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Medical hierarchy can spur problematic patient outcomes

You'd think that hospitals, while being occasionally tense places, would generally be bastions of calmness, right? Wouldn't that logically be the case, given the need for highly trained professionals to routinely act in a manner that best promotes optimal outcomes for ill and injured patients?

The author of a recent book on the role of nurses in medical facilities might say that, while most medical facilities convey a surface-level reality of civility and orderliness conducive to salutary outcomes, what is happening at a deeper level is something altogether different.

That tandem reality is anything but civil and placid, says author Alexandra Robbins. It is, rather, marked by fear and hostility borne out of doctor/nurse inequality that can engender medical error and adverse patient outcomes.

Consider this piece of information that Robbins passes along, courtesy of a medical survey: More than one-quarter of nurses responding to the survey stated that irate doctors had actually thrown objects at them. Nearly 75 percent of respondents told researchers that doctors had insulted or otherwise demeaned them.

That type of behavior has predictable consequences, especially in situations -- such as surgery -- where patients are depending on close and high-quality interaction from their integrated surgical team.

The Joint Commission, which accredits hospitals across the United States, cites a nexus between medical harm and "intimidating and disruptive behaviors." The commission states that many patient injuries can be traced directly to communication glitches among medical professionals.

Robbins posits that long-held notions about doctor superiority and corresponding nurse inferiority have led in many instances to physician bullying and nurses' reluctance to speak up when they have something important to say.

The author states that hierarchy in the medical field needs to be stressed less, with a greater emphasis being placed on teamwork and the important role that every care provider plays.

That relationship "reframing," she says, will promote in obvious ways what everyone agrees is the most important goal of medicine, namely, the best outcome for a patient in every case. Consultation service from Maloney Law is free. Contact us today to get started.

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