How bad-mouthing teammates can destroy patient trust
I had an opportunity recently to accompany a family member to an appointment for major surgery. I always learn a lot at these visits and am always attuned to what goes well and areas of opportunity for improvement. I definitely learned a lot at this most recent visit!
The pre-op nurse was incredibly friendly, which is great. In hindsight, though, I realized that much of her chatter was self-promotional. What wasn’t self-promotional was aimed at tearing down her teammates.
As she was preparing to leave, she turned to my brother and suggested that he run his hand under warm water before the next nurse arrived. “She’ll be starting your IV,” she explained, “and she’s not very good at it. I’m just saying, if your arm is warm, she’ll have a better chance.”
I watched his face as he heard this. His mouth dropped open. I could practically hear his thoughts: “You’re sending in someone who doesn’t have good experience with IVs?” “And she’s coming at me with a needle?”
Definitely not a parting comment designed to instill confidence.
When Bad-Mouthing Becomes Reality
Unfortunately, these types of comments can be self-fulfilling prophecies. In this case, the pre-op nurse’s prediction proved accurate. The next nurse made three failed attempts to start an IV, leaving my brother with three pressure bandages on his non-dominant arm and some doubts about the competency of the staff.
Then, the anesthesiologist arrived for his pre-op review.
When I asked if he would be starting the IV, he glanced at the three bandages, then looked at me and said, “I would get into a lot of trouble with the nurses. It doesn’t look good if I step in and start an IV when I haven’t been asked. I’m sure you understand.”
He left. Another nurse came in and made two more failed attempts. Five total needle sticks before they finally called in the anesthesiologist who was successful on his first try.
The Politics of Patient Care
Later, when I shared this story with my husband, he asked a great question: “What would you have advised in that situation?”
It’s definitely a tricky situation. The anesthesiologist was caught between the dynamics and culture of his organization and team members and patient needs. He could clearly see the nurse’s attempts had failed from the three pressure bandages.
But he chose not to step in.
My advice: He could have simply asked: “Are you requesting that I start the IV?” We would have said “yes” immediately. It then would become a matter of accommodating a patient request rather than stepping on toes.
Sometimes the solution is as simple as asking permission instead of assuming boundaries.
There’s more to unpack here, though.
The Five-Second Confidence Killer
The nurse who made those initial remarks had no business bad-mouthing her teammates. If you want to destroy your patient’s confidence in their care team in five seconds flat, do exactly what she did: talk badly about your teammates, particularly those who will be providing direct care.
How often does this happen in your organization? More importantly, what are you doing about it?
Building Skills, Not Barriers
Consider this. What if, instead of undermining colleagues, what can staff do to help build those skills? How can we create systems that support skill development rather than perpetuate deficiencies?
Here are some alternatives to consider:
- Offer to mentor colleagues who need skill development.
- Create practice opportunities in low-pressure environments.
- Establish protocols for when to call in additional expertise.
- Train staff on appropriate ways to prepare patients for procedures.
As you think about your own organization, ask yourself:
- Are we training people to “manage up” their colleagues appropriately?
- How do we handle skill gaps—with development or avoidance?
- What messages are our team members sending to patients about their confidence in each other?
- Do our staff feel comfortable asking for help when they need it?
Patient confidence in their care team shouldn’t be a casualty of workplace dynamics or professional insecurities. When we undermine each other, we ultimately undermine the very people we’re there to serve.
This should never happen in healthcare. Our patients deserve better, and so do our colleagues.
Tags: changing culture, company culture, culture catalyst, Culture Improvement, culture transformation, healthcare leadership, Organizational Culture
