Bullying, disrespect rampant in healthcare settings

Rude and disrespectful behavior including bullying and intimidation is a big problem in healthcare workplaces that erodes professional communication essential to patient safety, according to a recent study by the Institute for Safe Medication Practices (ISMP).

ISMP surveyed 4,884 healthcare workers during July and August 2013. Nurses (68%) and pharmacists (14%) represented the largest categories of respondents. But the survey also included more than 200 physicians and about 100 quality/risk management staff. Most respondents (70%) had more than 10 years of experience and were female (87%).     

Similar to one done in 2003, the survey found that disrespectful behaviors were not isolated events, were not limited to just a few practitioners, involved both lateral (peer-to-peer) and interdisciplinary staff, and involved both genders equally. According to the survey, physicians and other prescribers engaged in disrespectful behavior more often than other healthcare professionals. More than half of the respondents reported experiencing physicians/prescribers yelling, cursing, or issuing verbal threats within the past year.

“[The survey exposes] healthcare’s continued tolerance and indifference to disrespectful behavior. These behaviors are clearly learned, tolerated, and reinforced in the healthcare culture, and little improvement has been made during the last decade,” the report said. “This creates an environment in which victims may feel they have no choice but to become perpetrators and join in the practice.”

Specifically, 73% of respondents encountered negative comments about colleagues or leaders; 77% had experienced a reluctance or refusal to answer questions or return calls; 68% reported condescending language, demeaning comments, or insults; 69% have experienced impatience with questions or having been hung up on; and 66% reported colleagues who did not want to follow safety practices or work collaboratively.

Even worse, 46% of respondents said they had encountered shaming, humiliation, or spreading malicious rumors; 24% reported insulting or slighting individuals due to race, religion, or appearance; 18% reported having seen objects thrown at them or others; and 7% reported physical abuse.  

“Organizations have largely failed to address disrespectful behavior for a variety of reasons. First, some individuals who engage in disrespectful behaviors may be powerful in the organization, which may discourage reporting of the behavior due to fear of retaliation and a general reluctance to confront the individual,” the report said. “Organizations may also be wary of offending high-revenue producers and therefore fail to take action. But, the deep sense of frustration threaded through many of the comments from survey respondents suggest that now is the time for action.”