Joint Commission: disruptive behavior is bad. Very bad.
The Joint Commission has released a sentinel event alert, Behaviors that undermine a culture of safety, that addresses issues near and dear to my heart, as regular readers will know. Effective January 2009, the Joint Commission has added two leadership initiatives that address “disruptive and inappropriate behavior.” Why? It leads to sentinel events (a sentinel event is “an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof”)! Not only does disruptive behavior ultimately expose health care institutions to lawsuits—
“Studies link patient complaints about unprofessional, disruptive behaviors and malpractice risk.”
but it also increases costs and decreases staff retention (relevant because, if you haven’t heard, there’s a nursing shortage):
“Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.”
Basically, The Joint Commission is adding to our duties as health care providers to grow backbones and address bad behavior like adults instead of bitching about it to people who can’t do anything about it. They’re guilting us into it by reminding us that we really are all grownups and that patient safety and outcomes are at stake—as well they should!
It is interesting that bickering and back-stabbing in hospitals have reached a level critical enough to invite Joint Commission initiatives. My unit at work is emphasizing this lately, and oh boy does it need to. Our nursing director has even instituted a hand signal (a “talk to the hand” kind of dealio) that we should use when someone is gossiping or behaving inappropriately. We had a mandatory staff meeting on acting like adults.
Let us remember that it’s not just our egos and our comfort in the workplace at stake when folks aren’t getting along; miscommunication or noncommunication as a result of fear, anger, or simple pique could cause our next error that leads to patient harm. Yikes.
Hear, hear.
I just started a new position on a new unit and I have never heard such gossiping and backstabbing. I’m wondering how long it will be before management has a meeting with us about the new Joint Commission policies.
I remember reading about a unit at some hospital in Canada that adopted a voluntary no-gossip policy that charged them money for gossiping. They said after just a few weeks morale improved greatly, and patients were commenting on how happy the staff were.
Nice post.
I just graduated last year (with RN), and the level of viciousness and vitriol I heard during clinicals made me want to quit school and go back to my previous field. The teachers kept saying “nurses eat their young,” but it sounded to me more like “nurses hate nurses.” Luckily I work at a place where we say what we are thinking right away and don’t let it fester, and then we get over it and continue with our jobs.
Good topic for a post.
regards
When I read the line about, “inappropriate and disruptive behaviors” I thought the Joint Commission had finally come to their senses and decided that we could gork the every-loving-snot out of our patients of that variety, Then I read the rest. Oh, well. It was at least at thought.
Maybe we can get the Joint Commission to somehow work this around to enable us to give Ativan to families that showcase this behavior (especially the intimidating part). One can dream!
As an RN with 26+ years in my career, I know first-hand how awful this “disruptive and inappropriate behavior” can be. It’s happened to me countless times, by all levels of staff, and is just incredible when it does happen to you. I am always left thinking “what the hell was that?” It’s like nothing else I’ve experienced. I have had doctors tell me to go to hell, head nurses tell me that what I did was “all f-d up,” coworkers who talked about me right in front of me to everyone at the nurses’ station, and unit clerks who cursed at me & called me stupid in front of a whole area full of staff and family members … just incredibly hurtful, unnecessary, ugly things. I’ve even been in staff meetings where the dept. head & head of nursing said “Remember, you can all be replaced” to start the meeting. Unbelieveable! Fortunately, all of these incidents took place in civilian or private facilities. I will never work civilian again. I’ve had quite minor incidents in the military hospitals I now choose to work in, and very few of those. There is a REAL chain-of-command in these, not a quasi-COC which everyone is intimidated into not activating when these events,or worse,occur. I still observe much back-biting and gossiping among the nursing staff (currently the very worst offender is a male officer I work with!) which is sad and really does undermine unit cohesiveness. Check out the book I’m Dying to Take Care of You: Nurses and Codependence: Breaking the Cycles (Paperback)
by Candace Snow (Author), David Willard (Author). Also, From Silence to Voice: What Nurses Know And Must Communicate to the Public, Second Edition (Paperback)by Bernice Buresh (Author), Suzanne Gordon (Author). JC hasn’t a CLUE what real nursing is about, what doing a 12-hr shift on a busy unit is truly like, and I doubt they’ll ever address the “disruptive and inappropriate behavior” by patients & families. They can’t see past their own clipboards, I’m afraid.
I am in nursing school and my instructor is guilty of doing just the things that she tells us not to do. She gossips about the previous instructor, talks about the patients in derogatory ways. Is there a “Joint Commission” for nursing instructors or colleges?
Unfortunately no. You can find out your school’s accrediting agency (eg, the AACN) and drop a dime on ‘em. First talk to your dean, though. Chain of command and all that.