2009 Survey: Doctor Nurse Behavior Problems Impact Patient Care

  1. bad blood:
    doctor-nurse behavior problems impact patient care
    by carrie johnson

    examine the eye-opening results of the acpe survey on doctor nurse behavior and learn how the problems can directly affect patient care.

    [font=freighttext-light][font=freighttext-light][font=freighttext-light][font=freighttext-light]according to the survey results, outrageous behavior
    [font=freighttext-light][font=freighttext-light][font=freighttext-light][font=freighttext-light]is still common in this country's health care organizations.[font=freighttext-light]
    [font=freighttext-light][font=freighttext-light][font=freighttext-light]more than 2,100 physicians and nurses participated in the[font=freighttext-light]
    [font=freighttext-light][font=freighttext-light]survey, and some of the tales they related were surprising:[font=freighttext-light]

    [font=freighttext-light][font=freighttext-light]physicians groping nurses and technicians as they
    [font=freighttext-light][font=freighttext-light]tried [font=freighttext-light][font=freighttext-light]to perform their jobs.
    [font=infotext-bold][color=#e36a27][font=infotext-bold][color=#e36a27][font=infotext-bold][color=#e36a27]* [font=freighttext-light][font=freighttext-light]tools and other objects being flung across the or .

    [font=infotext-bold][color=#e36a27][font=infotext-bold][color=#e36a27][font=infotext-bold][color=#e36a27]* [font=freighttext-light][font=freighttext-light]personal grudges interfering with patient care.

    [font=infotext-bold][color=#e36a27][font=infotext-bold][color=#e36a27][font=infotext-bold][color=#e36a27]* [font=freighttext-light][font=freighttext-light]accusations of incompetence or negligence in front of

    [font=freighttext-light][font=freighttext-light]patients and their families.
    [font=freighttext-light][font=freighttext-light]according to the respondents, the fundamental lack of
    [font=freighttext-light]respect between doctors and nurses is a huge problem that
    [font=freighttext-light]affects every aspect of their jobs. staff morale, patient safety
    [font=freighttext-light]and public perception of the industry all suffer as a result.
    [font=freighttext-light]the electronic survey was emailed to about 13,000 doctors
    [font=freighttext-light]and nurses. of those who participated, about 67 percent
    [font=freighttext-light]were nurses and 33 percent were physicians.

    [font=freighttext-light]behavior problems are obviously pervasive: nearly 98
    [font=freighttext-light]percent of the survey respondents reported witnessing behavior
    [font=freighttext-light]problems between doctors and nurses in the past year.
    [font=freighttext-light]responses were divided over how frequently problems arose.
    [font=freighttext-light]about 30 percent of participants said bad behavior
    [font=freighttext-light]occurred several times a year, while another 30 percent said
    [font=freighttext-light]it happened weekly, and about 25 percent said monthly. a
    [font=freighttext-light]surprising 10 percent said they witnessed problems between
    [font=freighttext-light]doctors and nurses every single day.

    [font=freighttext-light]what was the most common complaint? degrading
    [font=freighttext-light]comments and insults that nearly 85 percent of participants
    [font=freighttext-light]reported experiencing at their organizations. yelling was second,
    [font=freighttext-light]with 73 percent. other typical problems included cursing,
    [font=freighttext-light]inappropriate joking and refusing to work with one another.
    [font=freighttext-light]some of described behavior is criminal, and would
    [font=freighttext-light]appear to meet the criteria for an assault charge, such as
    [font=freighttext-light]throwing scalpels or squirting a used syringe in a co-worker's
    [font=freighttext-light]face. but according to some survey participants, it's the dayto-
    [font=freighttext-light]day putdowns and slights that can be the most harmful.
    [font=freighttext-light]"the worst behavior problem is not the most egregious,"
    [font=freighttext-light]wrote one participant. "it's the everyday lack of respect and
    [font=freighttext-light]communication that most adversely affects patient care and
    [font=freighttext-light]staff morale."

    [font=infotext-bold][font=infotext-bold]physician, heal thyself

    [font=freighttext-light][font=freighttext-light]while there were complaints about nurse behaviors,
    [font=freighttext-light][font=freighttext-light]both doctors and nurses who filled out the survey said physicians
    [font=freighttext-light][font=freighttext-light]were to blame for a large part of disruptive behaviors.
    [font=freighttext-light][font=freighttext-light]many of the participants accused physicians of patronizing[font=freighttext-light]
    [font=freighttext-light]and belittling nurses, a pattern some surmise may have been

    [font=freighttext-light]instilled in medical school.

