Civility Between Doctors and Nurses<br />Presenters – Sarah Frenette, Elizabeth Allen, Richard Woodell<br />
Scenario<br />Theresa Browne, RN<br />“It was morning rounds in the hospital and the entire medical team stood in the pati...
Scenario<br />Theresa Browne, RN<br />What do you think was his reply?<br />“It was morning rounds in the hospital and the...
Scenario<br />Theresa Browne, RN<br />What do you think was his reply?<br />“It was morning rounds in the hospital and the...
SKIT<br />Bad Example<br /><ul><li>Script Writer</li></ul>Katie Walsh<br /><ul><li>Actressess </li></ul>Katie Walsh<br />K...
Past Trends<br />Incivility in the Healthcare Setting – Researcher – Michelle Kaufman<br />
Past Trends<br />Incivility in the Healthcare Setting – Researcher – Michelle Kaufman<br />How it was in the Past<br />‘[A...
Past Trends<br />Incivility in the healthcare setting – Researcher – Michelle Kaufman<br />Why we should bring it to light...
Past Trends<br />Incivility in the Healthcare Setting – Researcher – Michelle Kaufman<br />Why we should bring it to light...
Past Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />This is an exam...
Past Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This is ...
Current Trends<br />Incivility in the Healthcare Setting – Researcher – Tara Williams<br />
Current Trends<br />Incivility in the Healthcare Setting – Researcher – Tara Williams<br />Intimidating Communication<br /...
Current Trends<br />Incivility in the healthcare setting – Researcher – Tara Williams<br />Disruptive Physician<br />Intim...
Current Trends<br />Incivility in the Healthcare Setting – Researcher – Tara Williams<br />Disruptive Physician<br />Sexua...
Current Trends<br />Incivility in the Healthcare Setting<br />Thins<br />Things that Irk Nurses<br />3<br />Civility among...
Current Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />This is an e...
Current Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This ...
Ways to Improve<br />Incivility in the Healthcare Setting – Researcher – Ashleigh Peake<br />
Ways to Improve<br />Incivility in the Healthcare Setting – Researcher – Ashleigh Peake<br />What do Nurses Want?<br />Res...
Ways to Improve<br />Incivility in the healthcare setting – Researcher – Ashleigh Peake<br />How to improve<br />What do N...
Ways to Improve<br />Incivility in the Healthcare Setting – Researcher – Ashleigh Peake<br />How to Improve<br />Benefits ...
Standards for Establishing and Sustaining a Healthy Work Environment<br />
Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />
Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br />
Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br...
Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br...
Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br...
Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />Leadership<br />True ...
Ways to Improve<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />This is an ...
Ways to Improve<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This...
SKIT<br />Good Example<br /><ul><li>Script Writer</li></ul>Nikki Ruggles<br /><ul><li>Actressess</li></ul>Marla Bezares<br...
OTHER CONTRIBUTERS<br /><ul><li>Handout</li></ul>Carolina<br />Daniel<br /><ul><li>Power Point</li></ul>Jim Stangle<br />
Resources<br />Brown, T. (2011, May 7). Physician Heel Thyself.  The New York Times, p. WK8. . Retrieved from http://nytim...
