Dancing Gracefully Through Life

Bully Behavior in Medicine?  
by Lynn Durham, RN      
 
    All bullying behavior isn't relegated to the playground. All too often it's
found in nursing(1) and when it's there, it creates problems, not only for the
staff, but for patients as well including adverse events.(2, 3)  In nursing
there are already plenty of issues that need to be handled. Why would we ever
want to make more?

    Virginia gastroenterologist Patricia Raymond, MD(4) is attempting to shine a
light on the research and importance of civility in the medical workplace. She
is also giving some tips on how to change the culture and stop the bullying.


    Dr. Raymond cites three aspects of bully behavior: attack on competence and
reputation, personal attack, or attack through work tasks. And why is it
important to consider it? Studies have proven that when there are problems with
staff interaction it translates into adverse events for the patient and low
morale and increased staff turnover for the organization. Click on the links
below that were cited above to see more.

    If you are someone who wants this bullying to stop at your work location,
you have the Joint Commission behind you. They have zero tolerance for such
behavior. (5) If it's physical call 911.

    Conflicts will occur. Unfortunately, many nurses would prefer to switch than
fight. But it doesn't have to be a fight. It's not the conflict itself, but how
it's handled that's important. If you can calm yourself, release defensiveness
and be willing to enter a difficult conversation with patience and
understanding, successes can happen. Even if it's just you knowing that you have
spoken up with a confident voice.

    It may be difficult to admit that you might be the one exhibiting bully
behavior. Be honest with yourself, if it's ever been you, make a commitment to
stop right now.

    Dr Raymond recommends "curbing your docs," or anyone else for that matter.
She points out that just like you cannot correct a puppy through official
channels with a long delay, the bully behavior also has to be called to
attention and stopped in the moment it occurs.  One of her suggestions was
called "Code Pink," to describe an action of support that other staff members
can take when a nurse is being put down by a physician. The nurse's associates
would gather around and stare at the doctor. This action curbed that physician's
rude behavior! Raymond suggests augmenting the effect by notifying the CNO
afterwards, as approved by the JCAHO policies of zero tolerance.
 
    On the flip side, she reminds us "Resistance is futile. Non-resistance is
fertile."  One of her tips of non-resistance is to repeat, "Tell me more." I've
had the opportunity to watch it in action when I was helping to locate and set
up Red Cross disaster locations. A man was very angry with something that the
Red Cross had done in the past. My coworker and I just listened. We did not
defend, we did not resist. We heard his anger and gave him our attention. It was
amazing to me how it dissolved right before our eyes and we had a successful
conversation and secured another emergency location.

    You'll never know until you test it in your life. I remember learning about
the reflective technique in nursing school - repeating back your patients' words
to draw them out. When we tried it on each other it sounded silly. It seemed so
obvious to us that we "knew" our patients would notice what we were doing. They
did not. They just continued to give further details and we heard a lot of
information that we could have missed if we didn't reflect their last words back
to them.

 
    We each have the opportunity to choose how we will live, no matter what's
going on around us. The "they's" do not control our thoughts, our words or our
actions, we do. And we are contagious. I encourage you to be deliberate on what
you send out. Nurses are famous for their TLC for patients. Be willing to
request and to share that same tender loving care with each other.
 
    At the end of the  repeated "tell me more," when their steam runs out, Dr.
Raymond recommends that you ask: "What do you need?" or "What's missing for
you?" You may be surprised at what happens.
 
Let me know.
 
Communication & Creating Positive Workplaces.

Lynn Durham, RN is a well being coach, writing and speaking on mind/body/spirit
wellness. To get information on having her write for or present to your
organization you can contact her at 603-926-9700 or smile@lynndurham.com. Sign
up for her e letter at www.lynndurham.com
--
 
Did you know that 5 minutes of remembering anger can depress your immune
functioning for up to 6 hours?
What you think is very important and your well being coach says, "You're One
Thought Away From Feeling Better!"

Lynn Durham, RN Well Being Coach
603-926-9700
www.lynndurham.com