IN THIS ARTICLE...
A new survey about physician-nurse relationships uncovers a strikingly high prevalence of disruptive physician behavior that's affecting nurse retention.
RESULTS OF A NEW SURVEY show that disruptive behavior by physicians is helping to fuel the nationwide nursing shortage, heavily impacting job satisfaction and morale for nurses.
The survey results reveal the seriousness of the issue and highlight a lack of physician awareness, appreciation, value and respect for nurses.
Over 90 percent of the survey participants reported witnessing disruptive physician behavior. While disruptive events seem to involve only a small percentage of the medical staff, more than one-third of the participants reported knowledge of a nurse leaving an institution because of disruptive behavior by physicians.
Also disturbing is that more than two-thirds of the survey participants reported that their organizations had codes of conduct in place, but less than 50 percent felt they were effective.
Conducted by VHA, Inc.--a network of community-owned, non-profit health care systems and associated physicians--the 24-question survey was designed to assess the overall status of physician-nurse relationships.
The survey focused on four areas:
1. The overall status and significance of nurse-physician relationships at the hospital level
2. Specific issues related to disruptive physician behavior
3. Common trends, barriers and inciting events associated with disruptive behavior
4. Suggested strategies for support and resolution
A total of 2,562 respondents from 142 acute care, not-for-profit hospitals from 11 VHA regions across the country participated in the survey. Of the participants, 389 listed their title as physicians, 104 as senior level executives and 1,615 as nurses.
The survey asked about the types of disruptive behavior witnessed or experienced. The most frequent responses included:
* Berating colleagues
* Use of abusive language
* Condescending behaviors
What were the issues or events that precipitated disruptive behavior?
Nurses felt that the most common circumstances involved placing calls to physicians to clarify physician orders. Physicians indicated that orders not being carried out correctly or in a timely manner were the biggest problems.
The survey found that disruptive outbursts occurred most frequently in operating rooms, medical-surgical units, intensive care units, emergency departments and obstetrics areas.
When asked about disruptive behavior by physician specialty, general surgery ranked number one, followed by cardiology and cardiovascular surgery, neurology and neurosurgery, orthopedics, obstetrics and anesthesia.
Another survey question asked how serious an issue disruptive physician behavior was at the hospital. The overall response to this question was 6.77 on a scale of 1-10, with 10 being extremely serious.
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