Silent kills

Maxfield, David; Grenny, Joseph; Lavandero, Ramón; Groah, Linda K.

doi:10.1055/s-0032-1316454

Cited by 17 publications

(17 citation statements)

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“…Many studies document their reluctance to verbally intervene when they witness a colleague ignoring established safety protocols (Maxfield et al . ), selecting the wrong therapy (Blatt et al . ), or neglecting to recognise or act upon a dangerous change in a patient's condition (Lyndon , Simpson and Lyndon ).…”

Section: Introductionmentioning

confidence: 99%

Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety

Szymczak

2015

Sociology Health & Illness

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Clinician silence in the face of known threats to patient safety is a source of growing concern. Current explanations for the difficulties clinicians have of speaking up are conceptualised at the individual or organisational level, with little attention paid to the space between -the interaction context. Drawing on 103 interviews with clinicians at one hospital in the United States this article examines how clinicians talk about speaking up or not in the face of breaches in infection prevention technique. Accounts are analysed using a microsociological lens as stories of interaction, through which respondents appeal to situational and organisational realities of medical work that serve to justify speaking up or remaining silent. Analysis of these accounts reveals three influences on the decision to speak up, shaped by background conditions in the organisation; mutual focus of attention, interactional path dependence and the presence of an audience. These findings suggest that the decision to speak up in a clinical setting is dynamic, highly context-dependent, embedded in the interaction rituals that suffuse everyday work and constrained by organisational dynamics. This article develops a more sophisticated and distinctly sociological understanding of the reasons why speaking up in healthcare is so difficult.

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Section: Introductionmentioning

confidence: 99%

Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety

Szymczak

2015

Sociology Health & Illness

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“…The American Association of Critical Care Nurses conducted a survey of critical care healthcare providers, among them 1,143 nurses. While the purpose of this study was not to investigate bullying per se, the researchers found that 88% reported working with team members who divide the team, often at another's expense; 77% claimed that they worked with someone who is disrespectful, of which 33% were verbally abusive; and 52% reported that they worked with people who abused their authority, including pulling rank and bullying (Maxfield, Grenny, McMillan, Patterson, & Switzler, ). A study of 206 Turkish nurses (Efe & Ayaz, ) found that intensive care unit (ICU) nurses were more exposed to “mobbing” behaviors compared to other nurses.…”

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confidence: 99%

Bullying and Its Prevention Among Intensive Care Nurses

Ganz

Levy

Khalaila

et al. 2015

J of Nursing Scholarship

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“…VitalSmarts conducted a further study in 2010 “The Silent Treatment” and showed that a culture of silence in organizations leads to communication breakdowns that harm patients. 3 This study found that more than four out of five nurses have concerns about dangerous shortcuts, incompetence, or disrespect. More than half say shortcuts have led to near misses or harm; more than a third say incompetence has led to near misses or harm; and more than half say disrespect has prevented them from getting others to listen to or respect their professional opinion.…”

Section: Introductionmentioning

confidence: 74%

Overcoming difficult conversations in clinical supervision

Williams

King

Edlington

2016

JHL

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BackgroundClinical supervisors are responsible for managing many facets of clinical learning and face a range of challenges when the need for “difficult” conversations arises, including the need to manage conflict and relationships.MethodsSpotlight on Conversations Workshop was developed to improve the capacity of clinical supervisors to engage in difficult conversations. They were designed to challenge the mindset of clinical supervisors about difficult conversations with students, the consequences of avoiding difficult conversations, and to offer activities for practicing difficult conversations. Preworkshop, postworkshop, and 4-month follow-up evaluations assessed improvements in knowledge, intent to improve, and confidence along with workshop satisfaction.ResultsNine workshops were delivered in a range of locations across Victoria, Australia, involving a total of 117 clinical supervisors. Preworkshop evaluations illustrated that more than half of the participants had avoided up to two difficult conversations in the last month in their workplace. Postworkshop evaluation at 4 months showed very high levels of satisfaction with the workshop’s relevancy, content, and training, as well as participants’ intention to apply knowledge and skills. Also shown were significant changes in participants’ confidence to have difficult conversations not only with students but also with other peers and colleagues. In follow-up in-depth interviews with 20 of the 117 participants, 75% said they had made definite changes in their practice because of what they learned in the workshop and another 10% said they would make changes to their practice, but had not had the opportunity yet to do so.ConclusionWe conclude that the Spotlight on Conversations Workshop can improve the clinical supervisor–student relationship as well as build general difficult conversation capacity for a range of stakeholders in clinical settings.

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Silent kills

Cited by 17 publications

References 0 publications

Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety

Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety

Bullying and Its Prevention Among Intensive Care Nurses

Overcoming difficult conversations in clinical supervision

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