EXECUTIVE SUMMARY

Tension between patient access employees and colleagues produces negative effects on morale, productivity, and retention. Some strategies include:

  • holding a meeting with co-workers to resolve the issue;
  • instructing registrars how to speak up if they encounter disrespect;
  • responding to concerns within 24 hours.

Are Clinicians Really Rude, or Just Doing Their Jobs?

High-pressure situations may lead to misinterpretations of messages

A nurse rushes by a registrar on her way out of the treatment room without even making eye contact. A physician doesn’t even acknowledge the registrar in the room who’s obtaining demographic information. Are they being disrespectful, or just doing their jobs?

“Some clinicians viewed as difficult are merely driven and detail-oriented,” notes Lauren Blanchard, MBA.

ED nurses and physicians working in high-acuity, time-sensitive situations might appear rude when, in fact, they’re just doing what’s needed for the patient.

“If a trauma physician makes a demand and appears agitated or irate, it is often due to the critical nature of the patient,” Blanchard notes.

At times, if the registrar enters the patient’s information incorrectly or too slowly, it delays care.

“Harm could come to the patient,” Blanchard notes.

However, this doesn’t mean clinicians are allowed to be rude or inappropriate to registrars.

“To avoid these situations, create a culture of respect and responsibility between clinical and non-clinical staff,” Blanchard urges. She recommends patient access directors address concerns about rudeness by:

  • meeting with clinical leaders about the issue at a later point in time.

“It’s better to have the discussion about proper behavior at such time when patient safety will not be affected,” Blanchard says.

  • encouraging registrars to speak up if they feel they’re being disrespected.

Blanchard encourages registrars to use this format: “I felt (emotion) when (what happened) because (reason).”

For instance, “I felt disrespected when you demanded I update the patient’s information, because you yelled across the room and other patients and staff members could hear everything you said.” Or: “I felt confused when you told me to go to lunch right away, because another employee came in earlier than I did and had not gone to lunch yet.”

“This allows the employee to calmly convey what they felt, what triggered the reaction, and why, without accusing the other employee of any wrongdoing,” Blanchard explains.

  • creating a workflow for handling concerns in a private and timely fashion.

Blanchard responds to concerns within 24 hours to show she received the complaint. She provides a date as to when the employee can expect to hear back. “I usually offer follow-up within a week of the initial communication, regardless of whether there has been a resolution,” Blanchard says.

  • providing follow-up to the employee who brought up the concern, even if the cause for concern proves to be unfounded.

This shows the patient access employee that management takes time to investigate things that are important to the staff.

“By being diligent in providing two-way feedback, behaviors such as gossiping, complaining, and questioning leadership are greatly reduced,” Blanchard says.