Issue with safety? R-E-S-P-E-C-T missing

Is a respectful attitude missing among your staff? It has to come from the top down, says Stephen Trosty, JD, MHA, CPHRM, ARM, president of Risk Management Consulting Corp., in Haslett, MI.

For example, in the operating room, while surgeons traditionally are seen as captains of the ship, "that doesn't mean [they] need to be discourteous, rude, curt, or insulting toward [their] employees," Trosty says.

The same advice goes for nurses toward each other, and clinicians toward clerical staff, he says. Any time you're a negative team, you're putting patients at a greater risk, Trosty says.

Disrespect showed up as a primary concern in the recent study "The Silent Treatment: Why Safety Tools and Checklists Aren't Enough to Save Lives," sponsored by the Association of periOperative Registered Nurses (AORN), the American Association of Critical-Care Nurses (AACN), and VitalSmarts, a corporate training company in Provo, UT. Eighty-five percent of respondents said that 10% or more of the people they work with are disrespectful and therefore undermine their ability to share concerns or speak up about problems. Only 16% have confronted their disrespectful colleagues.

One solution is a code of conduct, as required by The Joint Commission. The code of conduct, which includes information on how to handle disrespectful behavior, should be reviewed with new employees, says Jan Davidson, MSN, RN, perioperative education specialist at the Association of periOperative Registered Nurses (AORN).

"Disrespectful behavior amongst peers or physicians should never be allowed, and there should be language in the medical staff bylaws and the employee handbook that emphasizes a zero tolerance for disrespectful behavior," Davidson says. (For more information on this topic, see The Joint Commission's brochure on having a code of conduct can be accessed at