We've all been in a situation where a comment is made in front of a resident or family member that undermines another healthcare professional. Perhaps the comment is made inadvertently, a slip of the tongue, or perhaps the intention is meant as a quasi-apology ("We're so sorry the bedrails weren't up, this is Nurse Sally's first week here"). Many human beings get an ego-boost from other people's short-comings. Regardless of the reasoning behind questioning some one's judgement publicly, it undermines the professionalism of an organization and creates a feeling of unease for the resident and family member.
Tennenhouse and Kasher list four basic rules to prevent criticism of the healthcare team in the resident's presence:
- Avoid Conveying a Negative Opinion About Another Healthcare Professional to the Resident: Never convey negative feelings about technique or competence of an associate in front of the resident or family member. Avoid making comments that imply an associate is lacking in experience or qualifications. In direct-care teaching situations avoid negative outcomes by assisting directly if necessary, and always wait until you are in a private space away from the resident to highlight areas of concern.
- Do not make unsolicited suggestions to another member of the team in front of the resident or family member: Unless in emergency situations, avoid suggestions for further treatment that may leave the resident wondering why they were not considered in the first place. Questions such as "Shouldn't this resident's bed be at a 45 degree elevation?" are better asked outside of the resident's hearing.
- Never assume that an associate has made a mistake based only on statements made by the resident or family. Often when someone comes to us with a concern about a specific associate, we are quick to answer "That is against our policy! I will speak with her supervisor and make sure this does not happen again." While it is important to let our residents know that we take followup seriously, it is better to let them know that you will " Check into the matter and let you know what I find out."
- Never criticize another healthcare organization for policies or problems encountered during care. As professionals we are often quick to identify issues with other organizations. When those issues affect our own facility, it is easier to share in the frustration with a resident than to address the issue on a professional level. When one of your long term residents spends two weeks in an acute care setting and returns with a new pressure area, resist the temptation to make comments to the family and physician such as "Everyone that goes to XYZ Hospital comes back a mess." Definitely address the issue with the proper hospital professionals, but act as a part of the Healthcare Community rather than a competitor eager to slander your competition.
These four rules seem like common sense but can sometimes, in a moment of frustration, be difficult to put into practice. To the resident or family member, undermining comments and moments of unprofessionalism will stick in their minds far longer than positive outcomes. Don't leave your residents with a lack of confidence in you, your fellow associates, or your organization.