When we find ourselves in a difficult clinical situation such as a resuscitation, stress levels are high and tempers can flare for both clinicians and parents—but sadly raising ones voice or being rude in a stressful situation is not the key to helping that child in distress. To prove that point Riskin et al. (10.1542/peds.2016-2305) decided to put 39 NICU teams through simulations of acutely ill neonates during which a team was randomly assigned to hearing rude comments from the infant’s mother unrelated to the teams’ performance or neutral (non-rude) comments. In addition, teams were also given a preventative or post-event therapeutic intervention to use if rudeness from a parent occurred. Team performance was then evaluated by judges blinded to the team exposure using a structured evaluation questionnaire to see if the team performed well with the sick infant.
As you might imagine, rudeness made a difference—but not a good difference in team dynamics. The rudeness affected diagnostic and therapeutic interventions being done in a timely and accurate way as well as in communicating and sharing information as a team. Having a preventative strategy worked but trying to diffuse the rudeness after the episode occurred did not influence the outcome of the child which was more deleterious in the setting of rudeness.
Do you have a strategy to diffuse rudeness when it occurs or prevent it from accelerating to the point where it can affect outcomes? We’d be interested in how you diffuse rudeness from colleagues or from patients by responding to this blog, commenting on our website or sharing a post on our Facebook or Twitter sites.
