Greetings!
I’ve recently returned from a couple days at the University of
Washington Medical Center Hospital going through tests I’d only
read about and where they ultimately stuck a very long needle in my
belly and pumped one and a half gallons of blackish fluid from a
tumor that took over the space.
Did you know that an x-ray of a belly full of fluid shows up as
a blackish nothing? I didn’t.
Next time I have a few things to say about that including
showing photos of incredible shots taken of the inside of my belly
drained of the excess fluid and showing the tumor still taking up
an inordinate amount of space.
The attending doctor, Brian Story Porter, MD,
took the time to show me the photos on a computer in my room and
then showed them a second time when my daughter was there.
More proof that UWMC doctor’s not only teach medical students, they
educate their patients too and have all along!
My lung doctor, Christopher Goss, MD – looks at
the whole patient – not just their lungs. His patients are
more than a lung, including his disease passion, Cystic
Fibrosis.
That said, I was shocked yesterday to run across the
following Perspective: A Culture of Respect, Part
1 and 2: The Nature and Causes of Disrespectful Behavior by
Physicians and thought you’d be interested too.
I am running most of it here. I’m also asking what we, as
patients, can do to help change it?
***
“22 May 2012
Perspective: A Culture of Respect, Part 1: The Nature and Causes
of Disrespectful Behavior by Physicians
Leape, Lucian L. MD; Shore, Miles F. MD; Dienstag, Jules L. MD;
Mayer, Robert J. MD; Edgman-Levitan, Susan PA; Meyer, Gregg S. MD,
MSc; Healy, Gerald B. MD
A substantial barrier to progress in patient safety is a
dysfunctional culture rooted in widespread disrespect. The authors
identify a broad range of disrespectful conduct, suggesting six
categories for classifying disrespectful behavior in the
health care setting: disruptive behavior; humiliating,
demeaning treatment of nurses, residents, and students;
passive-aggressive behavior; passive disrespect; dismissive
treatment of patients; and systemic disrespect.
At one end of the spectrum, a single disruptive physician can
poison the atmosphere of an entire unit. More common are everyday
humiliations of nurses and physicians in training, as well as
passive resistance to collaboration and change. Even more common
are lesser degrees of disrespectful conduct toward patients that
are taken for granted and not recognized by health workers as
disrespectful.
Disrespect is a threat to patient safety because it inhibits
collegiality and cooperation essential to teamwork, cuts off
communication, undermines morale, and inhibits compliance with and
implementation of new practices. Nurses and students are
particularly at risk, but disrespectful treatment is also
devastating for patients. Disrespect underlies the tensions and
dissatisfactions that diminish joy and fulfillment in work for all
health care workers and contributes to turnover of highly qualified
staff. Disrespectful behavior is rooted, in part, in
characteristics of the individual, such as insecurity or
aggressiveness, but it is also learned, tolerated, and reinforced
in the hierarchical hospital culture. A major contributor to
disrespectful behavior is the stressful health care environment,
particularly the presence of “production pressure,” such as the
requirement to see a high volume of patients.
(C) 2012 Association of American Medical Colleges
http://journals.lww.com/academicmedicine/Abstract/publishahead/Perspective___A_Culture_of_Respect,_Part_1___The.99620.aspx
Perspective: A Culture of Respect, Part 2: Creating a Culture of
Respect
Leape, Lucian L. MD; Shore, Miles F. MD; Dienstag, Jules L. MD;
Mayer, Robert J. MD; Edgman-Levitan, Susan PA; Meyer, Gregg S. MD,
MSc; Healy, Gerald B. MD
Creating a culture of respect is the essential first step in a
health care organization’s journey to becoming a safe,
high-reliability organization that provides a supportive and
nurturing environment and a workplace that enables staff to engage
wholeheartedly in their work. A culture of respect requires that
the institution develop effective methods for responding to
episodes of disrespectful behavior while also initiating the
cultural changes needed to prevent such episodes from occurring.
Both responding to and preventing disrespect are major challenges
for the organization’s leader, who must create the preconditions
for change, lead in establishing and enforcing policies, enable
frontline worker engagement, and facilitate the creation of a safe
learning environment.
When disrespectful behavior occurs, it must be addressed
consistently and transparently. Central to an effective response is
a code of conduct that establishes unequivocally the expectation
that everyone is entitled to be treated with courtesy, honesty,
respect, and dignity. The code must be enforced fairly through a
clear and explicit process and applied consistently regardless of
rank or station.
Creating a culture of respect requires action on many fronts:
modeling respectful conduct, educating students, physicians, and
nonphysicians on appropriate behavior, conducting performance
evaluations to identify those in need of help, providing counseling
and training when needed, and supporting frontline changes that
increase the sense of fairness, transparency, collaboration, and
individual responsibility.
(C) 2012 Association of American Medical Colleges”
http://journals.lww.com/academicmedicine/Abstract/publishahead/Perspective___A_Culture_of_Respect,_Part_2__.99622.aspx
***
It all started with Chronic Obstructive Pulmonary Disease and a
forty-year smoking habit.
Thanks for reading…. Sharon O’Hara