THANK YOU!<br />
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Group Presentation 2

  1. 1. Civility Between Doctors and Nurses<br />Presenters – Sarah Frenette, Elizabeth Allen, Richard Woodell<br />
  2. 2. Scenario<br />Theresa Browne, RN<br />“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.<br />Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”<br />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.<br />As we walked out of the patient’s room I asked the doctor if I could quote him in an article.” (*1)<br />
  3. 3. Scenario<br />Theresa Browne, RN<br />What do you think was his reply?<br />“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.<br />Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”<br />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.<br />As we walked out of the patient’s room I asked the doctor if I could quote him in an article.”<br />Everyone knows that the nurse is always right, I was just kidding.<br />1<br />You know that we work together in a very civilized manner.<br />2<br />2<br />The client knows that it is the lab’s fault.<br />2<br />3<br />It’s a time-honored tradition – blame the nurse whenever anything goes wrong.<br />4<br />
  4. 4. Scenario<br />Theresa Browne, RN<br />What do you think was his reply?<br />“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.<br />Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”<br />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.<br />As we walked out of the patient’s room I asked the doctor if I could quote him in an article.”<br />Everyone knows that the nurse is always right, I was just kidding.<br />1<br />You know that we work together in a very civilized manner.<br />2<br />2<br />The client knows that it is the lab’s fault.<br />2<br />3<br />It’s a time-honored tradition – blame the nurse whenever anything goes wrong.<br />✓<br />4<br />
  5. 5. SKIT<br />Bad Example<br /><ul><li>Script Writer</li></ul>Katie Walsh<br /><ul><li>Actressess </li></ul>Katie Walsh<br />Krystal Petersen<br />
  6. 6. Past Trends<br />Incivility in the Healthcare Setting – Researcher – Michelle Kaufman<br />
  7. 7. Past Trends<br />Incivility in the Healthcare Setting – Researcher – Michelle Kaufman<br />How it was in the Past<br />‘[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.’<br />McGregor-Roberston, 1902<br />‘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’<br />Sara Dock, 1917<br />1<br />
  8. 8. Past Trends<br />Incivility in the healthcare setting – Researcher – Michelle Kaufman<br />Why we should bring it to light<br />How it was in the Past<br />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.<br />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.<br />‘[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.’<br />McGregor-Roberston, 1902<br />‘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’<br />Sara Dock, 1917<br />2<br />1 <br />
  9. 9. Past Trends<br />Incivility in the Healthcare Setting – Researcher – Michelle Kaufman<br />Why we should bring it to light<br />Implications if Ignored<br />How it was in the Past<br />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.<br />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.<br />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.<br />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<br />‘[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.’<br />McGregor-Roberston, 1902<br />‘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’<br />Sara Dock, 1917<br />3<br />2<br />3<br />1<br />
  10. 10. Past Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />This is an example text. Go ahead and replace it<br />This is an example text. Go ahead and replace it<br />2<br />3<br />This is an example text. Go ahead and replace it<br />4<br />This is an example text. Go ahead and replace it<br />
  11. 11. Past Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This is an example text. Go ahead and replace it<br />2<br />3<br />This is an example text. Go ahead and replace it<br />4<br />This is an example text. Go ahead and replace it<br />
  12. 12. Current Trends<br />Incivility in the Healthcare Setting – Researcher – Tara Williams<br />
  13. 13. Current Trends<br />Incivility in the Healthcare Setting – Researcher – Tara Williams<br />Intimidating Communication<br />Intimidating communication and ineffective teamwork can compromise patient safety.<br />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.<br />1<br />
  14. 14. Current Trends<br />Incivility in the healthcare setting – Researcher – Tara Williams<br />Disruptive Physician<br />Intimidating Communication<br />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.<br />Abusive behavior by physicians is tolerated despite many institutions code of conduct.<br />Intimidating communication and ineffective teamwork can compromise patient safety.<br />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.<br />2<br />1 <br />
  15. 15. Current Trends<br />Incivility in the Healthcare Setting – Researcher – Tara Williams<br />Disruptive Physician<br />Sexual Harassment<br />Intimidating Communication<br />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.<br />Abusive behavior by physicians is tolerated despite many institutions code of conduct.<br />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. <br />Intimidating communication and ineffective teamwork can compromise patient safety.<br />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.<br />3<br />2<br />2<br />3<br />1<br />