    'disheartening' developments for disruptive behavior

    by carrie johnson

    early intervention can help prevent disruptive behavior

    by alan h. rosenstein md, mba

    strengthening physician-nurse partnerships
    to improve quality and patient safety

    by michael buckley, md, john laursen and victoria otarola

    pennsylvania hospital launches doctor-nurse partnership program and finds that better working relationships lead to better patient care.

    crucial conversations:
    the most potent force for eliminating disruptive behavior

    by joseph grenny

    techniques are available to begin to address bad behaviors, including encouraging health care workers to speak up and discuss their concerns.
    Last edit by NRSKarenRN on May 19, '10
  2. Visit NRSKarenRN profile page

    About NRSKarenRN, BSN, RN Moderator

    Joined: Oct '00; Posts: 27,411; Likes: 13,627
    Utilization Review, prior Intake Mgr Home Care; from PA , US
    Specialty: 40 year(s) of experience in Home Care, Vents, Telemetry, Home infusion


  3. by   eternalbride
    why can't these negative things change.
    We should all do something about this!
  4. by   HonestRN
    Doctors bring in the patients and big money so as long as it's that way things won't change.
  5. by   CrufflerJJ
    Quote from HonestRN
    Doctors bring in the patients and big money so as long as it's that way things won't change.

    Ahh, yes - the Golden Rule. He who has (or in this case, he who brings in) the gold makes the rules.
  6. by   carolinapooh
    I hate to say it, but I don't see it that way at all.

    As long as it's tacitly tolerated, it will continue.

    Doctors are not God, and nurses are not doormats. As long as RNs sit back and take it, it will continue. Secretaries don't take it anymore from CEOs, so why do RNs keep saying "oh, that's just the way it is because doctors have all the power".

    Folks, I'm raising the BS flag on that one.
  7. by   PostOpPrincess
    It's changing.

    I pulled in an MD into a big convo with a VP.

    Let's just say, he is much better.
  8. by   chani
    the way I see it is that badly behaved healthcare professionals, including doctors, nurses, physiotherapists and the rest, have not risen above the level of the 2yr old tantrum and so long as anyone allows it to happen to them it will continue. I just walk away from the tantrum 'cause you cant reason with a two yr old having a tantrum AND you dont give them an audience either. I may not change that particular person's behavior but I have too much respect for myself to put up with it. I havent been in an office with a manager throwing a tantrum but I would do the same thing.
  9. by   HouTx
    It's true that Physicians have traditionally been in a 'power position' as far as health care goes but that is changing. Just because a physician is a high-volume admitter does not necessarily mean that she adds to the overall bottom line. She may cost the organization more than the revenue his patients bring by refusing to be a team player - working with everyone to manage the care so that it is most efficient and costs less. We know the ones -- "I don't care if you want to transfer to the floor, my patient is going to stay in ICU over the weekend".

    Disruptive behavior interferes with overall productivity and has a very scary effect on patient safety. We all need to step up to eliminate it.
  10. by   brillohead
    Looks like it's time to call in Jojo the SuperNanny for some behavioral training with The Naughty Chair!!!
  11. by   NSJodi
    I'm at a teaching hospital that is not owned by the university. Here the nurses have the majority of the power over the doc's (well except for the attending md's, but they're not around much). We can override an MD's order to transfer if the bedside RN and the charge believes it is in the patient's best interest (regardless of who writes the order). And we can also transfer to a higher level of care without approval from the team (again if it is in the pateint's best interest).These rules have greatly changed how the nurses are treated by the MD's and there seems to be a more collaborative working relationship. One very wise attending once told me "a good nurse will almost always make up for a bad doctor, but it's never the other way around, that's how important the nurse is to the equation". I think the culture is changing.
  12. by   pjpj
    I believe respect is a two way street.
  13. by   longbow.shelly
    This reminds me of the relationship between officers and enlisted in the military. I have been on both sides of that fence. The bottom line is, devaluing your support is like shooting yourself in the foot. Doctors have a critical role/ function in the direction of patient care. But the backbone to execute those orders effectively, resides with the nurses. Undermining the people who are supposed to make you look good is a poor leadership style. As they say in the military, maybe doctors (officers) should be required to spend time as nurses (enlisted non-commissioned officers) before taking the reigns. That yields a perspective like no other. What about an Internship in nursing as part of their medical training, or at least a clinical rotation??? LOL! (I can see doc types in my mind right now, who look like Mr. Peanut, top hat and one eye spectacle, gafawing and exclaiming, "PREPOSTEROUS! OFF WITH HER HEAAAADDDDDD!!!!!")
  14. by   imintrouble
    I don't like doctors. I see a NP. If I could avoid them I would. Unfortunately, the are kind of vital to the job I do. Even the decent ones will sit silently and let one of their own berate nurses publicly.