What Has Happened to Respect in Healthcare?

Carolyn Buppert, MSN, JD

Disclosures

January 21, 2016

In This Article

Rewards of Nursing: Where Does Respect Fit In?

When asked, "What is the most rewarding aspect of a nurse's job?" nurses' answers to a Medscape 2015 survey[1] went like this:

  • Relationships with patients: 26%;

  • Being good at what I do: 22%;

  • Proud of being a nurse: 18%; and

  • Respect from peers and team: 9%.

Perhaps respect just isn't the most rewarding aspect of a nurse's job. But another way to interpret this list is that most nurses do not feel respect from peers and the team that they work with. Disrespect in the healthcare workplace is well documented, and in curious contrast to the data on the public's respect for nurses. Various national polls published in 2014 and 2015 placed nurses at fifth on the list of the most prestigious jobs in the United States (Harris poll)[2] and first on the list of most trusted professionals in a Gallup poll.[3]

Workplace incivility is not limited to healthcare settings. The authors of the article "The Price of Incivility" in Harvard Business Review[4] said that in their polls of thousands of workers, 98% reported being on the receiving end of uncivil behavior and 50% experienced incivility at least once a week. Those numbers are in line with what researchers found in the healthcare workplace.

Some organizations have attempted to address the problem of disrespect in the healthcare workplace, but many still act as though it doesn't happen. How prevalent are these feelings of being disrespected? Who is doing the disrespecting? What are the consequences? What can be done about it, on an organizational level and individual-to-individual?

How Prevalent Is the Lack of Respect?

Several national organizations have spent considerable time and effort looking into the problem of disrespect in the healthcare workplace. The former American College of Physician Executives (ACPE; now the American Association for Physician Leadership) conducted a survey[5] of 13,000 doctors and nurses (67% nurses, 33% physicians) in 2009, in which nearly 98% of respondents reported witnessing behavior problems between nurses and doctors in the past year. Such problems were said to happen weekly (by 30% of the respondents), 25% said that these problems happened monthly, and 10% claimed that they happened every day. Degrading comments and insults were reported by 85%, and 73% reported yelling. The most egregious (and criminal) acts were throwing scalpels or squirting the contents of a used syringe in a colleague's face.

The Institute for Safe Medication Practices (ISMP) conducted a national survey[6] of nurses, pharmacists, physicians and other healthcare professionals in 2003 and again in 2013, finding that disrespectful behaviors were not isolated events, nor were they limited to just a few difficult practitioners. Disrespect involves both lateral (peer-to-peer) and intradisciplinary relationships, and affects both sexes equally.

In the 2013 survey, 88% of respondents reported that in the year before the survey, they had encountered condescending language or intonation; 87% encountered impatience with questions; and 79% encountered reluctance or refusal to answer questions or phone calls. Almost one half of the respondents reported more explicit forms of intimidation, such as being subjected to strong verbal abuse (48%), threatening body language, (43%), or physical abuse (4%). A comparison with the 2013 survey[7] (with 4884 respondents) showed that disrespect had not declined from 2003 to 2013.[8]

In 2010, the American Association of Critical Care Nurses (AACN) surveyed 6500 nurses and nurse managers, all members of either AACN or the Association of periOperative Registered Nurses (AORN).[9] In that survey, 85% of respondents said that 10% or more of the people with whom they work are disrespectful, and these behaviors undermine the ability to share concerns or speak up about problems. Yet, only a small percentage of nurses (7% in one report, 16% in another) have confronted disrespectful colleagues.[9,10]

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