Читать книгу Toxic Nursing, 2nd Ed - Cheryl Dellasega - Страница 19

In this example, at least two doctors are known on the unit for berating new nurses. Sadly, many of us have experienced a transitional shock coming from a rigorous academic environment with a sense of accomplishment, excitement, and commitment to practice to this hostile and disrespectful “welcome” to the real-world nursing environment.

Stopping this disruptive behavior is crucial for collaborative, safe care and for rewarding, long-term careers. Ideally, the nurse manager would have spoken with these physicians individually prior to Hector’s starting on the unit. A quick chat in private about the expectation of respectful behavior, sentinel event data related to poor communication, the cost of recruiting and retaining qualified staff, and an invitation to look at teaching opportunities as they arrive may be all that is needed. Because that didn’t happen, the nurse manager should speak with Hector privately and explain that she is working on addressing this behavior with the physicians, that Hector should try not to take it personally, and that she would like to help Hector be assertive with these doctors the next time an incident occurs. They could use a scenario to role-play a response.

This would provide Hector with language and leadership support for the next time he is attacked by these doctors. Using a clear, firm voice and confident body language, Hector might say, “Dr. Monroe, your comments about all nurses lacking common sense are offensive. My goal is to work with you collaboratively for the safest and best care of our patients. I am happy to hear feedback on your preferences and concerns, and I expect you to treat me with respect. Can I count on you for this?” Or, “Dr. Carter, your insulting language is inappropriate. I agree that nutrition is an important factor of caring for our patients. There are many challenges associated with feeding patients, including their willingness to eat, the food, and the time and staff available to help. Let’s schedule a meeting with the unit manager to discuss our concerns and address this issue.”

Finally, the nurse manager should be aware that supportive staff “running interference” may be contributing to an unhealthy alignment of us versus them with the physicians.

–Beth Boynton

While the claims of the physicians might be correct, the way they expressed them was inappropriate. Given the way the information was presented, the physicians’ rudeness could be considered bullying. Either way, I believe that Hector should talk to the physicians and tell them he was frustrated not by what they told him, but by how they told him.

–Dilek Yildirim