  16. 16. Current Trends<br />Incivility in the Healthcare Setting<br />Thins<br />Things that Irk Nurses<br />3<br />Civility amongst nurses and doctors is linked to a decrease in medication errors, and an increase in patient safety.<br />Civility in the healthcare settin also creates job satisfaction and employee retention.<br />“I feel that physicians don’t always recognize the knowledge and experience base that nurses have and often overlook it as a resource.”<br />This is an example text. Go ahead and replace it with your own text. <br />1<br />1<br />Templates<br />Things that Irk Nurses<br />“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.”<br />2<br />Things that Irk Nurses<br />“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.”<br />This is an example text. Go ahead and replace it with your own text. <br />3<br />
  17. 17. Current Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />This is an example text. Go ahead and replace it<br />This is an example text. Go ahead and replace it<br />2<br />3<br />This is an example text. Go ahead and replace it<br />4<br />This is an example text. Go ahead and replace it<br />
  18. 18. Current Trends<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This is an example text. Go ahead and replace it<br />2<br />3<br />This is an example text. Go ahead and replace it<br />4<br />This is an example text. Go ahead and replace it<br />
  19. 19. Ways to Improve<br />Incivility in the Healthcare Setting – Researcher – Ashleigh Peake<br />
  20. 20. Ways to Improve<br />Incivility in the Healthcare Setting – Researcher – Ashleigh Peake<br />What do Nurses Want?<br />Respect, a willingness to listen, and a sense that we are on the same team!<br />As nurses we must take responsibility for doing everything possible to help improve relationships.<br />We need to collaborate and share information about mutual dissatisfaction and suggest strategies to deal with each problem to fix it.<br />1<br />
  21. 21. Ways to Improve<br />Incivility in the healthcare setting – Researcher – Ashleigh Peake<br />How to improve<br />What do Nurses Want?<br />Nurse/physician rounds to ensure both the nurse and doctor are on the same page and agree on care for the patient.<br />Collaborative education programs to help assist with communication and education on for both the nurses and the doctors.<br />Collaborative membership on hospital committees to find ways to continue improving.<br />Respect, a willingness to listen, and a sense that we are on the same team!<br />As nurses we must take responsibility for doing everything possible to help improve relationships.<br />We need to collaborate and share information about mutual dissatisfaction and suggest strategies to deal with each problem to fix it.<br />2<br />1 <br />
  22. 22. Ways to Improve<br />Incivility in the Healthcare Setting – Researcher – Ashleigh Peake<br />How to Improve<br />Benefits of Improving<br />What do Nurses Want?<br />Nurse/physician rounds to ensure both the nurse and doctor are on the same page and agree on care for the patient.<br />Collaborative education programs to help assist with communication and education on for both the nurses and the doctors.<br />Collaborative membership on hospital committees to find ways to continue improving.<br />Improves job satisfaction, productivity, and patient safety and welfare.<br />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.<br />Respect, a willingness to listen, and a sense that we are on the same team!<br />As nurses we must take responsibility for doing everything possible to help improve relationships.<br />We need to collaborate and share information about mutual dissatisfaction and suggest strategies to deal with each problem to fix it.<br />3<br />2<br />2<br />3<br />1<br />
  23. 23. Standards for Establishing and Sustaining a Healthy Work Environment<br />
  24. 24. Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />
  25. 25. Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br />
  26. 26. Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br />Effective Decision Making<br />
  27. 27. Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br />Appropriate Staffing<br />Effective Decision Making<br />
  28. 28. Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />True Collaboration<br />Recognition<br />Appropriate Staffing<br />Effective Decision Making<br />
  29. 29. Standards for Establishing and Sustaining a Healthy Work Environment<br />Skilled Communication<br />Leadership<br />True Collaboration<br />Recognition<br />Appropriate Staffing<br />Effective Decision Making<br />
  30. 30. Ways to Improve<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />This is an example text. Go ahead and replace it<br />This is an example text. Go ahead and replace it<br />2<br />3<br />This is an example text. Go ahead and replace it<br />4<br />This is an example text. Go ahead and replace it<br />
  31. 31. Ways to Improve<br />Question<br />Templates<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This is an example text. Go ahead and replace it<br />2<br />3<br />This is an example text. Go ahead and replace it<br />4<br />This is an example text. Go ahead and replace it<br />
