Disruptive Behaviors in an Emergency Department: the Perspective of Physicians and Nurses

Abstract

Introduction: Disruptive behaviors cause many problems in the workplace, especially in the emergency department (ED).This study was conducted to assess the physician’s and nurse’s perspective toward disruptive behaviors in the emergency department. Methods: In this cross-sectional study a total of 45 physicians and 110 nurses working in the emergency department of five general hospitals in Bojnurd participated. Data were collected using a translated, changed, and validated questionnaire (25 item). The collected data were analyzed by SPSS ver.13 software. Results: Findings showed that physicians gave more importance to nurse-physician relationships in the ED when compared to nurses’ perspective (90% vs. 70%). In this study, 81% of physicians and 52% of nurses exhibited disruptive behaviors. According to the participants these behaviors could result in adverse outcomes, such as stress (97%), job dissatisfaction and can compromise patient safety (53%), quality of care (72%), and errors (70%). Conclusion: Disruptive behaviors could have a negative effects on relationships and collaboration among medical staffs, and on patients’ quality of care as well. It is essential to provide some practical strategies for prevention of these behaviors.

The current status of nurses–doctors collaboration in clinical decision and its outcome in Tanzania

“…Other nurses joined in one voice to ensure their opinions were adhered to when they feel they are right. This is similar to another study where nurses joined hands and with one voice denounced the habit of an MD by writing a letter to the administration of a particular health facility to express their discomfort in working with an MD (Maddineshat, Rosenstein, Akaberi, & Tabatabaeichehr, 2016).…”

Inter-professional collaboration of nurses and midwives with physicians and associated factors in Jimma University specialized teaching hospital, Jimma, south West Ethiopia, 2019: cross sectional study

“…Moreover, the experience of disruptive behavior with physicians was also found to decrease the participant's inter-professional collaboration with physicians (AOR, 0.229 (0.141-0.372). Almost nearer finding was obtained in an Iranian study [11]. But, this finding was inconsistent with (lower than) the study done in West Coast, the United States of America (USA) as most of (92.5%) 0f the respondents mention that they encounter disruptive behaviors though it was not mentioned as a significant factor [28].…”

“…It is demonstrated in two different studies that more than half of nurses and midwives exhibited noncollaborative behaviors and generally had not a good collaboration with physicians [10,11]. Another study conducted in Iran indicated that near half (48%) of nurses reported their remarks concerning the patient's health are ignored by physicians [12].…”

Nurses' views on workplace wellbeing programmes

“…The environments in which this data was collected continue to generate high levels of stress and emotional burden (e.g. Emergency Departments: Maddineshat et al, 2016;Burns Units: Kellogg et al, 2014) The self-selecting nature of the sampling strategy and the small number of participants means that care needs to be taken when transfering the findings to other settings. All participants were women and this means that the findings may not reflect the experiences of male nurses.…”