How rude! The effects of a bad attitude on patient safety

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Dealing with rude behavior — even mild rudeness — is not just bothersome, it can actually influence a medical team's performance and, ultimately, potentially jeopardize patient safety, according to a new study published in the journal Pediatrics.

Researchers worked with 72 neonatal intensive care unit clinicians and divided them into 24 teams including one physician and two nurses. The teams participated in a training simulation in which they were instructed to examine and treat a mannequin of a premature infant with necrotizing enterocolitis and were observed by a expert.

According to the study, some teams were placed in a group that was overseen by an expert with a bad attitude who would use "mildly rude statements completely unrelated to the teams' performance," while the other teams were placed in a control group with an expert who only used neutral comments.

The simulations were evaluated by three independent judges who assessed team performance, information-sharing and help-seeking. The judges found:

1. The composite diagnostic and procedural performance scores were lower for members of teams exposed to rudeness than to members of the control teams.

2. Rudeness alone was the source of nearly 12 percent of the diagnostic and procedural performance variation.

3. Teams that were exposed to the rude expert were less likely to share information and ask for help than those in the control group.

Tel Aviv University professor and co-author of the study Peter Bamberger, PhD, told The Advisory Board that rude behavior reduces the "cognitive resources" available to providers, which can "put patients at risk because those caring for (patients) just aren't able to make decisions or process information the way they should."



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