Rudeness from patients or their relatives can have a significant impact on clinical performance and lead to more errors, according to researchers.
They noted that emotions often ran high in hospitals and it was not uncommon for patients or their loved ones to be rude to clinicians when they perceived inadequate care.
“They cannot get over rudeness because it interferes with their cognitive functioning”
But new findings, published in the journal Pediatrics, suggest that such incidences of rudeness can have “devastating effects on medical performance”.
The study authors said poor judgment and tiredness accounted for 10-20% of the variance in practitioner performance, but claimed the effects of rudeness could account for more than 40%.
They said teaching clinical professionals to handle rudeness more effectively should be a priority for the healthcare community.
In the study, 39 neonatal intensive care unit teams – two doctors and two nurses – simulated five scenarios where they treated infant medical mannequins for emergency situations such as severe respiratory distress or hypovolemic shock.
An actress playing the baby’s mother scolded certain teams while the control groups experienced no rudeness.
The researchers, from the US and Israel, found that the teams that experienced rudeness performed poorly compared to the control groups.
”Now that we’ve found serious effects, we need to find more realistic interventions”
Those that encountered rudeness were deficient in all 11 of the study’s measures, including diagnostic accuracy, information sharing, therapy plan and communication over the course of all five scenarios – indicating that the negative effects could last the entire day.
Study author Professor Amir Erez, from the University of Florida, said the study showed that rudeness was “affecting the cognitive system, which directly affects your ability to perform”.
“Even if clinicians have the best intentions in mind, as they usually do, they cannot get over rudeness because it interferes with their cognitive functioning without an ability to control it,” he said.
He added: “The purpose of this research was to identify what’s going on here. Now that we’ve found serious effects, we need to find more realistic interventions.”
To combat the effect of rudeness, the researchers also included “interventions” for some teams taking part in the study.
Before taking part in the study scenarios, some participated played a computer game designed to raise their sensitivity threshold to anger and aggression.
The intervention worked well, said the researchers, with clinical staff “basically immunized from the effects of rudeness”.
Increase in nurse errors linked to patient rudeness
The researchers found no difference in the performances of the control groups and the teams that played the computer game. Teams recognized the mother’s rudeness, both midway and after the simulation, but were not affected by it.
Meanwhile, other teams participated in a post-test intervention, which consisted of team members writing about the day’s experience from the perspective of the baby’s mother.
However, although previous research has shown it to be extremely successful for trauma patients, the intervention actually had a negative effect on teams, said the researchers.
Professor Erez said: “What is really concerning is that, at midday, these teams recognized the mother was rude to them. But at the end of the day, they did not. So not only did it not work, but it caused them to not recognize rudeness later.”