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Rude behaviour may impact on patient safety


Aggressive or rude behaviour between nurses and other members of staff could lead to errors and have a negative impact on patient safety, according to new research.

A study at the University of Aberdeen looked at the impact of rudeness on how people carry out tasks.

It found a rude comment or overhearing such a remark can cause people to make a mistake.

In one study, students who were insulted by a professor on the way to the test performed worse on a series of memory tasks than others who had not been spoken to rudely.

Writing in the British Medical Journal (BMJ), Rhona Flin, professor of applied psychology, said human attention “is powerfully driven by emotion”.

“This reaction is probably caused by the emotional arousal caused by the rudeness, which resulted in a switchover of cognitive capacity to deal with the required emotional processing, or it may, more simply, be caused by distraction,” Prof Flin said.

Professor Flin said the link between performance and rudeness was particularly worrying when it comes to healthcare, with patients potentially being put at risk.

In operating theatres, even witnessing rudeness between doctors can impact on how the team performs.

“Recent studies suggest that disagreements and aggression between clinical staff are not uncommon,” she wrote.

In a survey of 391 NHS operating theatre staff, 66% said they had been the victim of aggressive behaviour from nurses and 53% from surgeons during the previous six months.

Professor Flin said: “If incivility does occur in operating theatres and affects workers’ ability to perform tasks, the risks for surgical patients - whose treatment depends on particularly high levels of mental concentration and flawless task execution - could increase.”


Readers' comments (7)

  • Steve Williams

    What money-wasting bull-excrement... both the report and the fact the NT chose to report it in the first place - scratching around for something interesting to publish eh?

    "In a survey of 391 NHS operating theatre staff, 66% said they had been the victim of aggressive behaviour from nurses and 53% from surgeons during the previous six months"... ah yes, probably all male nurses and obviously all surgeons are male!

    Lay it on with it a trowel NT why don't ya?

    One minute you are wailing about the prospect of 10,000 peoples jobs in the NHS being threatened and the next you are spotlighting a report about the tender sensitivities of patients to rudeness.

    No worries, pretty soon there will be no 'bitching' nurses or Doctors... so the patients won't get their feelings hurt. They won't get their operations either - but then that's just a small detail after all eh?

    Nanny State? The UK has become a 'wet-nurse' state in more senses than one.

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  • 7th, July, 2010,8:14 pm
    Well then .. enough said Steve.I think your blog kind of underscores the point the report was making.
    I can see nothing wrong with professional courtesy towards patients and colleagues
    myself . If it protects the safety of patients and the mental health and well being of staff .. then bring it on. Ever heard of post traumatic stress dsiorder brought on by working with bullying staff in unpleasant working environments?
    Prime cause of long term conditions such IBS and arhtritis/immune disorders to name but a few. I don't think NHS needs to drum up business for itself does it?

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  • Rachel Murray’s unpublished PhD research into nurses suspended from work, revealed that there were often precursors to the poor performance such as bullying behaviours.
    CAUSE (Campaign Against Unnecessary Suspension and Exclusions UK) has heard from staff who fear suspension may be imminent because of a fraught environment and the impact it was having on their mental and physical health and therefore on their performance. They were very unhappy about the impact it was all having on patient care.
    The more people who flag up the detriment of these behaviours through thorough research, the more chance there is that some action will be taken to change or prevent them.
    Julie Fagan, founder member CAUSE

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  • I am not sure that I agree with the findings about patient safety being affected - nurses should be stronger to rise above the ignorance of those who we have the misfortune to work with those who are 'rude; & trying to flex their muscles. There behaviour 'should' be managed/challenged as nurses/midwives it is more likely to be - doctors - there's another story.Many dont' even realise the impact.
    All I would say is that the number of complaints I have to deal with would reduce if some consultants had manners when dealing with patients & could recognise that patients have a right to question & want to be kept informed/involved.

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  • I think we should consider why staff are considered as 'rude' and what behaviour are the respondents to these surveys considering 'rude' to be.

    I consider myself to be very polite and considerate to all staff, but in stressful situations I would describe myself as 'direct'. I don't have time to fanny about worrying about individual sensitivities when a patient is in danger or my ward is being put under yet more pressures.

    Rudeness from individuals daily will affect the way a person will interact with others in all spheres of their life and this article considers the rudeness of staff only.

    When a member of the public is aggressive or displays what I consider to be unreasonable behaviour towards me, despite 20 years experience I can honestly say that it ruins my day. These situations occurr too frequently for me to consider.

    I expect all my staff to treat patients and each other with dignity and respect, but when they're screamed at, abused continually and treated with contempt, how can I blame them for being 'direct'?

    I don't have the answers but I wonder whether a little old-fashioned respect & courtesy would benefit all?? I'm an open, friendly individual, but wonder whether speaking to each other or introducing ourselves to the patients using our official titles or positions would improve all behaviours? I remember being in awe of our 'night sisters' where I trained - I very recently met one sitting in our discharge lounge...a robust lady in her late 70s, I was shocked to be introduced to her by a flippant HCSW who referred to her by her first name - it sounded very wrong, disrespectful.

    It may sound ridiculous, but I really think we should give a more formal approach to our positions a highly trained professionals working in often impossible situations we deserve to be treated better by the public and by our own colleagues.

    I've rambled somewhat, but would appreciate polite and constructive response!!

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  • I am curious about the nature of the responses to this research, as it would appear to me that there is a degree of defensiveness and justification. As health care providers, we are, and work with human beings. Yes there are times when we are stretched, things are busy, colleagues are sometimes less than helpful or worse bullying; patients are distressed, unhappy in pain; but does that mean that it is acceptable to join the emotionally fraught, reactive soiree? It feels as though some how, somewhere we forgot that we are human beings too; the only thing that should make us 'different' is a capacity to be 'reflective' and self aware in our interactions with others. It is not a personal attack to consider this research, and possibily learn something from it, rather than look for a rationale, justification or another profession to blame for our failings. I would like to think it is not about accepting/tolerating bullying, or unpleasant behaviour, nor joining the club and being equally unpleasant, but an opportunity to learn from our collective experiences about what does not help us do our job, in relation to things 'we' can do something about.

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  • From Medscape Nurses > Nursing Perspectives

    The Downward Spiral: Incivility in Nursing

    Laura A. Stokowski, RN, MS

    Authors and Disclosures

    Posted: 03/24/2011

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