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Civility Between Doctors and Nurses,[object Object],Presenters – Sarah Frenette, Elizabeth Allen, Richard Woodell,[object Object]
Scenario,[object Object],Theresa Browne, RN,[object Object],“It was morning rounds in the hospital and the entire medical team stood in the patient’s room.  A test result was late, and the patient, a friendly, middle-aged man, jokingly asked his doctor whom he should yell at.,[object Object],Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”,[object Object],This vignette is not a scene from the medical drama “House,” nor did it take place 30 years ago, when nures wehre considereed subservient to doctos.  Rather, it happened just a few months ago, at my hospital, to me.,[object Object],As we walked out of the patient’s room I asked the doctor if I could quote him in an article.” (*1),[object Object]
Scenario,[object Object],Theresa Browne, RN,[object Object],What do you think was his reply?,[object Object],“It was morning rounds in the hospital and the entire medical team stood in the patient’s room.  A test result was late, and the patient, a friendly, middle-aged man, jokingly asked his doctor whom he should yell at.,[object Object],Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”,[object Object],This vignette is not a scene from the medical drama “House,” nor did it take place 30 years ago, when nures wehre considereed subservient to doctos.  Rather, it happened just a few months ago, at my hospital, to me.,[object Object],As we walked out of the patient’s room I asked the doctor if I could quote him in an article.”,[object Object],Everyone knows that the nurse is always right, I was just kidding.,[object Object],1,[object Object],You know that we work together in a very civilized manner.,[object Object],2,[object Object],2,[object Object],The client knows that it is the lab’s fault.,[object Object],2,[object Object],3,[object Object],It’s a time-honored tradition – blame the nurse whenever anything goes wrong.,[object Object],4,[object Object]
Scenario,[object Object],Theresa Browne, RN,[object Object],What do you think was his reply?,[object Object],“It was morning rounds in the hospital and the entire medical team stood in the patient’s room.  A test result was late, and the patient, a friendly, middle-aged man, jokingly asked his doctor whom he should yell at.,[object Object],Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”,[object Object],This vignette is not a scene from the medical drama “House,” nor did it take place 30 years ago, when nures wehre considereed subservient to doctos.  Rather, it happened just a few months ago, at my hospital, to me.,[object Object],As we walked out of the patient’s room I asked the doctor if I could quote him in an article.”,[object Object],Everyone knows that the nurse is always right, I was just kidding.,[object Object],1,[object Object],You know that we work together in a very civilized manner.,[object Object],2,[object Object],2,[object Object],The client knows that it is the lab’s fault.,[object Object],2,[object Object],3,[object Object],It’s a time-honored tradition – blame the nurse whenever anything goes wrong.,[object Object],✓,[object Object],4,[object Object]
SKIT,[object Object],Bad Example,[object Object],[object Object],Katie Walsh,[object Object],[object Object],Katie Walsh,[object Object],Krystal Petersen,[object Object]
Past Trends,[object Object],Incivility in the Healthcare Setting – Researcher – Michelle Kaufman,[object Object]
Past Trends,[object Object],Incivility in the Healthcare Setting – Researcher – Michelle Kaufman,[object Object],How it was in the Past,[object Object],‘[A nurse] must begin her work with the idea firmly implanted in her mind that she is only the instrument by whom the doctor gets his instructions carried out; she occupies no independent position in the treatment of the sick person.’,[object Object],McGregor-Roberston, 1902,[object Object],‘No matter how gifted she may be, she will never become a reliable nurse until she can obey without question.  The firs and most helpful criticism I ever received from a doctor was when he told me I was supposed to be simply an intelligent machine for the purpose of carrying out his orders’,[object Object],Sara Dock, 1917,[object Object],1,[object Object]
