A medical environment with respectful staff is a safer one.
Having a bad day at work can happen to anyone, anywhere, at any time.
However, if you are a doctor, a bad day at work could put someone’s life at risk.
Whether it’s being pre-occupied by non-work issues or having to face more than your share of daily work challenges, how you respond to a difficult situation can, in fact, determine your patient’s outcome.
As a consultant, I have had moments when events have prompted my reaction to vary from mild irritation and annoyance to outright infuriation and anger. Medical students, junior doctors, midwives, nurses, other hospital staff—I have had experiences with all of them when it is virtually impossible to keep cool under pressure.
Nevertheless, there is a professional responsibility not to rise to provocation, no matter how difficult that may be, and to exert self-control to get the best out of a tricky situation for the patient’s benefit. After all, mistakes in hospitals can have grave consequences, and ultimately, I am responsible for my patients’ well-being.
In Trinidad and Tobago, if you have been in a medical institution, whether you were a member of staff, a student, a doctor, a nurse or a patient or even a visitor, you may have at some point noticed behaviour that could be considered to be rude, insulting, boorish or just downright unfriendly and unhelpful. Whether it happens between staff members, seniors and juniors or doctor and patient, it is bound to make you feel uncomfortable and uneasy.
Other than just the unpleasantness of it all, the impact of uncivil behaviour on everyone around is what is most distressing and can, in fact, lead to underperformance which then equates to poor health care.
There is now research to back this up.
For instance, a senior doctor who reprimands their junior counterpart in a disrespectful way, results in a 61 per cent reduction in cognitive ability in the junior doctor as well as 38 per cent reduction in their quality of work and a 48 per cent reduction in their time at work.
For staff bystanders who witness any form of rude behaviour, this may also result in a 20 per cent decrease in their performance and a 50 per cent decrease in their willingness to help others while they are also 50 per cent more likely to miss an error in calculations. In addition, junior staff are less likely to call for help if they feel that they will be chastised or reprimanded.
All of this adds up to less effective patient care and more likelihood for mistakes.
Crucially, the view from the hospital bed is also not rosy.
Patients who are involved in such situations with seemingly unsympathetic or unhelpful staff or indeed witness rude behaviour feel intimidated and apprehensive and are often too scared to ask for help.
On the other side of the coin, inappropriate behaviour from patients’ relatives has been proven to worsen the healthcare team’s performance with resultant adverse effects on necessary interventions.
Even for surgical procedures, studies have shown that non-technical skills are just as important as practical surgical skills, but in the field of medicine, these are woefully neglected. In safety-critical industries such as the aviation industry, pilots are trained and individually assessed on skills such as team-communication, stress and risk tolerance, high-speed decision making and effects of fatigue on crew error. No doubt, the surgical ability to do a Caesarean section is essential, but good communication, making crucial decisions, and being respectful and civil to all team members is not optional.
Uncivil behaviour in a hospital setting is not unique to us here in T&T and in the UK, there is currently an ongoing campaign of “Civility Saves Lives” that aims to highlight this issue. They emphasise what we may consider to be common sense, but it does need to be said all the same.
When we permit rudeness, patients suffer unnecessarily, but creating a culture of respect and kindness improves confidence, competence and can only benefit all involved.
