from Oncology Issues
John-Henry Pfifferling, Ph.D.
Disruptive behavior by any member of the oncology team can sabotage professionalism and has clinical, operational, and economic consequences. The interdisciplinary team becomes less productive and creative. At best, work is not as exhilarating as it could be. In the worst-case scenario, working becomes filled with anxiety.
When caregivers tolerate disruptive behavior from a member of the oncology team, the patient is the loser. Patients with cancer are dealing with intense fear and feelings of isolation. If their caregivers are emotionally unavailable and distracted by the behavioral ups and downs of a colleague, that sense of isolation will be intensified. The possibility also exists that important clinical information will be missed because the attention of the staff is not where it should be.
Cancer caregivers cannot develop strong therapeutic teams without a policy for dealing with disruptive behavior. The delivery of cost-effective, humane cancer treatment requires the healing or removal of disillusioned, angry, or "disruptive" professionals from direct patient care.
While no single definition of disruptive behavior exists, most authorities agree such behavior undermines practice morale, increases staff turnover, sabotages effective teamwork, increases the risk of ineffective care, and causes distress to peers, staff, patients, or others in the practice.
Disruptive behavior includes bullying, abusive language, shaming others for negative outcomes, criticizing team members in front of others, and threatening a team member with retribution, litigation, violence, or job loss. (See case studies on page 20). Disruptive individuals rely on intimidation to accomplish their goals and refuse to honor cultural differences. A disruptive staff member may also violate personal boundaries or refuse to comply with clinical practice standards.
The consequences to the disruptive individual may be severe, including loss of privileges, employment, and employability. He or she may be at increased risk of lawsuits from disgruntled colleagues and patients, or become "isolated" from colleagues and experience increased workloads because other team members will not provide assistance and support.
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