Doctors need to listen more to nurses

Doctors need to listen more to nurses, and to potentially vital information from patients, says a report from the University of York.

At the moment, although doctors and nurses are increasingly sharing roles, patients are still in awe of doctors and find nurses easier to talk to.

And while nurses glean important information during their consultations, doctors are not told as much by their patients, although they are listened to attentively.

But the important information nurses gather isn't always being passed on, and patients' concerns are not being addressed.

A team on effective consultations, led by Sarah Collins of the Department of Health Sciences, discovered that patients found nurses easy to talk to and approachable. On the other hand, doctors were people to whom they listened attentively and sought guidance from, rather than people with whom they had a conversation.

The report, funded by the Economic & Social Research Council, argues that health care professionals should exploit these differences by working more closely together.

Ms Collins said: "It seems paradoxical that patients found it easier to talk with nurses and would say more to them, but took more from what doctors said."

"There are clear potential benefits if this distinction were to be exploited and used in team-working."

The research, which included recordings of 100 consultations, found that doctors and nurses had not considered the effects of their own communication and the overall impression left with the patient.

Distinctive ways that doctors and nurses talk with patients were identified by the study:

• Doctors tended to have more authority and be in a position to make decisions.
• However, doctors heard less than nurses and did not have the complete picture.
• Doctors set a sense of direction for the consultation as a whole, while the nurses were more open to anything the patient might want to say.

The report adds that though they are aware of these differences, health care professionals do not exploit them in the best way. Ms Collins added: "It tended to be that the complement between a doctor's consultation with a patient and a nurse's consultation with a patient was one way - from nurse to doctor. Nurses were supporting doctors' work more than doctors were supporting nurses' work, and this inevitably had an effect on whether and how patients' needs and expressed wishes and concerns were met."

The research team found a similar situation in all the cases it studied, with limited opportunities for nurses, doctors, and other health professionals to work together on what the patient had said.