Survey: Doc verbal abuse is contagious

Younger nurses in hospital settings, on short-staffed units and working day shifts are most likely to experience physician verbal abuse, concluded a survey of 1,328 newly licensed registered nurses from the Robert Wood Johnson Foundation's RN Work Project.

While the survey found high levels of verbal abuse were not common, about 1,300 nurses reported moderate verbal abuse--or up to five incidents of abuse by doctors or other nurses in the preceding three months, The Philadelphia Inquirer reported.

Moreover, the survey suggests verbal abuse is contagious. Situations with physician-to-nurse abuse also are more likely to have nurse-to-nurse abuse, according to the study announcement.

"One potential explanation is that negative behavior exhibited by one member of a group spills over to other members of the group and hurts the group dynamic," Carol Brewer, Ph.D, R.N., study researcher and professor at the University at Buffalo School of Nursing, said in the announcement.

However, the study reveals a chicken or the egg situation, unable to determine whether physician verbal abuse creates an unfavorable work environment or poor working conditions create an environment with verbal abuse by physicians.

Regardless, the issue can affect hospitals' bottom line as a good nurse work environment means lower readmission rates.

To foster a good work environment, hospitals must overcome the historic tension between physicians and nurses and their conflicting viewpoints based on education, training and communication style. So some medical schools require interprofessional education for nursing and medical school curriculums to improve how nurses and physicians work together before they enter the clinical environment, and also teach medical and nursing students to respect each other's areas of expertise, Courtney H. Lyder, dean and professor of the UCLA School of Nursing wrote last month in a Hospital Impact blog post.

And noting that a disrespectful hospital work environment can jeopardize patient safety and care quality, Virginia Mason Medical Center, a 336-bed hospital  in Seattle, established a Respect for People initiative that defines the top 10 respectful behaviors workers need to perform, according to June Hospital Impact post from Virginia Mason Chairman and CEO Gary S. Kaplan, M.D.

According to RN Work Project, such efforts must come from the top. "Leaders set the tone," Brewer told the Inquirer. "A zero-tolerance policy has to come from leadership."

For more:
- here's the announcement (.pdf) and abstract
- read the Inquirer article