The impact of disruptive behaviour in the healthcare setting may have far-reaching consequences and hence needs attention and action to rectify it.

While most doctors adhere to professionalism a small percentage of doctors are known to indulge in unruly or disruptive beahviour. A surgeon berating the staff in the operating room or a senior nurse bullying a junior colleague are typical examples of disruptive behaviour, which not only includes physical aggression but also amounts to verbal abuse, with disdainful, impolite, humiliating comments. In a healthcare setting, such behaviours hinder the development of a safe and effective work environment, cause medical errors and may have a direct impact on the delivery of good quality patient care.

How does disruptive behaviour affect the healthcare organization?

Disruptive behaviour of a physician can jeopardise the future of the practice.Other implications of such behaviour are stated below.

1. Absenteeism from work: When disruptive behaviours at the workplace become unbearable, victims (other healthcare providers, nurses or allied health professionals) usually consider absenteeism as an option of self-protection. When the victims are absent, the organization has to bear the cost for their sick time, reimbursement of the replacements etc.

2. High turnover of staff: When healthcare professionals are subjected to disruptive behaviours frequently, they may resort to leave their present jobs, and look for new organizations for practice. Some might even consider changing their profession. According to a study done by Rosenstein and O’Daniel, nurses report that disruptive behaviour is a significant factor for job satisfaction and 31% of the nurse knew at least one nurse who had left the organization due to this. When such turnovers increase, organisations end up taking in inexperienced healthcare professionals and need to shed more money for their training and orientation.

3. Decreased commitment to the organisation: When the organisation fails to take actions against such behaviours, the healthcare professionals lose confidence in their organisation. This results in the loss of dedication and commitment towards the organisation.

4. Increased legal liability: More often than not, unruly beahviour, if unchecked, is likely to lead to unpleasant incidences that may escalate the legal liability.

How does disruptive behaviour affect patients care?

1. Patients hesitate to communicate with the healthcare team: The victims of disruptive behaviours tend to communicate less to avoid further mistreatment. This may lead to a decrease in the exchanging of clinical information or delay in providing care. Poor communications have a great impact on patient care, increasing the risk of complications and death.

2. Poor clinical decision-making: The victim, who is a member of the healthcare team, may avoid being actively involved in deciding the treatment plan and may approve of anything that the instigator has ordered. This may negatively influence patient care.

3. Low technical performance: Disruptive behaviours may have a negative effect on the procedural skills, treatment delivery, and this leads to substandard practice.

The Takeaway

In a cordial work environment, patients’ needs are met, and all are benefited. Though the number of healthcare professionals who engage in disruptive behaviours is actually very small, the impact it creates is huge.Bad days are a reality for everyone and measured responses on bad days do not count as disruptive behaviour.But repeated outbursts certainly demand attention. 

It is in the best interest of doctors to tackle stress and ensure a cordial work environment that will, in turn, ensure high standards of patient care delivery.