In order to reduce diagnostic errors that have a negative impact on patients, it has been suggested that it is important for multiple professions, not just doctors, to be involved in diagnosis. In particular, it is expected that the active involvement of nurses, who have the most opportunities to come into contact with patients, will lead to improved diagnostic accuracy.
On the other hand, especially in Japan, there is an absolute hierarchy between doctors and other medical professionals, and nurses may not be able to communicate concerns about a doctor's diagnosis.
Therefore, a research group at Juntendo University investigated the extent to which nurses feel concerned about doctors' diagnoses, the extent to which they are able to express those concerns, and the reasons why they are unable to communicate their concerns to doctors.
The survey targeted nurses registered with Nikkei Medical, Japan's largest medical professional internet site, and 430 people responded. The results showed that 1% of nurses had concerns about a doctor's diagnosis in the past month. Multivariate analysis revealed that nurses with more years of experience were more likely to have concerns.
Next, it was found that 52.5% of nurses who had concerns did not communicate them to doctors. Multivariate analysis confirmed that younger nurses or those with more experience were less likely to communicate their concerns, and that hospitals and clinics with fewer hospital beds were also less likely to communicate their concerns. As for the background of doctors, it was confirmed that doctors in their 20s to 40s were more likely to be reluctant to communicate their concerns than those in their 60s.
Reasons given for not communicating concerns included fear of hurting the doctor's pride (21.1%), fear of being ignored by the doctor (18.6%), and because diagnosis is something that doctors make (not the role of nurses) (15.7%).
Based on these results, it is important for doctors to reflect on their communication with nurses and foster a culture in which diagnoses can be made as a team.
Paper information:[Scientific Reports]Survey on nurse-physician communication gaps focusing on diagnostic concerns and reasons for silence
