THE EFFECT OF DOCTOR-NURSE RELATIONSHIP ON PATIENT CARE

1.1 Introduction

Nursing is a communication intervention, and its foundational communicative attitude is the desire of mutual understanding, coordination, and collaboration. An essential component of nursing practice is the nurse's ability to communicate with the patient in an efficient manner. In nursing care, an effective doctor-nurse connection is essential because it helps the patient feel comfortable both within and outside of the hospital. It represents a mutual understanding between the patient and the nurse to cooperate for the patient's benefit. There has to be effective communication between nurses and patients for a nurse-patient relationship to be therapeutic. The distinction between mediocre and outstanding nursing care is in the ability to communicate.

The way nurses interact and communicate with patient's shapes their perception of them, and this perception affects the patients' level of satisfaction and, ultimately, the quality of care provided (Papagiannis, 2009). Furthermore, according to Bach and Grant (2009), one method to achieve holistic and client-centered care is for nurses to have a thorough grasp of the roles, effective communication techniques, and obstacles that affect the process and results of healthcare providing.

This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.

1.2 Background of Study

In the 21st century, Nursing is a communication intervention and that the pursuit of mutual understanding, coordination, and cooperation is the communicative attitude that forms the basis of nursing. The nurse's capacity to interact with the patient effectively is a vital aspect of nursing practice. According to reports, patients have less influence in the nurse-patient interaction, which may increase their susceptibility if nurses treat them disrespectfully. Patients with mental, physical, or emotional issues can be challenging for nurses to manage in a relationship. Nurses must, therefore, uphold their professional standards and their interpersonal relationships by fully demonstrating the ideas of therapeutic relationships.

Moussas et al., (2010) asserted how the two sides interpret the communication pattern will determine the features of the nurse-patient relationship. Ineffective communication results in unfavourable generalizations and attitudes, which are frequently caused by a failure to acknowledge and adhere to the two-way capability of communication (Moussas et al., 2010).

Regardless of the duration of interaction, the fundamental values of a therapeutic relationship remain the same: confidentiality, active listening, respect, sincerity, empathy, and trust. The goals of the therapeutic alliance are to assist the patient, encourage recovery, and maintain or improve functioning. In contrast to social relationships, therapeutic relationships have clear limits and are patient-centered and health-focused.

According to Orlovsky (2007), ineffective communication is the leading source of major medical mistakes, but efficient communication with patients is increasingly recognised as essential to providing patient-centered care in all healthcare settings (Smith & Pressman, 2010). A better level of patient care is achieved through effective communication, which happens when the knowledge, abilities, and distinct viewpoints of doctors and nurses are combined (Lindeke & Sieckert, 2005). Orlovsky suggests that in order to communicate effectively, nurses should be confident, courteous, skilled at small chat, able to resolve dispute, and aware of the bigger picture.

The majority of a nurse's working hours and patient interactions are devoted to connecting work that supports physician consultations. They act as the "glue," escorting patients into consultation rooms, empathizing with the difficulties of sticking to lifestyle changes by sharing their own stories, letting patients share concerns that they would not otherwise share with doctors, being gregarious, cracking jokes, and offering explanations when doctors' words have fallen short (Collins, 2009).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Effect of Doctor-Nurse Relationship on Patient Care.

1.3 Statement of Problems

Investigation revealed that Nursing professionals have an obligation to establish a therapeutic connection, identify any power imbalances, and anticipate clients' propensity for intimidation. As a result, this knowledge aids in setting and upholding proper limits. However, it is evident from news reports, publications, and some patients' personal experiences that patients do not receive enough care from their doctors and nurses. Because they frequently lack defences, patients may rely on nurses to take care of their fundamental requirements.

Beyond the practice setting, patients may desire to rely on the nurse since they may not have a network of supporting family and friends. Certain patients may be especially susceptible, such as those who require continuous care or who have mental health issues. The Federal Medical Centre in Owerri undertook a research to determine the nature of the interaction between nurses and patients in response to this disparity. The doctor-nurse dynamic at the hospital will benefit from this.

1.4 Aim and Objectives of Study

The aim of the study is to investigate the Effect of Doctor-Nurse Relationship on Patient Care using Federal Medical Centre Owerri, Imo State as a case study. In achieving this aim, the following specific objectives were laid out as follows:

1. To assess nurses' knowledge of the importance of communication among nurses in the delivery of patient care;
2. To examine the effects of doctor-nurse relationship on the health of the patients;
3. To identify the factors that influence nurses' interaction with patients and colleagues; and
4. To determine whether the socio-demographic characteristics of the nurse and the patients affect the type of relationship between them.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Does nurses' knowledge of the importance of communication among nurses in the delivery of patient care?
• Are there factors that influence nurses' interaction with patients and colleagues?
• What are the effects of doctor-nurse relationship on the health of the patients?
• What are the socio-demographic characteristics of the nurse and the patients affect the type of relationship between them?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant factors that influence nurses' interaction with patients and colleagues
• H1: There are significant factors that influence nurses' interaction with patients and colleagues

1.7 Significance of Study

The significance of applying the bio-psychosocial paradigm to healthcare was raised in the study. The findings of the research will help patients and nurses alike better comprehend the doctor-nurse interaction.

The outcome of the research will also highlight how crucial it is for nurses to provide patient-centered care rather than task-centered care. Additionally, the research will broaden the corpus of information already known about the topic.

Finally, this study will be extremely helpful to other researchers who wish to learn more about it. Non-researchers can also use it to expand on their own research projects. This research adds to the body of knowledge and may help direct future investigations.

1.8 Scope of Study

The scope of the research is focused on the Effect of Doctor-Nurse Relationship on Patient Care using Federal Medical Centre Owerri as a case study.

1.9 Limitations of the Study

During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:

1. Time Constraint:The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research Material: availability of research material is a major setback to the scope of the study.
3. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
4. Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.

1.10 Operational Definition of Terms

Nursing Care Plan:

It is a medical plan that is used in practice to determine each person's unique care needs through a methodical, scientific approach to problem-solving.

Health:

It is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.

1.11 Organization of the Study

For the information presented in a research work to be clearly understood and appreciated, a systematic and chronological presentation of the work is of greater importance. In keeping with this, this research has been organized and presented in five chapters;

Chapter One of the study, provides background of the study, stating the problem of the study and the research questions and hypotheses to be tested in the study. It also highlights the significance of the study and scope of the study.

Chapter Two reviews related literature on the Effect of Doctor-Nurse Relationship on Patient Care.

Chapter Three; information on the method employed in the collection of data and their analysis can be found in this chapter. Also in this chapter, justification is provided for the adoption of the methods and analytical techniques employed.

Chapter Four; This involves the presentation and analyses of data findings from the testing of hypothesis are also presented here.

Chapter Five; This is the final chapter and it contains the summary of the entire work done, the conclusions down, and the recommendations made by the researcher based on the findings of the research work.

Appendices; It is usual practice that in the final pages of research work, reproductions of some document such as questionnaire relevant tables, statute, and letters attached for a better appreciation of the research work by the reader. This can also serve as a means of verification work done.