Past Trends,[object Object],Incivility in the healthcare setting – Researcher – Michelle Kaufman,[object Object],Why we should bring it to light,[object Object],How it was in the Past,[object Object],In a survey conducted by VHA West Coast, 78% of nurses surveyed reported that they had witnessed or personally experienced disruptive behavior by physicians.  This survey also noted that 50% of physicians had witnessed their peers exhibiting disruptive behavior.,[object Object],This survey also brought to light that employees who experienced uncivil behavior at work intentionally reduced their work effort and the quality of their work which then in turn decreases their effectiveness and safety.,[object Object],‘[A nurse] must begin her work with the idea firmly implanted in her mind that she is only the instrument by whom the doctor gets his instructions carried out; she occupies no independent position in the treatment of the sick person.’,[object Object],McGregor-Roberston, 1902,[object Object],‘No matter how gifted she may be, she will never become a reliable nurse until she can obey without question.  The firs and most helpful criticism I ever received from a doctor was when he told me I was supposed to be simply an intelligent machine for the purpose of carrying out his orders’,[object Object],Sara Dock, 1917,[object Object],2,[object Object],1 ,[object Object]
Past Trends,[object Object],Incivility in the Healthcare Setting – Researcher – Michelle Kaufman,[object Object],Why we should bring it to light,[object Object],Implications if Ignored,[object Object],How it was in the Past,[object Object],In a survey conducted by VHA West Coast, 78% of nurses surveyed reported that they had witnessed or personally experienced disruptive behavior by physicians.  This survey also noted that 50% of physicians had witnessed their peers exhibiting disruptive behavior.,[object Object],This survey also brought to light that employees who experienced uncivil behavior at work intentionally reduced their work effort and the quality of their work which then in turn decreases their effectiveness and safety.,[object Object],One implication is medication errors.  Medication errors occur more frequently due to this incivility.  According to the research of Alan Rosenstein, a leading researcher on the topic of incivility in the medical field, 60% of medication errors are related to toxic behavior or incivility.  This occurs most commonly because nurses are afraid to bring up a potential error or unclear order because they are afraid to face a rude or uncivil doctor.,[object Object],Stress-related responses affects focus, concentration, communication, collaboration, and the ability to transfer and interpret vital information which can also negatively impact patient health outcomes,[object Object],‘[A nurse] must begin her work with the idea firmly implanted in her mind that she is only the instrument by whom the doctor gets his instructions carried out; she occupies no independent position in the treatment of the sick person.’,[object Object],McGregor-Roberston, 1902,[object Object],‘No matter how gifted she may be, she will never become a reliable nurse until she can obey without question.  The firs and most helpful criticism I ever received from a doctor was when he told me I was supposed to be simply an intelligent machine for the purpose of carrying out his orders’,[object Object],Sara Dock, 1917,[object Object],3,[object Object],2,[object Object],3,[object Object],1,[object Object]
Past Trends,[object Object],Question,[object Object],Templates,[object Object],This is an example text. Go ahead and replace it,[object Object],1,[object Object],This is an example text. Go ahead and replace it,[object Object],This is an example text. Go ahead and replace it,[object Object],2,[object Object],3,[object Object],This is an example text. Go ahead and replace it,[object Object],4,[object Object],This is an example text. Go ahead and replace it,[object Object]
Past Trends,[object Object],Question,[object Object],Templates,[object Object],This is an example text. Go ahead and replace it,[object Object],1,[object Object],✓,[object Object],This is an example text. Go ahead and replace it,[object Object],2,[object Object],3,[object Object],This is an example text. Go ahead and replace it,[object Object],4,[object Object],This is an example text. Go ahead and replace it,[object Object]
Current Trends,[object Object],Incivility in the Healthcare Setting – Researcher – Tara Williams,[object Object]
Current Trends,[object Object],Incivility in the Healthcare Setting – Researcher – Tara Williams,[object Object],Intimidating Communication,[object Object],Intimidating communication and ineffective teamwork can compromise patient safety.,[object Object],The joint Commission states that ineffective communication is the root cause of the majority of sentinel events since 1996.  This caused healthcare organizations to implement policies and procedures addressing the situation and is now mandated by the Joint Commission Sentinel Event Alert.,[object Object],1,[object Object]
Current Trends,[object Object],Incivility in the healthcare setting – Researcher – Tara Williams,[object Object],Disruptive Physician,[object Object],Intimidating Communication,[object Object],Popular belief is the hierarchy of healthcare that physicians have the most power as a result the healthcare organization caters to a physician despite their tone or attitude.,[object Object],Abusive behavior by physicians is tolerated despite many institutions code of conduct.,[object Object],Intimidating communication and ineffective teamwork can compromise patient safety.,[object Object],The joint Commission states that ineffective communication is the root cause of the majority of sentinel events since 1996.  This caused healthcare organizations to implement policies and procedures addressing the situation and is now mandated by the Joint Commission Sentinel Event Alert.,[object Object],2,[object Object],1 ,[object Object]
