This study (PDF here) from an outfit called The Physician Executive Journal of Medical Management tells us what we all know too well: poisoned relations between nurses and physicians, specifically and mostly consisting of the latter abusing the former, but also sometimes the other way around, is bad for patients.
What was the most common complaint? Degrading comments and insults that nearly 85 percent of participants reported experiencing at their organizations. Yelling was second, with 73 percent. Other typical problems included cursing, inappropriate joking and refusing to work with one another.
Some of described behavior is criminal, and would appear to meet the criteria for an assault charge, such as throwing scalpels or squirting a used syringe in a co-worker’s face. But according to some survey participants, it’s the day-to-day putdowns and slights that can be the most harmful.
“The worst behavior problem is not the most egregious,” wrote one participant. “It’s the everyday lack of respect and communication that most adversely affects patient care and staff morale.”
Another float in the Parade of the Blindingly Obvious. But now — hurray! — we have a study, instead of the avalanche of nursing anecdotes we all have been repeating to ourselves since Flo was emptying bedpans, but all ignored because, you know, we’re just a bunch of whiny nurses.
A few things caught my eye. The cases of physical assault were striking. Having scapels thrown at you, or getting your head stuffed down a garbage can by a physician is, as the study points out, actual criminal assault. Don’t care if Dr. Obnoxious was having a bad day, or his wife left him, or his last three patients developed post-op nosocomial infections — things which another article in the same issue charmingly and evasively calls “acute stressors.” I would be curious if any of these physicians were ever charged with assault, and if not, why. I think the answers would be revealing.
Alas, the study — nor the related articles in the same issue — doesn’t quite address the underlying causes of abusive behaviour. Well, almost. From the same study, here’s a clue:
So in other words, though physicians account for the most instances of bad behaviour, nurses are the ones that get in in the neck.
Speaks volumes about the power differentials in your average health care setting, doesn’t it? And just maybe, there’s an unexamined relationship between power and abusive behaviour?