As an RN in a, small, 20-bed ED I have the opportunity to work side be side, and have face-to-face communication with, the attending physicians (including the ED chair), physician assistants, residents, multi-functional techs, nursing supervisor, charge nurse, triage nurse, unit secretary, environmental services, X-ray technicians, CT technicians, US technicians, and transporters. The importance of open communication between all parties involved in patient care has been stressed since the first night I stepped onto the ED floor. During my orientation I was encouraged to, respectfully, question physician orders which did not make sense to me and now when I precept a new graduate I encourage the same. In our department we are able to question such orders without push-back from physicians, residents, or PAs. They are typically grateful when a nurse has caught a medication order which was meant to be ordered on another patient. Generally, they will take accountability for the fact that they ordered under the wrong chart and they will say thank you. On occasions which an order is questioned due to lack of understanding of the disease process on the part of the nurse or when the nurse just missed a piece of the clinical picture, the physicians typically take it as a teaching opportunity, almost never making a nurse feel that the order was not worth questioning.
Just about everyone is referred to on a first name basis or nickname, including several of the attending physicians. It is such a team environment. For the most part, all team members realize that it takes each person involved to create safe, high-quality patient experiences free of preventable error. As this is my very first nursing position out of nursing school, this is the only interprofessional dynamic I know. I would never want to work on a unit where this level of comfort for communicating with team members did not exist. I consider myself very blessed to work in such a climate where interprofessional communication is, for lack of a better word, easy.
