According to an analysis in the May 2016 issue of BMJ, medical errors in U.S. healthcare facilities are incredibly common and are now the third leading cause of death—more than respiratory disease, accidents, stroke, and Alzheimer’s disease. There are many reasons for this, and one is workplace incivility and the fear and bullying that go with it. We’ve heard explanations aplenty for this error expansion, but there’s no exculpation. Patients are put at risk by workplace incivility and bullying.
Perhaps I am too simplistic, and most assuredly I am old-fashioned, but it seems to me that restoring courtesy as a cultural norm might help. Perhaps human behavior has changed over the years, but time hasn’t changed. Technology has changed, populations have changed, even bacteria and viruses have changed—but time itself simply marches on, one moment at a time, until we finally run out of it. And we wonder, “What have I done with the moments allotted to me?” Without time and the past it represents, we lose something important: the relationships on which caring and friendship are built.
We don’t have time to listen anymore, and certainly not to hear. We don’t even have time to say “please” and “thank you.” We are so busy and our work is so urgent that it excuses rudeness (in the view of many). And as some see it, we almost have a duty to bully those who are less proficient or experienced. Is it any wonder we’ve gone from about 100,000 unnecessary deaths annually (according the 1999 Institute of Medicine report To Err is Human: Building A Safer Health System) to about 250,000, according to BMJ?
When did it become acceptable to treat professional colleagues, coworkers, and even patients with less attention than we give to a beep on our smartphones? Why is it acceptable to talk on the phone (or text or tweet) rather than pay attention to the people in our presence? I know generational differences exist, but presence is still presence, listening is still listening, kindness is still kindness, respect is still respect.
We could begin to make the workplace a kinder, gentler, and safer place if we actually listen to what others are saying. If we have to bring a “live” communication device into a meeting or an interview with patients or families, let’s put it on vibrate and explain the urgent reason that may call our attention away from those in our presence. If you allow the device to take precedence over those you are meeting with, you’re conveying the opinion that whoever or whatever is sending you a message is more important than the people you’re face-to-face with. People resent nurses’ addiction to a morality-free, soul-free, wireless, deus ex machina: the all-consuming communications device.
Courtesy refers to behaviors designed to avoid hurting other people’s feelings. It costs nothing. It takes no extra time; actually, it may save time. Being polite means being aware of and respecting the feelings of others, who may not always notice courtesy but always notice rudeness. Good manners change how others react to you and the organization you represent. It’s only one small step toward deescalating violence in the workplace, but it’s a step in the right direction. And it makes life so much more pleasant.
Leah Curtin, RN, ScD(h), FAAN
Executive Editor, Professional Outreach
American Nurse Today
Consultant to CGFNS International
Institute of Medicine. To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press; 1999.
Makaray, MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016;353:i2139.