Survey: Disruptive doctor-nurse behavior affects patients

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More than 97 percent of healthcare organizations experience behavior problems from doctors and nurses that can directly affect patients and their families, according to a report from the American College of Physician Executives (ACPE).

The survey, in which more than 2,100 physicians and nurses participated, found that the most common complaints of respondents were with degrading and insulting comments (85 percent) and yelling between doctors and nurses (73 percent). Other problems included cursing, inappropriate joking and refusal to work with one another, with nearly 70 percent of the aforementioned bad behavior taking place in the hospital setting.

Reported accounts also included stories of physicians "groping" nurses and technicians as they tried to perform their jobs; tools and other objects "being flung" across the operating room; personal grudges interfering with patient care; and accusations of incompetence or negligence in front of patients and their families.

The ACPE reported that 67.2 percent of the survey participants were nurses, with doctors accounting for 32.8 percent. While versions varied, both doctors and nurses who participated said physicians were to blame for a large part of disruptive behaviors.

“Some [emergency department] physicians do not respect the nurses’ opinions or suggestions,” one respondent wrote. “They will then appear to delay patient care ‘just to show’ the nurse.”

The most prevalent complaints on physicians’ behaviors found by the survey included belittling and patronizing nurses, throwing hospital equipment and sexual harassment.

Complaints of nurses’ behavior, on the other hand, centered on spreading rumors and attempting to get a physician or other hospital employees disciplined or fired unjustly.

In terms of punishment, 61.2 percent of participants answered “yes” to the question inquiring if any nurses had been terminated due to bad behavior at their healthcare organization in the past year, as opposed to the 22.2 percent of participants answering “yes” to the same question regarding physicians.

Despite the various behaviorial problems exhibited by both physicians and nurses, the survey found that participants could agree that a fundamental lack of respect and communication between doctors and nurses accounts for the most significant problem.

As a result of this issue, staff morale and patient safety may suffer.

Education was a common theme in the survey as a potential solution for the behavioral problems. One participant wrote, “[Reduction of behavioral problems] needs to be thoroughly ingrained during medical school and nursing school. Bad behavior needs early intervention.”

For those who have already completed medical school, training, increased awareness and positive reinforcement were noted as additional strategies in eliminating pre-existing bad behaviors.

“Prioritize and emphasize corporate citizenship. Have policies and bylaws that support the efforts. And, most importantly, early intervention and timely feedback,” one participant wrote.

In the past year, 58.8 percent of participants surveyed reported that their healthcare facilities have held staff training programs in attempts to lessen behavioral problems between physicians and nurses.