8. Require temporary leave
If counseling has not been effective in curbing a staffer's incivility, it is
often wise to recommend a leave of absence. In some cases, it's wise
to require counseling during this leave. I know of one physician who
was required to attend anger-management classes during his leave of
absence, and I'm aware of a nurse who had to receive treatment for
alcohol abuse. Leaves of absence can be remarkably successful. I
have seen staffers and physicians return from leave with an entirely
new outlook on life.
9. Terminate
If none of the above is successful and damaging behavior continues, it
may be time to let the employee go. Remember, no matter how high
they are in the institutional hierarchy, no one is immune from
consequences. Showing your team that bullying will not be tolerated
is a net positive.
10. Hire for fit
So often, physicians especially are recruited solely on the basis of
where they went to school and who they trained with; seldom does
their willingness and ability to collaborate with others come into the
picture. Thoroughly assessing a potential hire's emotional maturity
and respect for others will pay more dividends in the long run.
Leading by example
Organizations really need to invest time and money into training their
employees at all levels. We need to teach nurses how to navigate
difficult conversations with each other, management how to handle
conflict on their units and executive-level administrators how to be
respectful. Civility should be exemplified from the top down in every
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