Nurses and Pharmacists: New Alliance Leads to Happier Workplaces

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By Jessy Thomas, PharmD

The link between nurse job satisfaction and patient satisfaction has been well-documented, with one study showing that for every 10 percent of nurses reporting job dissatisfaction, the likelihood of patient recommendations of that hospital decreases by 2 percent. Recognizing the correlation between staff satisfaction and patient satisfaction, health care leaders have been placing a greater focus on employee engagement to improve HCAHPS scores – the government survey that measures patient satisfaction – with the goal of higher reimbursements and increased profitability.

To help improve job satisfaction, with the aim of creating a better patient experience and then, ultimately, increasing profitability for hospitals, health care executives would do well to start by concentrating on a particular relationship, the one between the staffs within the pharmacy and nursing departments. While both groups have a shared primary goal to deliver quality patient care, a poor relationship between these two departments can negatively impact patients’ impressions of the facility and could even lead to adverse reactions. Tension and frustration can be common between the two disciplines, so efforts to improve this relationship can put a hospital on the right path toward a more positive and collaborative culture and working environment.

To help maintain a strong working relationship between these two groups, here are four strategies to consider:

Consider alternative pharmacy models. Introduce a decentralized pharmacy model that provides nurses a go-to pharmacist who is dedicated to a particular floor and can assist directly with medication needs. The traditional model, which has, to date, been the default in an estimated 80 percent of U.S. hospitals, often sees the pharmacist isolated, located on a separate floor and away from the action. This can not only be a cause of frustration for nurses who are on the front line and have to manage a patient who might be in serious pain, but it also reinforces the perception that since the pharmacist isn’t interacting directly with the patient, he or she doesn’t appreciate the urgency of the situation or the level of pain the patient is experiencing.

By contrast, the decentralized model calls for a delegated pharmacist on the floor, which can minimize medication delays and also allows the pharmacist to be available in person to answer any specific questions a patient, nurse or other health care provider might have. Being able to interact in person instead of over the phone also helps the two disciplines better understand the other’s stressors and encourages them to work together as a team to identify potential issues and solutions.

Getting the balance right from a resourcing perspective is critical when considering the decentralized model. Pharmacists must still spend time in the pharmacy dispensing medication, so the staff roster needs to ensure that the pharmacy is still appropriately resourced. For executives seeking to implement this model, consider putting a pharmacist on select floors, such as the neonatal intensive care unit, pediatric intensive care unit, oncology unit or cardiology unit as a matter of priority.

Improve communication. Encourage regular interdisciplinary meetings on the floor to help troubleshoot issues and listen to updates on staff resourcing or repeat concerns. The best time for these meetings will vary from one hospital to the next, but this forum will ensure regular open dialogue and face-to-face discussions amongst nurses and pharmacists, as well as other members of the health care team, including physicians or lab technicians. Why is this important? Poor communication is a key reason for conflict within a hospital, and for nurses and pharmacists, this largely centers on medication preparation and delivery. While nurses might be concerned with medication delivery delays, certain medications require more time for preparation due to product dilution or patient safety measures. Having a dedicated time every day, such as at morning bed meetings, for disciplines to meet, discuss issues and share concerns will go a long way toward helping improve communication and ensuring both disciplines better understand the other’s stressors and are able to work together to find resolutions.

Make recruitment a cross-department endeavor – Involve pharmacists in the hiring of nurse leadership positions and vice versa. Executives will find that each discipline brings a different perspective to the process, which will increase the hospital’s likelihood of hiring the best candidates for its open positions. It also provides an opportunity to establish a collaborative, team environment at the hospital, which is easier done during hiring rather than after. This further promotes understanding between both professions.

Foster a positive culture from the top down – Health care leaders must regularly demonstrate, promote and communicate a multidisciplinary, collaborative team culture, reinforcing that each department plays a critical role in the overall health of the patients and hospital performance. Setting strong patient-centric values early on and then consistently reinforcing them is vital in improving the hospital culture in a way most likely to foster an improved patient experience. Of course, workplace issues will arise; but how staff and health care teams respond to each other to rectify and, ultimately, solve these issues will determine the work environment. Working together with mutual respect and understanding will make for not only a happier workplace, but also a better for the hospital for the patient, both of which are important indicators of a hospital’s financial future.

Jessy Thomas, PharmD, director of pharmacy for CompleteRx, one of the nation’s leading pharmacy management companies, has been the director of pharmacy for Driscoll Children’s Hospital in Corpus Christi, Texas, for the last five years. She was previously the pediatric intensive care unit clinical pharmacist at Driscoll Children’s Hospital. Jessy holds a doctor of pharmacy degree from Philadelphia College of Pharmacy and completed a residency in pharmacy practice.

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