Is Bullying by Doctors and Nurses Compromising Patient Safety?

Online, May 4, 2010 (Newswire.com) - Beth Boynton, RN, MS, author of Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces, is adamant about the need to address underlying bullying dynamics that lead to costly medical mistakes. Medical Error has been rated as the 5th leading cause of death in the U.S.! In addition, it contributes to thousands of injuries, diseases, and is an enormous waste of scarce resources such as time and money.

"We've known for years that communication problems are the leading root cause of adverse events," says Boynton. "We have been implementing efforts to address them with limited success because we are not getting at the underlying dynamics that interfere with respectful collaboration among professionals.

"I have worked with nurses and other healthcare professionals in various organizations around the country and am convinced that aggressive and passive-aggressive behaviors on the part of a small percentage of doctors, nurses, and administrators, along with workplace cultures that enable them, is undermining every corrective strategy we employ."

Boynton speaks passionately about the limited impact that computerized medical records, operating room check lists, and structured communication models have on patient safety, quality of care, and job satisfaction. "Concerned consumers can gain useful information from statistics on what we call Sentinel Events on The Joint Commission's website, www.jointcommission.org, A Sentinel Event is described as "an unexpected occurrence involving death or serious physical or psychological injury".

"For example, using simple and inexpensive checklists in the operating room has been effective in reducing wrong-site surgery, but only in some organizations. This is because, in some cases, there are dysfunctional relationships among professionals and there are workplace cultures that enable them. Here are two common examples of challenging situations that operating room nurses recently shared with me as I was preparing a workshop on assertiveness for them. In my experience, these types of dynamics are present in all sorts of healthcare settings and practice specialties."

A surgeon compromises patient safety by a breech in surgical technique and ignores, or becomes angry, when the nurse requests he stop and address the issue.

A nursing colleague purposefully holds back information about a surgery to
make another nurse look bad in front of the surgeon.

"If we really want 'Patient-Safe" care, there must be no double standards or mixed messages," Boynton avers." Too often I hear about organizations providing assertiveness training to nurses without addressing aggressive physicians. Assertiveness, as a technique, is not going to last in a culture that tolerates overt or covert bullying. If we want nurses and consumers to speak up about concerns, we must create safe environments for them to do so.

"Long-term and successful change requires acknowledging the depth and breadth of the problem and facing it head on with training, practice, role modeling, and enforcing of respectful communication at ALL levels. Helping nurses and other healthcare professionals become more effective, respectful communicators and showing them how to build positive workplaces, is key to creating safe, quality, and cost-effective care."