To strengthen the medical and surgical team, each nurse must feel valued for their skills and knowledge. This recognition is a powerful driver of continued quality nursing care, increased job satisfaction, and nurse retention. Ideally, the medical/surgical team should feel empowered to invest in the nursing team by listening, challenging and educating, thereby strengthening the quality of the team as well as the level of care delivered to the patients.

A good clinical team will learn to adopt a patient-family centered model which enthusiastically embraces the patient’s relationship with their support system [12]. A challenge to this status quo is the person-centered approach. A person-centered approach recognizes the individual over their diagnosis (e.g. “the leg injury patient” becomes “Mr. Smith with a leg injury”) and can drive a personalized patient-care approach, thereby reinforcing a humanistic culture of care. A person-centered approach can improve patient satisfaction scores that focus on the perception of care as it relates to listening, respect, explanation and viewing the patient as an individual. A distant second reason for providing this humanistic approach is that it can also be fiscally advantageous as patient satisfaction scores now impacts reimbursement.

The cultivation of a safe care environment requires a system dedicated to refining the standard of clinical practice through robust multidisciplinary alignment that engages all staff. According to Spears et al. [13], sustained high quality nursing care engages and integrates multidisciplinary teams to work more effectively and safely; this integration should involve both frontline and nurse leaders. Physicians may be reluctant to involve nursing leadership, nurse leadership involvement starting from the unit leadership to hospital nurse. Efforts to engage often pays dividends by building the relationship, helping to drive change and add another layer of accountability for sustainable quality care. McSherry and Douglas [14] assert that nurse managers play a substantial role in facilitating frontline nurses to innovate and dispense high-quality compassionate people-centered nursing care. While physician input to on nursing performance is essential, good nursing leaders will reciprocate with physician feedback, fostering an open relationship built on improving the level of care delivered.

According to The Joint Commission [15], approximately 60 % of medical errors are a direct result of communication failures. Effective communication can prevent these errors and deliver the desired care by a cohesive team. Collaboration between nurses and physicians is vital for improving patient care quality indicators as well as patient satisfaction. The advantages of effectual nurse/physician relationships include decreased errors with decreased cost, better patient care, and decreased patient morbidity and mortality [16]. Like any relationship, success requires effort from both parties, along with trust that both share common goals good patient care, clinical excellence, and patient/family satisfaction.

Studies have repeatedly shown that Nurses who work closely with physicians and contribute in shared decision making encounter less burnout. Conversely, disruptive physician behavior has been cited as a contributor to the national nursing shortage [17]. The first step to develop a good nurse-physician relationship is to personally know and value the other, fostering respect, trust, and open honest communication. The nurse perspective is typically systematic in approach and often elaborate in day to day details, whereas the physician is in broader strokes about general disease progression; however, both have the same objective of improving the patient’s condition and can use this foundation to strengthen their team.

Pain management following surgical procedures is an imperative matter when appraising the effectiveness of the nurse-medical team interventions [18]; effective pain control is an essential component of safe care. Nurses often try many methods for pain control, some dictated by standard unit practices, some from their clinical knowledge and sometimes intuition of what will help the patient [19]. Continual assessment by skilled trusted nurses ensures that pain is constantly being adequately addressed. Moreover, both Joint Commission as well as state agencies require that pain is not only measured, but that pain management is commensurate with the level of pain experienced. For example, while one medication may be sufficient for moderate pain, a more powerful medication could be needed as the level of pain escalates a robust system that scores pain level on a 1–10 scale can guide management, providing alternatives for breakthrough pain.