  32. 32. SKIT<br />Good Example<br /><ul><li>Script Writer</li></ul>Nikki Ruggles<br /><ul><li>Actressess</li></ul>Marla Bezares<br />Olga Garcia<br />
  33. 33. OTHER CONTRIBUTERS<br /><ul><li>Handout</li></ul>Carolina<br />Daniel<br /><ul><li>Power Point</li></ul>Jim Stangle<br />
  34. 34. Resources<br />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<br />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<br />1<br />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<br />2<br />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<br />3<br />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<br />4<br />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<br />5<br />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<br />6<br />7<br />
  35. 35. THANK YOU!<br />
  36. 36. Templates<br />Your own sub headline<br />2<br />This is an example text. Go ahead and replace it with your own text. tThis 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. <br />This is placeholder text. <br />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. This is an example text. Go ahead and replace it with your own text. <br />This is placeholder text. <br />This is an example text. Go ahead and replace it with your own text. tThis 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. <br />This is placeholder text. <br />Your own footer<br />Your Logo<br />
  37. 37. Templates<br />Your own sub headline<br /><ul><li>TemplateText</li></ul>Text for templates<br />-Exampletext<br /><ul><li>Text
  38. 38. TemplateText</li></ul>Text for templates<br />-Exampletext<br /><ul><li>text</li></ul>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. This is an example text. Go ahead and replace it with your own text. <br />Your own footer<br />Your Logo<br />
  39. 39. Templates<br />Your own sub headline<br />Templates<br />Templates<br />tThis is an example text. Go ahead and replace it with your own text. tThis is an example text. Go ahead and replace it with your own text. <br />This is an example text. Go ahead and replace it with your own text. <br />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. <br />This is an example text. Go ahead and replace it with your own text. <br />1<br />2<br />Your own footer<br />Your Logo<br />
  40. 40. Templates<br />Your own sub headline<br />Templates<br />This is an example text. Go ahead and replace it with your own text. tThis 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. <br />3<br />1<br />Templates<br />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. This is an example text. Go ahead and replace it with your own text. <br />2<br />Templates<br />This is an example text. Go ahead and replace it with your own text. tThis 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. <br />Your own footer<br />Your Logo<br />
  41. 41. Templates<br />Your own sub headline<br />This is placeholder text. <br />This is placeholder text. <br />This is an example text. Go ahead and replace it with your own text. tThis 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. <br />This is placeholder text. <br />Your own footer<br />Your Logo<br />
  42. 42. Your own footer<br />Your Logo<br />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. <br />This is an example text. Go ahead and replace it with your own text. <br />
  43. 43. Templates<br />Your own sub headline<br />✓<br />This is an example text. Go ahead and replace it<br />1<br />✓<br />This is an example text. Go ahead and replace it<br />2<br />✓<br />This is an example text. Go ahead and replace it<br />3<br />✓<br />This is an example text. Go ahead and replace it<br />4<br />✓<br />This is an example text. Go ahead and replace it<br />5<br />✓<br />This is an example text. Go ahead and replace it<br />6<br />✓<br />This is an example text. Go ahead and replace it<br />7<br />Your own footer<br />Your Logo<br />
  44. 44. Editable diagram - Pyramid<br />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. <br />This is an example text. Go ahead and replace it with your own text.<br />This is an example text. Go ahead and replace it with your own text. <br />Your own footer<br />Your Logo<br />
  45. 45. Data driven diagram – Line diagram<br />This is an example text. Go ahead and replace it with your own text.<br />6<br />This is an example text<br />5<br />Text<br />4<br />1<br />2<br />3<br />2009<br />2008<br />2007<br />2005<br />2010<br />2006<br />Your own footer<br />Your Logo<br />Templates<br />
  46. 46. Templates<br />Data driven diagram – Bar diagram<br />Your own footer<br />Your Logo<br />
  47. 47. Templates<br />Data driven diagram – Pie diagram<br />Templates<br />If youareusing PowerPoint 2007 double click the chart and click "convert all”.<br />This is an example text. Go ahead and replace it with your own text. This is an example text. <br />Go ahead and replace it with your own text. <br />This is an example text. Go ahead and replace it with your own text.<br />text<br />Logo<br />text<br />Your own footer<br />Your Logo<br />
  48. 48. Arrow Process<br />Your own subheadline<br />Your own footer<br />Your Logo<br />
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