We Are All in the Same Boat: The Role of Professionalism in Cross Departmental Report

Background: As part of their care routine, nurses give and receive report multiple times every day. With each encounter, nurses are required to communicate with other nurses. However, not all nurse to nurse communication encounters are positive nor do they reflect the key elements of professionalism. In their sentinel event report on patient safety, The Joint Commission (TJC) discusses the implications of a hostile work environment, including its negative effects on patients and their families (2008). The Joint Commission also emphasizes how intimidating and disruptive behaviors erode professional behavior. Although several studies examined negative communication encounters between nurses, few studies focused on nurse to nurse report as a key contributor to unprofessional behaviors. In addition, no studies were found that explored the interactions between report and professional behaviors as perceived by the nurses themselves.

Purpose: The purpose of this study is to examine professional elements that contribute to success and satisfaction with nurse to nurse cross-departmental report. Research questions include: a) what are the contributing factors to cross-departmental nurse to nurse communication success and satisfaction, b) what are the barriers to cross-departmental nurse to nurse communication success and satisfaction, and c) how does individual nurse perception of professionalism influence the nurse to nurse communication encounter?

Methodology: The sample consisted of 12 Registered Nurses working in a variety of acute care settings the central valley of California. Data was collected through in-depth interviews and analyzed using Grounded theory methodology. Data collection and analysis occurred simultaneously using the constant comparative method.

Results: Findings indicate that a successful and satisfying cross departmental report encounter included a thorough and uninterrupted exchange. Additional components included listening, a positive attitude, relevant information, mutual respect, and report being presented in a systematic manner. Barriers to a positive experience included interruptions, negative attitudes or tone of voice, being rushed and/or disorganized, involved difficult and complex patients, and encounters where nurses were made to feel inferior. Nurses had a wide range of perceptions on how professionalism impacted their cross departmental report encounters. They discussed preconceived ideas about unprofessional behaviors from certain departments that influenced them even before encounters occurred. Unfortunately, nurses reported unprofessional behaviors more often than professional ones. Most nurses were able to articulate what report would look like if professionalism were the standard. However, these discussions were framed in the ideal world rather than the real world. Negative encounters with giving and receiving report have led to generalized assumptions about “All ICU nurses” or “All PACU nurses”, when giving report to certain areas.

Implications for Practice: When nurses discussed what could be done to improve professional behaviors in the workplace, they frequently revealed the need to recognize “we are all in the same boat”. All nurses struggle with heavy workloads, complicated patients, and/or not enough time.  The idea that mutual respect needs to be promoted and nurtured was evident in their discussions of professionalism. Using standardized reporting tools was another suggestion from these participants to improve cross departmental nurse to nurse reporting.