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Bad Behavior in Medical Facilities Revisited

Posted Nov 03 2008 9:02pm

Has anyone else noticed that a certain subject will be covered in a magazine article, for instance, and then over a span of several days the subject will be covered on TV, in the newspaper and online in pieces that are seemingly disconnected? This happened several months ago in regard to medical personnel and hand washing, or the absence thereof. Now, the same is occurring on the topic of bad behavior by medical professionals in employment settings.

Julie Salamon, author of Hospital, spoke to the issue in her recently released book and later wrote a piece on the bad behavior/lack of respect problem in hospitals that appeared in the Los Angeles Times. It was my reading of that article that influenced my writing a post to this blog on the subject.

Shortly after that, an RN friend who manages a surgery center lamented that she was stressed by a situation in her workplace involving a surgical tech’s bad attitude toward her. The female tech doesn’t hesitate to voice her displeasure regarding decisions made by the RN, doing so in a hateful tone of voice. She turns on her heel and stomps away like a spoiled child when conversations end in her not getting her way.

Two days after hearing my RN friend’s story, the New York Times ran an article that addressed bad attitudes within the medical community. Now, I’ve received an e-mail from a friend in another state who commented that she had read with interest a piece on the NurseZone Web site about bullying in hospitals. Disrespect is a problem in the OR where she works, she said, and her director is constantly trying to keep the troublemakers in line. She expressed amazement that two-year certified scrub techs (all male) are talking down to the surgeons and getting away with it.

Why, all of a sudden, is bad behavior a hot topic? Are incidents more prevalent? Are we, like Peter Finch in Network, mad as h*ll and not going to take it anymore? Or, as in my case, are we simply incredulous and outraged that bad behavior is being tolerated, even a little bit.

I realize that legalities have put a stranglehold on management where swift termination is concerned, but surely a surly employee could be put on probation or "written up" in some way in a prompt fashion.

When I questioned the out-of-state RN as to why continuing problems in her OR are not squelched by firing, she mentioned the fine legal line management must walk and the mounds of documentation required to take such action. She also revealed that some surgeons put up with bad attitudes because the techs exhibiting those attitudes possess excellent technical skills valued by the doctors. Her director, she says, does not want to incur the wrath of prominent surgeons who want exceptional assistants and is, therefore, reluctant to tell the offenders that they must change their behavior or risk being terminated. As a result, the techs wield a surprising degree of power and control in the OR.

The most important point that this RN made is that resentment and avoidance among the surgical team damages communication and a lack of communication can lead to a sentinel event (an accident or near miss) during surgery.

"Communication is vital," she said. "We have a set surgical team in every room and if even one person isn’t communicating it is a problem."

Is bad behavior a problem in your work place? Are solutions being attempted? Tell me about it.

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