Strengthening the Nurse-Physician Relationship to Improve Cardiovascular Disease Care

The Heart of Teamwork

Cardiovascular disease (CVD) remains the leading cause of death in the United States, contributing to more than 650,000 deaths in 2023.¹ Improvement in preventing and managing the disease requires more than new guidelines and treatments; it demands a coordinated team effort among nurses and physicians. Physicians and nurses are two healthcare professionals who determine the quality of care CVD patients receive. They both form the backbone of prevention and care, in their respective roles, by identifying risk factors for the disease, educating patients about their diagnosis, prescribing or administering treatments, and evaluating healthcare outcomes. Thus, their collaborative efforts impact the overall health outcomes of their patients with CVD. Collaboration is a clinical competency that students should develop through education, practice, and professional development to ensure coordinated interprofessional care. The purpose of this article is to highlight how strengthening nurse-physician relations can improve heart disease prevention and care.

Building Collaboration During Degree Training

The beginnings of collaborative care can begin before nurses and physicians begin their work in clinical practice. Historically, the educational training of nurses and physicians is a siloed process. Each discipline may learn about the other during their training; however, learning together is often a rare occurrence—a study by Bovo et al. investigated how medical students perceived nurse-physician relationships.² One of their findings suggests that nurses were viewed as practicing within a teamwork-driven environment, whereas medical students view physicians as having more structured and less collaborative interactions. The students also reported that physicians appeared more likely to display negative responses when engaging with nurses. Wang et al. looked at nurse-physician relationships from the perspective of nursing students and found that students viewed communication and collaboration as essential to provide good care to patients.³

Together, these findings underscore the importance of introducing collaboration long before nurses and physicians enter practice. Some examples for introducing collaboration among health profession students include: joint clinical rotations,⁴ interprofessional simulation exercises,⁵ and grand round projects.⁶ These experiences can teach students the importance of teamwork and how their roles complement each other.

Fostering Psychological Safety and Respect in Practice

Nurses and physicians must also work in environments that foster psychological safety and respect in practice. Mehta et al7 described psychological safety as a person having a sense of inclusion and feeling safe to learn, contribute, and speak up without consequences.⁷ In cardiovascular care, seconds can determine the health outcomes of a patient. Thus, the ability to voice an observation or concern is lifesaving for a patient. A psychologically safe environment can also encourage adherence to hospital policies, enhance learning, and promote mental health.⁷ Nurse managers and medical directors, as leaders in their respective roles, can set the tone for psychological safety and respect in practice. The traits of an individual, team, and healthcare organization can serve as either a facilitator or barrier to psychological safety.⁸

Mehta et al. provides tips for cardiovascular health leaders to foster psychological safety in the workplace.⁷ These tips include:

• Measuring and understanding the current level of safety in the workplace through data collection, and then using the findings with staff input to improve the workplace
• Reviewing current practice and policies and ensuring they foster a psychological safety environment
• Showing staff appreciation
• Offer ongoing training in teamwork, communication, and psychological safety
• Model habits that demonstrate wellness-oriented habits, inclusiveness, trustworthiness, and open leadership behaviors

The Role of Professional Organizations in Team Building

Several professional organizations are leading efforts to strengthen collaboration in cardiovascular care by creating structured opportunities. The Preventive Cardiovascular Nurses Association (PCNA) reinforces collaboration through its events, resources, and partnerships with other organizations. At their annual Cardiovascular Nursing Symposium, they host interdisciplinary sessions with nurses, medical doctors, physician assistants, nurse practitioners, etc. PCNA also offers provider toolkits to aid healthcare professionals in collaborating on patient care, both in the clinic setting and in the community. Further, PCNA has partnerships with several collaborative organizations, including the American College of Cardiology (ACC), American College of Sports Medicine, and several scientific councils within the American Heart Association (AHA).

The Macy Foundation focuses on preparing health professionals to meet the needs of our diverse nation. One of the foundation’s priorities is interprofessional education, where students from different health fields learn together as a team. Through grants, programs, and conferences, the foundation supports initiatives that prepare a team-based healthcare workforce.⁹ Similarly, the AHA and ACC co-sponsor sessions, webinars, and statements that bring interdisciplinary professionals together.

Teamwork in Cardiovascular Care

Nurse-physician relationships are essential to deliver consistent, quality care to all patients with CVD. By fostering psychological safety and respect in practice and building collaboration during training, we can begin to bridge gaps in education and practice. Every collaboration we initiate brings us one step closer to better cardiovascular care for all patients.