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Group calls for zero tolerance of doctor bullies
By CARLA K. JOHNSON
Associated Press Writer
Wed Jul 9, 3:08 PM ET

Bullying doctors can make nurses afraid to question their performance,
resulting in medical errors, according to a hospital group that
announced new requirements for cracking down on intimidating behavior.

Outbursts and condescending language threaten patient safety and
increase the cost of care, according to a safety alert issued
Wednesday by the Joint Commission, an independent organization that
accredits most of the nation's hospitals.

Hospitals will be required by next year to have codes of conduct and
processes for dealing with inappropriate behavior by staff, said the
group's president, Dr. Mark Chassin. Hospitals without such systems
risk losing their accreditation, he said.

Powerful doctors mean money for hospitals because they choose where to
admit their patients, but they "should not be left off the hook," said
Dr. Peter Angood, vice president of the group, which is based in
suburban Chicago.

Grena Porto, a nurse involved in the group's efforts, said nurses need
to be "appropriately assertive" and feel safe enough to ask a doctor,
"Are you sure we're supposed to operate on the right leg, rather than
the left?"

Nurses, pharmacists and hospital administrators also can be culprits,
but it's the doctors who bully nurses that are the most significant
for patient safety, said Dr. Alan Rosenstein, a researcher on the
topic. He applauded the group's action.

Rosenstein, medical director of VHA West Coast, an alliance of
nonprofit hospitals, surveyed 1,500 hospital employees for a 2005
study published in the American Journal of Nursing, and received
comments like these:

• "Most nurses are afraid to call Dr. X when they need to, and
frequently won't call. Their patient's medical safety is always in
jeopardy because of this."

• "I have caught myself in the middle of mislabeling specimens after
confrontations that have been upsetting."

Another survey in 2003 by the Institute for Safe Medication Practices
found that 40 percent of health providers said they had kept quiet
rather than question a known bully.

Hospitals have pecking orders and are stressful work environments, but
"there's a right way and a wrong way to manage that stress," Chassin
said.

___

On the Net:

Joint Commission: http://www.jointcommission.org/

Copyright © 2008 The Associated Press.
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