Nursing communication: advocacy for the patient or physician?

Communication among nurses, patients, and physicians is a key component of effective health care. In addition to communication with patients, nurses directly or indirectly influence physician-patient communications. This secondary analysis examined registered nurses' interactions with a simulated patient regarding what the physician had told the patient about the reason for hospitalization. Taped interviews (N = 86) were transcribed and content analyzed to classify nurses' approaches to assessment and intervention. The second researcher coded 10% of the transcripts to ensure satisfactory interrater consistency. Major patterns of nursing communication were the following: assessing what the physician had told the patient (85%), encouraging clarification with the physician (62%), encouraging a second opinion, and defending the physician's competence (9%). Findings support literature suggesting that nurses mediate and clarify communications between the patient and the physician. Patient advocacy was also illustrated; however, a small number of nurses advocated most clearly for the physician.