Current Trends,[object Object],Incivility in the Healthcare Setting – Researcher – Tara Williams,[object Object],Disruptive Physician,[object Object],Sexual Harassment,[object Object],Intimidating Communication,[object Object],Popular belief is the hierarchy of healthcare that physicians have the most power as a result the healthcare organization caters to a physician despite their tone or attitude.,[object Object],Abusive behavior by physicians is tolerated despite many institutions code of conduct.,[object Object],Can occur between a doctor and nurse or a nurse to a doctor and is inappropriate in any workplace setting.  It can be grounds for a sexual harassment complaint, termination of employment, and criminal and civil penalties. ,[object Object],Intimidating communication and ineffective teamwork can compromise patient safety.,[object Object],The joint Commission states that ineffective communication is the root cause of the majority of sentinel events since 1996.  This caused healthcare organizations to implement policies and procedures addressing the situation and is now mandated by the Joint Commission Sentinel Event Alert.,[object Object],3,[object Object],2,[object Object],2,[object Object],3,[object Object],1,[object Object]
Current Trends,[object Object],Incivility in the Healthcare Setting,[object Object],Thins,[object Object],Things that Irk Nurses,[object Object],3,[object Object],Civility amongst nurses and doctors is linked to a decrease in medication errors, and an increase in patient safety.,[object Object],Civility in the healthcare settin also creates job satisfaction and employee retention.,[object Object],“I feel that physicians don’t always recognize the knowledge and experience base that nurses have and often overlook it as a resource.”,[object Object],This is an example text. Go ahead and replace it with your own text. ,[object Object],1,[object Object],1,[object Object],Templates,[object Object],Things that Irk Nurses,[object Object],“On one hand, the physicians dismiss your judgment, and on the other, they expect you to remind them to place orders and follow up on patients’ test results.”,[object Object],2,[object Object],Things that Irk Nurses,[object Object],“Most physicians don’t let us nurses know what their plans are for the patient.  We try to explain to the patient but have to decipher illegible progress notes and make an educated guess.”,[object Object],This is an example text. Go ahead and replace it with your own text. ,[object Object],3,[object Object]
Current Trends,[object Object],Question,[object Object],Templates,[object Object],This is an example text. Go ahead and replace it,[object Object],1,[object Object],This is an example text. Go ahead and replace it,[object Object],This is an example text. Go ahead and replace it,[object Object],2,[object Object],3,[object Object],This is an example text. Go ahead and replace it,[object Object],4,[object Object],This is an example text. Go ahead and replace it,[object Object]
Current Trends,[object Object],Question,[object Object],Templates,[object Object],This is an example text. Go ahead and replace it,[object Object],1,[object Object],✓,[object Object],This is an example text. Go ahead and replace it,[object Object],2,[object Object],3,[object Object],This is an example text. Go ahead and replace it,[object Object],4,[object Object],This is an example text. Go ahead and replace it,[object Object]
Ways to Improve,[object Object],Incivility in the Healthcare Setting – Researcher – Ashleigh Peake,[object Object]
Ways to Improve,[object Object],Incivility in the Healthcare Setting – Researcher – Ashleigh Peake,[object Object],What do Nurses Want?,[object Object],Respect, a willingness to listen, and a sense that we are on the same team!,[object Object],As nurses we must take responsibility for doing everything possible to help improve relationships.,[object Object],We need to collaborate and share information about mutual dissatisfaction and suggest strategies to deal with each problem to fix it.,[object Object],1,[object Object]
