Friday, June 3, 2011

The Silent Treatment: Unspoken Words Can Harm Our Patients

I was watching an episode of “Grey’s Anatomy” the other night, and the story line involved a competition between surgical residents for the position of chief resident. Every resident was developing a project with the hope that it would help land the coveted position. One of the young doctors created a pre-op safety checklist for the staff but it was tossed aside by one of her arrogant co-workers who saw it as a waste of time and a rule that didn’t apply to her.

I thought of that scene when I read about the results of a study conducted by American Association of Critical Care Nurses and the Association of periOperative Registered Nurses. Called “The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives,” it identified “concerns that often go undiscussed and contribute to avoidable medical errors,” according to the summary. It found that “the ability of health professionals to discuss emotionally and politically risky topics in a healthcare setting (is) key to patient safety, quality of care, and nursing turnover.”

Bottom line: When nurses fail to speak up, patient health and safety can suffer.

And why don’t nurses speak up?

They may feel incompetent, inferior or insecure, or fear losing their job when they have to stand up to co-workers who are arrogant, lazy, in superior positions, have personality problems or like to bully.

Here are some of findings of the study, which surveyed more than 6,500 nurses and nurse managers in 2010:
• More than 80 percent of those surveyed said that they have concerns about shortcuts (i.e. not washing hands) and the disrespect and incompetence demonstrated by co-workers.
• Nearly three out of five nurses said they felt unsafe about speaking up or couldn’t get others to listen to their concerns.
• Less than half of concerned nurses have spoken to their managers about a co-worker who most concerns them.
• Eighty-five percent said they’ve been in situations in which safety checks or procedures warned of a problem, and one in three nurses said such problems came up “at least a few times a month.”
• More than half said that a lack of respect prevented them from getting others to pay attention to their concerns, and only 16 percent confronted their disrespectful co-worker.
• More than half said they had seen shortcuts that led to near misses or harm, but only 11 percent said something to their incompetent co-workers.

You can read about the study at www.silenttreatmentstudy.com

Do you feel free to discuss safety concerns with your manager or superior, such as dangerous actions of co-workers?

Have you ever been in a situation in which you knew the rules were being broken but you didn’t feel comfortable pointing this out to the offending party?

Has being bullied by a co-worker ever prevented you from ensuring a patient’s safety?

Have you ever been berated for following safety precautions?

Tell us about it.

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