Katharine Ryan
Ventiv Health
We have already considered in previous
articles the role of the nurse adviser and how nurses cope with the transition
from NHS into a commercial environment. This month we look at how nurse
advisers and medical representatives can get the best out of their working
relationship, without compromising ethical standards.
The Medical
Representative’s Perspective
Nurse adviser teams are still a
fairly new concept. Many representatives still have little or no direct
experience of working for a company that sponsors such a team. This means that
there is often a lack of understanding of how these teams work, particularly in
terms of the relationship with the representative.
This lack of
understanding can lead to misconceptions and concerns about the impact of the
nurse on the representative’s territory. Some representatives are
concerned that the nurses may upset their customers and ruin their established
relationships. Some may see the nurse as being in competition with
them.
Other representatives may welcome the nurse with open arms,
believing that they will be a great source of information on individual doctors
and clinics. This group rapidly become frustrated when they discover that
ethical and confidentiality constraints prevent this.
For many
projects, particularly when they are first set up, it is down to the
representatives to refer practices/departments that are interested in the nurse
adviser service. Often representatives do not see the value in this additional
work, particularly if customers are resistant to the idea, so they may not make
sufficient referrals to allow the nurse to work to her fullest
capacity.
In fact, the thought of working with a nurse adviser team can
leave the representative thinking ‘All this extra work and what is in it
for me? How is this going to help me achieve my territory objectives?’
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The Nurse Adviser Perspective
If we then consider the nurse’s perspective, they have a completely
different set of concerns. One of their highest priorities is that they do not
compromise their ethics. As healthcare professionals, working within the
pharmaceutical arena, nurse advisers are keen to ensure their independent
status conforms to the statutory requirements of their regulatory body, the
UKCC code of conduct. Nurse advisers are very clear about their non-promotional
status (they do not promote any product or provide a "service for products"
i.e. they do not provide a service in exchange for product usage, they provide
it for the purpose of improving patient outcomes). In fact, they are so clear
on this point that some may see no possible need to have a relationship with
the wholly promotional sales representatives.
One of their other
concerns is the impact on their credibility with customers if they are seen
with or linked to a representative. Nurses tend to approach the situation from
a different angle to the representatives. They have a different relationship
with clinicians in that they are able to work with the clinicians peer-to-peer,
providing advice and assistance in implementing best practice. Unsurprisingly,
nurse advisers are keen to preserve this relationship.
All these factors
can lead to a nurse adviser expecting the representatives to provide the
centres that they will work in and then leave them to it. For some nurses this
is as much of a relationship as they see necessary.
Maximising the
Relationship
Looking at it from the 2 perspectives, both groups
appear to have quite divergent agendas. However, by maximising their working
relationship, within clear ethical boundaries, each party can gain significant
help in the achievement of their own quite separate goals.
The
representative can ensure that the nurse adviser service is sold as a concept,
to enough customers, to maintain the level of throughput of centres/practices
that the nurse requires. They can also ensure that the introductions are
appropriate so as not to waste either the customer’s or the nurse’s
time.
Once in the practice the nurse can ensure that the relationships
that they build and the service that they provide further enhances the
reputation of the sponsoring company as being experts in a particular arena.
Their positive experience and the positive feedback from their patients, as
well as the measurable improved patient outcomes, can only assist the
representative in their future dealings with the practice. It is up to the
representative to then capitalise on this.
The key to maximising the
relationship is, as with many things, communication. Both parties need to have
a clear understanding of and mutual respect for each others roles, objectives
and boundaries. This enhanced understanding can be facilitated through
meetings.
Meetings between nurses and representatives can aid the
situation, provided there are very clear guidelines for these meetings so that
their independent status and other ethical boundaries are not compromised. On
some occasions it may even be appropriate for the representative to be involved
in the introduction of the nurse, to facilitate the process, but both parties
need to understand that once the nurse is introduced they need to be left to
work independently.
In addition communication between the two groups can
be enhanced by the Nurse Managers, part of whose remit is to balance the
commercial and ethical issues. By attending regional, national meetings and
initial training courses the manager can provide feedback on the team’s
achievements and the do’s and don’t’s of how the two groups can
work together.
Once good communication and understanding are in place,
everyone involved starts to see the benefits of the programmes. One
representative described her expectations of working with nurse advisers when
she first joined her current employer, ‘my initial expectations were quite
high because when I joined the team, my first day was a regional meeting where
there was an update on the nurse team. Three of my colleagues were already
using the service. I was listening to the feedback from them about a
professional service with well trained nurses who are adaptable and really try
to help the surgeries as much as possible’. Having now worked alongside
her local nurse for some time her personal experience has only served to
enhance this position, ‘I am proud to discuss the nurse adviser’, she
says, ‘what a wonderful service, what a wonderful team’.
So
although the relationship between nurses and their sponsoring company’s
representatives can be a tricky balance and whilst it does not always get off
to a good start, with a clear understanding of each other’s aims and the
benefits for both, a positive working relationship can be established which
leads to positive outcomes for all.
About the author
Katharine Ryan is the Communications and Recruitment Director for
Ventiv Health, a leading provider of sales and marketing solutions to the
pharmaceutical industry. In the last seven years Ventiv has successfully
delivered Nurse Advisor solutions for many of the leading pharmaceutical
companies.
