Doctors and Nurses and the Problem of Their Disruptive Behavior
One group of nurses banded together to try to get a physician unfairly disciplined, while another encouraged fellow nurses to disobey doctors' orders outright. A surgeon told his staff that monkeys could be trained to do what scrub nurses do, while another doctor told a patient that the nurse in the room didn't know what she was doing.
A nurse witnessed the onset of complications in an intensive care patient but refused to contact the on-call physician for fear of his temper -- a delay at least one observer thought contributed to the patient's death.
This excerpt is from November 16, 2009 American Medical Association News, amednews.com
The article is all about what is happening now in hospitals, clinics and other healthcare facilities around the United States. It is all about disruptive and intimidating behavior of physicians and nurses which has been going on for years but now, starting about a year ago, the Joint Commission which certifies hospitals and other institutions for government reimbursement in the interest of patient safety declared that these institutions must present evidence of “zero-tolerance” for these unprofessional behaviors which potentially can impact negatively on the care and safety of the patients. However, there still is a lot still missing in institutional and personal compliance to the Joint Commission’s order.
A 2009 study of behaviors "Bad Blood: Doctor-Nurse Behavior Problems Impact Patient Care," American College of Physician Executives 2009 Doctor-Nurse Behavior Survey,Physician Executive Journal, November/December showed the following:degrading comments and insults comprised 84.5% of the behaviors followed by yelling 73.3%,cursing 49.4%, inappropriate joking 45.5%, refusing to work with colleague 38.4%, refusing to speak to colleague 34.3%, trying to get someone unjustly disciplined 32.3%, throwing objects 18.9%, trying to get someone unjustly fired 18.6%, spreading malicious rumors 17.1%, sexual harassment 13.4%, physical assault 2.8% and others 10%.
However, what is happening is that there seems to be a difficulty in separating disruptive speech and actions from honest attempts in certain situations to protect patients and to disclose to hospital administration of weaknesses in the hospital’s healthcare system or in the harmful behavior of certain physicians or nurses—that is, “whistle blowing”. Unfortunately, these actions may be considered disruptive, not constructive and behavior which must be suppressed to keep to the Joint Commission’s rule and it is the “whistle blower” who is accused of being disruptive. Further, staff may be reluctant to report on behavior of superiors or other colleagues in fear for personal repercussions.
Obviously, much more has to be done besides hospitals simply writing a policy about these matters. Read the full article and the linked references there and return and give your opinion about the issue and any disruptive behavior you have witnessed, but please give no names. ..Maurice.
Graphic: Photograph, taken by me, of a painting ("Self-portrait, Yawning, Joseph H. Ducreux, 1783 from the Getty Museum, Los Angeles)but modified with Picasa3. Basis for selection of this graphic for this thread: Somehow, the painting looked to me like a disruptive yelling rather than a benign yawn. What do you think?