working on the same side, right? Not in all cases. There’s definite tension between some nurses and doctors. Nurses tend to call on patients’ needs more than the patient’s physician (as much as five times more). Physicians are under-staffed, but the nurse is counted on to be readily available to answer questions, serve the patient, serve the family and communicate back to the doctor. It could be argued in many cases the nurse may know more about the patient than the actual assigned doctor. There is also the new a new trend of “hospitalists,” an on-site doctor assigned to all “in-patients.” The hospitalist completes rounds on behalf of the patient’s actual doctor, who doesn’t see the patient until after discharge. This trend at first seems incredibly convenient, but we’re learning it’s also damaging the patient experience at times. Not all patients want to see a slew of people. They want direct access to their doctor, and when they don’t get it, it’s the frontline nurses generally taking the disgruntled heat.

In order to deliver optimal patient care, nurses and physicians must collaborate. However, more often than not, physicians see a distinct difference in their roles for caring for patients. There’s an apparent level of hierarchy, and nurses tend to receive the short end of the stick. We hear of a lack of respect, recognition and appreciation for each others’ contributions to patient care. Physicians and nurses need to find a balance in their roles and set expectations to make sure each delivers equal and agreed upon care for the patient.

It’s also imperative for physicians to recognize the strengths and skills nurses bring to the healthcare profession. Nurses have a direct impact on patient health outcomes too. Physicians need recognition for their approach to patients, as well as feedback on ways to make the healthcare environment better for everyone.

At the end of the day, both nurses and physicians want the best treatment and care for their patients. To achieve this shared goal, they need to realize they have to work through their differences and appreciate each other’s contributions. When the working environment is better for the people providing the care, patients ultimately win with a better experience and care.

Note from Mindy: I’m pleased my colleague, Amy Kramer, Healthcare Sector Strategist at Maritz, will contribute her expertise to Rewarding Health with a series of posts focusing on the impact of hospitals and hospital staff on patient wellness and satisfaction. Amy’s role at Maritz is to build strategy and business solutions to help healthcare companies meet business requirements for growth and sustainability. Her posts will be particularly insightful to hospital management, public health officials, wellness managers and anyone who has had an extended hospital stay (or may have one in the future).

In an October post, Mindy touched on the issue of physician shortage, and its impact on our healthcare system. I’d like to discuss another significant shortage trend in healthcare impacting the delivery of quality care and patient wellness – the lack of nurses.

The American Hospital Association reports a 400,000 shortage of nurses by 2010. This is an astonishing gap, especially when you consider the nurse is essentially the full-time caretaker of most inpatients. Nurses interact with patients more than the doctor. They treat the patient, dispense medications and provide a compassionate, comfortable and optimistic environment. Nurses are overworked, under compensated and under appreciated. Combine these factors with intense physical labor and an emotional environment, and you end up with an increasing burnout rate. Adding to the problem, it’s also increasingly difficult to recruit new nurses and retain high-performers.

The end result of the nursing shortage directly impacts the quality of patient care. When employee satisfaction is poor, the quality of care decreases and patient satisfaction suffers. Also, the limited number of nurses means there are a limited amount of resources available to treat patients. Both situations elevate the possibilities for undesirable situations, , such as longer waiting times, care complications and more hospital visits. Ultimately, a nursing shortage negatively impacts the patient experience, one of the key factors in a hospital’s Joint Commission on Accreditation of Healthcare Organizations (JACHO) scores. Lower JACHO scores could cost a hospital millions of dollars.

To help address the nursing shortage, hospitals first need to develop an employee engagement strategy specifically for nurses. The strategy should incorporate recognition, as well as focus on building a stronger culture with better work/life balance. Many hospitals only recently started to consider offering recognition programs to employees. Some even listed recognition as a line item on P and L sheets. This shift towards recognition is a great step to help patch the tainted feelings of nurses. However, much more needs to be done to get the nursing profession back on track. If the nursing shortage improves, expect to see overall wellness and patient satisfaction improve as well.

You can read more about this in a recent Forbes magazine article, which showcases the patient satisfaction issues U.S. hospitals face.