How practicing good interpersonal skills aids patient outcomes

By | 2021-05-07T17:28:29-04:00 November 21st, 2016|Tags: , |1 Comment

Nancy Brent, RN

In today’s world, we are much more aware of instances of bullying, harassment, intimidation and threats, and there’s no doubt that good interpersonal skills in all healthcare settings can mitigate those issues and aid surgical patient outcomes.

Whether lateral and horizontal violence, incivility, nurse-to-nurse or physician-to-nurse bullying, such conduct is unacceptable in all areas of nursing and nursing practice, including perioperative practice. 

Perioperative nursing involves many roles, including circulating nurses, nurses who provide direct patient care and monitoring in the postanesthesia area, and RN first assistants. In addition to the perioperative nursing staff, other staff also are present, including the surgeon and his team, and the nurse anesthetist or the anesthesiologist.

Patient outcomes

Because the very nature of perioperative nursing is complex and demanding, misconduct resulting from poor interpersonal relationships and poor communication skills can result in adverse outcomes for the surgical patient. Continuity of care is essential and poor communication or poor interpersonal relationships can clearly add to such adverse outcomes.

In 2015, The Association of periOperative Registered Nurses, published its position statement on a healthy perioperative practice environment, in order to encourage safe patient care practices, promote optimal patient outcomes and foster a desirable workplace.

The position statement lists collaborative practice, a communication-rich culture, adequate staffing systems, and expert, credible and visible nursing leadership, among other factors, as contributing to a “healthy perioperative practice environment.”

Unhealthy workspaces and the law

When the perioperative work setting is unhealthy, another risk that emerges is the risk that federal and/or state laws that protect nurse employees may be violated. In one such case (Graham v. Memorial Health University Medical Ctr.,S.D. Ga., 2013), alleged destructive conduct on the part of several OR nurses toward another OR staff member resulted in a lawsuit filed in federal court. The allegations of the nurse plaintiff included, among other allegations, retaliatory discharge, racial discrimination and the presence of a hostile work environment created by her nursing staff colleagues.

It is important to note the nursing staff colleagues were individually named as defendants along with the medical center where they worked.

Responding to the defendants’ motion for summary judgement, the court reviewed the facts in the case. The plaintiff, who is white, alleged she was continually harassed by two African-American nurses on the OR staff. Their conduct included “yelling and screaming at the plaintiff, requesting assistance and then refusing it from [plaintiff], unwarranted warnings and threats, intensive and unnecessary oversight of [plaintiff’s] work and overloading [plaintiff] with work.” The nurse plaintiff also alleged that African-American nursing staff were not subject to similar harassment.

The plaintiff’s attempts to remedy the unhealthy work environment fell on deaf ears, despite complaints to the harassers directly, to her nurse manager and to the human resources department. After these attempts, the plaintiff’s work schedule of covering cross-over shifts was changed to a lower paying day-shift schedule without advising her of this change.

Shortly thereafter, the plaintiff was terminated because of what were described as violations of two OR policies. The lawsuit was subsequently filed.

Although the court dismissed many of the claims made by the plaintiff after carefully analyzing the applicable law, it allowed the claims of disparate treatment and retaliatory discharge against the medical center and two others to proceed to trial. The two people who remained as defendants included the plaintiff’s nurse manager and the perioperative services director.

The final result of this particular case is yet to be determined. Even so, it illustrates the distressing manner in which the plaintiff allegedly was treated by her peers, her nurse manager and the administration, whether or not their conduct violated federal law.

Guidance from the case is fairly clear. Behaving in a manner that is not consistent with a healthy workplace can result in discord, disorganization and a disrespect for fellow nursing staff. It also can result in the utilization of the judicial process, which is costly, emotionally draining and may not always result in justice for the alleged victim of an unhealthy workplace.

It’s better to avoid such discord, disorganization and disrespect for fellow nursing staff. This involves being respectful and honest in your interpersonal relationships with fellow workers.

Disagreements, a dislike of another colleague, or having a bad day that is taken out on a fellow nurse does occur. However, attempting to resolve such situations amicably, and in a humane way, is essential. A healthy work environment and better patient care outcomes are sure to ensue.





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About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

One Comment

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    Cathy Spisak, BSN, RN, CNOR January 8, 2017 at 11:26 pm - Reply

    This issue is very current within my facility and has fallen on deaf ears also. The negative work environment from the manager and the chain of command up don’t listen. I work in a union based environment in which management is not part of. Therefore, the rules for them are different. Favoritism is a big issue with the manager and the few staff that are “liked”. I am the only original RN under this manager. She has lost over 25 staff members because of her dictatorship, unprofessional behavior, either by forced retirement or new positions. She was walked out by the police for violence in the workplace, given a 8 week paid “vacation” and returned to be promoted from her assistant RN manager position to the current manager in the OR. I am the only one that is left and I have been blacklisted by her to the point of not being able to procure a different position within the hospital. Of course, I can’t “prove this”, but there are positions, her included, that I was qualified for and never even interviewed. I love what I do, but don’t like where I work.

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