(photo credit: INGIMAGE)
It is in patients’ self-interest to treat medical staffers in hospitals and clinics with respect rather than discourtesy, according to a recent study published in the prestigious journal Pediatrics.
Being rude to medical teams, according to researchers from the Technion-Israel Institute of Technology and Bnai Zion Medical Center, impairs their professional performance and causes harm to patients.
Verbal violence has been endemic in hospital emergency rooms and some inpatient wards, and crowding and the shortage of beds and medical staffers has led even to physical violence.
The researchers, led by Prof. Arik Riskin of the Technion’s Rappaport Faculty of Medicine and Bnei Zion Medical Center, examined the implications of such incidents. Rudeness by patients or family members, they found, produces antagonism in doctors, nurses and auxiliary staff, even it comes in small doses. Scorn, contempt and insensitivity not only sadden the individual, but also impair his performance in the aspects of memory, concentration, attention to detail, problem solving and performing various cognitive tasks.
The researchers, who tested 24 medical teams from four neonatal intensive care units in Haifa, found that rudeness, even when moderate, dramatically impairs the medical staff’s performance. This impairment, whose severity increases in stressful situations, is evident in the quality of treatment, the level of diagnostics and the technical skills of the staff.
The medical teams were invited to a training workshop on the subject of team reflexivity as a tool for improving quality of care. The workshop examined a scenario involving the treatment of a premature infant whose condition suddenly deteriorated due to necrotizing enterocolitis, a medical condition seen mostly in premature infants, when parts of the bowel suffer necrosis (tissue death) and is the second most common cause of death in preemies.
This scenario required the participants to identify and diagnose the deterioration and administer treatment, including cardiopulmonary resuscitation.
It was explained to them that an expert from the US would be watching them remotely (via a video camera) and would occasionally comment and advise them by phone.
During the simulation, half of the teams received comments from a neutral expert who spoke in general terms about the importance of training and practice using simulations. The rest of the teams were severely criticized by a rude specialist who didn’t even comment on the specific situation and on their performance but strongly criticized the “poor quality of medicine” in Israel.
The simulations were recorded on video and presented to judges who evaluated the teams’ performance in accordance with defined criteria – diagnostic capabilities, performance of actions and procedures and behaviors involving the sharing of information and asking for help. The judges did not know the identity of the participants or the nature of the expert that they were exposed to, whether he was polite or rude.
An analysis of the results led to clear conclusions. “The teams that were exposed to rudeness displayed lower capabilities in all performance metrics,” said Riskin. “This study demonstrates that rudeness impairs patient safety, all the more so in neonatal intensive care units and intensive care departments, where the slightest error could cause tremendous damage.”