From the staff development bookshelf: Incidents of disruptive physician behavior

Staff Development Weekly: Insight on Evidence-Based Practice in Education, May 25, 2012

According to nurses, disruptive physician behavior most often occurs after they place phone calls to physicians, after they ask questions or seek clarification of physician orders, when physicians feel their orders were not carried out correctly or in a timely manner, when there are perceived delays in care, and when there are sudden changes in patient status (Rosenstein 2002).

Physicians believe the primary cause of their disruptive behavior is when their orders are not being carried out correctly or in a timely manner (Rosenstein 2002). Nurses depend on the actions of personnel in other departments; physicians often perceive a delay in medication administration or delivery of supplies as ineptitude on the part of the nurse. When studying the nurses' work, researchers found that nurses experience an average of 8.4 system interruptions per eight-hour shift (Tucker). Therefore, managers must follow up on delays or incorrect treatment. If they do not, physicians will be left to draw their own conclusions, which will most likely be that 'it was the nurse's fault'.

And there's always one thing in common with bad scenes: a tremendous amount of emotional charge. No one can solve a problem in the midst of so much hurt and anger.

The answer is to disengage-to physically remove yourself and others from the verbal abuse-and return to the issue at a later date.

Book excerpt adapted from
Speak Your Truth: Proven Strategies for Effective Nurse-Physician Communication by Kathleen Bartholomew, RN, MN

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