Criticising doctors and nurses ‘causes medical errors’
US study says even with good intentions, doctors and nurses cannot get over rudeness and it interferes with their cognitive functioning
By Julia Medew
Ever lost your cool in a hospital? New research suggests you would be wise to stay calm.
Criticising doctors and nurses while they’re caring for you or a loved one increases the risk of potentially catastrophic errors, a study of intensive care units has found.
With thousands of people dying every year due to preventable errors in hospitals, a team of American researchers set out to test whether rude parents undermined the care of their children.
Doctors and nurses from 39 neonatal intensive care units in Israel were asked to work through five mock clinical scenarios with mannequins to replace seriously ill infants.
When actors playing parents berated the teams with lines such as “I knew we should have gone to a better hospital”, the team’s performance dropped.
Compared to other teams where parents made neutral comments on the sidelines, the scolded teams scored lower on all measures including time to diagnosis, diagnostic accuracy, information sharing, treatment planning and communication between team members.
The researchers concluded that rudeness could lead to “potentially catastrophic clinical outcomes” and was more of a problem than sleep deprivation for health professionals when it came to factors influencing the quality of care.
The study, published in the journal Pediatrics this month, follows a similar one by the same researchers at the University of Florida showing that rude colleagues in medical teams diminish performance.
“People may think that doctors should just ‘get over’ the insult and continue doing their job,” said lead author Professor Amir Erez.
“However, the study shows that even if doctors have the best intentions in mind, as they usually do, they cannot get over rudeness because it interferes with their cognitive functioning without an ability to control it.”
While patients and their loved ones are being encouraged to speak up more to reduce medical errors, research suggests even mildly rude behaviour will be counterproductive.
One study showed that simply witnessing insensitive comments or disrespectful utterances in the workplace affects people’s cognitive performance.
Executive director of the Australian Institute for Patient and Family Centred Care, Dr Catherine Crock, AM, said rude behaviour in hospitals and medical clinics was undoubtedly dangerous because it distracted people during complex tasks.
“It can interrupt your thought process. You literally forget what you’re supposed to do next,” she said.
But in good news, Dr Crock said kindness had been found by neuropsychologists to be contagious. With this in mind, she said health workers, patients and their families could all contribute to safer care by respecting others, even if they’re stressed.
“The great thing is, this doesn’t cost more money,” said the doctor who works at the Royal Children’s Hospital in Melbourne.
“If I do a kind act to you, you’re more likely to be kind to the next person you encounter. It is actually contagious.”
Australian experts say about one in 10 patients experiences an adverse event while in hospital, although not all of these events are serious. They include medication errors, misdiagnoses, and pressure ulcers from not being moved enough.
A study by Johns Hopkins University in Baltimore has estimated that medical errors cause more than 250,000 deaths every year in the US.