Ways to Improve,[object Object],Incivility in the healthcare setting – Researcher – Ashleigh Peake,[object Object],How to improve,[object Object],What do Nurses Want?,[object Object],Nurse/physician rounds to ensure both the nurse and doctor are on the same page and agree on care for the patient.,[object Object],Collaborative education programs to help assist with communication and education on for both the nurses and the doctors.,[object Object],Collaborative membership on hospital committees to find ways to continue improving.,[object Object],Respect, a willingness to listen, and a sense that we are on the same team!,[object Object],As nurses we must take responsibility for doing everything possible to help improve relationships.,[object Object],We need to collaborate and share information about mutual dissatisfaction and suggest strategies to deal with each problem to fix it.,[object Object],2,[object Object],1 ,[object Object]
Ways to Improve,[object Object],Incivility in the Healthcare Setting – Researcher – Ashleigh Peake,[object Object],How to Improve,[object Object],Benefits of Improving,[object Object],What do Nurses Want?,[object Object],Nurse/physician rounds to ensure both the nurse and doctor are on the same page and agree on care for the patient.,[object Object],Collaborative education programs to help assist with communication and education on for both the nurses and the doctors.,[object Object],Collaborative membership on hospital committees to find ways to continue improving.,[object Object],Improves job satisfaction, productivity, and patient safety and welfare.,[object Object],This can be achieved by promoting greater nurse/physician professional respect, improving communication and collaboration educating physicians about nursing roles and skills, and addressing misconduct.,[object Object],Respect, a willingness to listen, and a sense that we are on the same team!,[object Object],As nurses we must take responsibility for doing everything possible to help improve relationships.,[object Object],We need to collaborate and share information about mutual dissatisfaction and suggest strategies to deal with each problem to fix it.,[object Object],3,[object Object],2,[object Object],2,[object Object],3,[object Object],1,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object],Skilled Communication,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object],Skilled Communication,[object Object],True Collaboration,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object],Skilled Communication,[object Object],True Collaboration,[object Object],Effective Decision Making,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object],Skilled Communication,[object Object],True Collaboration,[object Object],Appropriate Staffing,[object Object],Effective Decision Making,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object],Skilled Communication,[object Object],True Collaboration,[object Object],Recognition,[object Object],Appropriate Staffing,[object Object],Effective Decision Making,[object Object]
Standards for Establishing and Sustaining a Healthy Work Environment,[object Object],Skilled Communication,[object Object],Leadership,[object Object],True Collaboration,[object Object],Recognition,[object Object],Appropriate Staffing,[object Object],Effective Decision Making,[object Object]
Ways to Improve,[object Object],Question,[object Object],Templates,[object Object],This is an example text. Go ahead and replace it,[object Object],1,[object Object],This is an example text. Go ahead and replace it,[object Object],This is an example text. Go ahead and replace it,[object Object],2,[object Object],3,[object Object],This is an example text. Go ahead and replace it,[object Object],4,[object Object],This is an example text. Go ahead and replace it,[object Object]
Ways to Improve,[object Object],Question,[object Object],Templates,[object Object],This is an example text. Go ahead and replace it,[object Object],1,[object Object],✓,[object Object],This is an example text. Go ahead and replace it,[object Object],2,[object Object],3,[object Object],This is an example text. Go ahead and replace it,[object Object],4,[object Object],This is an example text. Go ahead and replace it,[object Object]
SKIT,[object Object],Good Example,[object Object],[object Object],Nikki Ruggles,[object Object],[object Object],Marla Bezares,[object Object],Olga Garcia,[object Object]
OTHER CONTRIBUTERS,[object Object],[object Object],Carolina,[object Object],Daniel,[object Object],[object Object],Jim Stangle,[object Object]
Resources,[object Object],Brown, T. (2011, May 7). Physician Heel Thyself.  The New York Times, p. WK8. . Retrieved from http://nytimes.com/2011/05/08/opinion/08Brown.html,[object Object],This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text,[object Object],1,[object Object],This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text,[object Object],2,[object Object],This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text,[object Object],3,[object Object],This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text,[object Object],4,[object Object],This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text,[object Object],5,[object Object],This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text,[object Object],6,[object Object],7,[object Object]
THANK YOU!,[object Object]

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