4. Encourage "trusting circles"
Every single staffer should establish a group of peers — or at least an
individual co-worker — with whom they can talk out civility
questions in confidence. Whether a nurse, technician or a physician,
each team member needs someone to "bounce things off" when
situations become stressful, whether they have been uncivil to
someone else or when they've been on the receiving end. This type of
trustful peer-to-peer dialogue can often defuse situations before they
turn into crises.
Chris, a friend who works in my facility, is someone to whom I can
tell anything and know that it will be kept completely confidential.
Chris recently asked me about a confrontation I had with another
staffer, "Do you think that was the right action to take in this
situation?" After reflecting, I said, "No, I do not." Chris's feedback
spurred me to go back to the person I treated poorly and say, "I
should never have said that to you. I had concerns and I was
frustrated, but that is no excuse for my behavior." These types of
conversations almost always end up being productive. Every
healthcare professional needs at least one peer to go to for honest,
unvarnished, consequence-free feedback.
5. Hold each other accountable
A 2011 study on improving physician-nurse relationships in Archives
of Surgery showed that accountability is key to stemming physician-
to-nurse incivility. When doctors or staff are held accountable for
bullying behavior it sends a message to them, their colleagues and to
staff that the institution will not tolerate it.
I was once in the OR with a pediatric surgeon performing open-
heart surgery on an infant — clearly a stressful case. At one point,
the surgeon became so frustrated that he threw a prep bottle
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