Interprofessional Conflicts

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Why weren’t my orders followed?



Watch the video to see one approach Dr. Miles might take. After watching the video, take a few minutes to answer the questions and then click the grey button for feedback.

"Why weren't my orders followed?"




What do you think of the physician’s approach?


What appears to be her goal in this conversation?


How effective is her opening?


What emotion is she conveying?



What appears to be her goal in this conversation?
  • Dr. Miles’ goal appears to be asserting her authority so that the care plan she discussed with Mrs. Stein is followed. She does not elicit or try to understand the nurse’s intentions in giving Mr. Stein antibiotics. She emphasizes that she does not see these decisions as part of the nurse’s role: “That is not your decision to make, that decision is Mrs. Steins and she made it thoughtfully and in consultation with me, you are not helping the patient or Mrs. Stein by going over my head.”

How effective is her opening?
  • Dr. Miles started the conversation from a judgmental position, assuming that the nurse was challenging her authority: “Why weren’t my orders followed?”

What emotion is she conveying?
  • Dr. Miles appears angry and defensive, emphasizing a worrisome power differential: “That’s not your decision to make….I’ll have the antibiotics stopped immediately.”