Physican and Nurse Conflicts Result in Policy Review

The worst kept secret in hospitals nationwide is the widespread
tension and conflict between physicians, nurses, physician assistants,
nurse practitioners, administrators and other ancillary staff such as
inhalation therapists and nurse anesticists.

Work stress is par for the course in almost all areas of inpatient
hospital care. It is not reasonable to expect an absence of stress in
Emergency Rooms, or among Cardiologists, Surgeons, Neurologists,
Gynecologists, Oncologists and most other critical care specialists.
However, medical staff, working in any of these areas of
specialization can and should be expected to be able to recognize and
manage their own stress rather than have it turn into anger, abuse or
person-directed aggression.

The nature of the work in all of the areas mentioned is, in itself
stressful. There are however, additional stressors which until
recently, have not been adequately addressed.
These include the debilitating stresses placed on all hospitals by the
constraints of Managed Health Care. Physicians are no longer able to
provide the level of care to their patients which are needed. Rather,
they must seek/beg for permission from some non-physician (MBA) at the
end of an 800 line to approve or disapprove of each procedure based on
cost. Therefore, doctors tend to displace their frustration, anger and
stress on to nurses and other members of the treatment team including
technicians and ancillary staff.
Hospitals are being forced to close Emergency Rooms because a lack of
adequate funding which adds to staff stress and patient distress.

Patient care is no longer based on the needs of the patient but
instead on the cost of the procedure. This is demeaning to physicians
and life threatening to patients. Unfortunately, patients are angry at
the physicians for not providing the care needed without recognizing
the current limitation placed on physicians by the patients' own
health care plan.

In an attempt to address at least part of this quiet crisis in
healthcare, the Joint Commission on Hospitals Accreditation issued a
directive to all hospitals requiring written policies to be in place
effective April 1, 2007 to address the issue of "disruptive
physicians". Disruptive physician is defined as those physicians whose
"aggressive, abusive behavior" impact patient care and treatment team
effectiveness.

Simply put, nurses, physicians and other treatment staff can now
formally complain about unfair treatment/abuse from physicians in the
course of their hospital work.

Enlightened Hospital Administrators, Physician Well-Being Committees
and Hospital Admitting Staff Credential Committees have begun to move
quickly to require that doctors who are defined as "disruptive" are
required to complete an Executive Coaching/anger Management Class to
enhance skills in recognizing and managing stress, anger, enhancing
assertive communication and increasing emotional intelligence.

Nurses and ancillary staff are now being required to participate in
Organizational Training Courses in which the same topics along with an
assessment is given with the option of small group anger management
classes for those who score in the deficit range in managing stress,
anger, communication or emotional intelligence.

In summary, previously ignored behavior which impacts patient care and
staff morale are being address by using anger management and executive
coaching for physicians and ancillary staff in most hospitals. This
will likely have the impact of reducing litigation and increasing
staff morale as well as increasing effective patient care nationwide.

George Anderson, MSW, CAMF, BCD.
http://www.linkedin.com/in/geoanderson
www.andersonservices.com
www.aaamp.org
www.anger-management-resources.org