Respect Among Hospital Employees is a Benefit for the Patient

Does your hospital have a problem with bad behavior among its employees to the extent that the staff is required to attend classes to learn proper conduct?

To her astonishment, during the year that Julie Salamon, a former New York Times and Wall Street Journal reporter, spent observing the goings-on in a large Brooklyn hospital, that is exactly what she found there.

Salamon has turned her experience as a fly-on-the-wall spectator into a book. Entitled Hospital, it is the subtitle that is the attention grabber: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids.

When the current president and CEO of the hospital Salamon observed took the leadership reins ten years ago, she instituted a Code of Mutual Respect in an effort to eliminate a longstanding atmosphere of "rudeness, incivility and bullying." Classes for doctors, nurses and other employees reinforce the tenets of courtesy, respect and basic good manners.

Salamon found among the provisions mentioned in the code are reminders not to use racial or ethnic slurs or profane or sexually explicit language. Employees are admonished to refrain from shouting, using foul language or throwing objects, prompting Salamon to incredulously wonder, "Slurs? Throwing things? Was this a hospital or a reform school?"

During my ten years of hospital nursing I witnessed several incidents of bad behavior, all by doctors. Shouting was the most common offense, often brought about by displeasure over the way a particular something was done. A procedure, perhaps, or the passing of a defective or wrong instrument.

A pediatrician, who was an attending in the hospital’s outpatient department where I worked, would on rare occasion arrive at the clinic in such a prickly mood that it was impossible to please him. He would shout and make insulting comments to the staff and to the patients’ parents. A couple of times he used his forearm to sweep all the instruments off the roll-about table in the treatment room and onto the floor. At other times he was at the opposite extreme, jovial, laughing raucously and extremely entertaining. Now, years later, I suspect his behavior was the result of a bi-polar condition, although I have no documentation that that was the case.

The hospital president mentioned above is of the opinion that disrespect by employees for one another is a roadblock to communication and that a breakdown in communication can result in harm to the patient. Her Code of Mutual Respect extends beyond doctors and nurses, to clerks and housekeeping—to everyone—so that lines of communication are kept open between one group to another: nurse to doctor, doctor to clerk, housekeeping to nurse and so on.

Does your hospital have a formal program for behavior training? How is it working? What do you like about it? If not, do you think such a program is needed at your facility?