Intimidating and disruptive behaviors

Instead, he kicks the vice principal in a frenzied effort to escape.

The staff calls 911, and James ends up in the Emergency Room.

In 2008 a sentinel event alert was issued by the Joint Commission (TJC) to warn organizations of the safety risks posed by disruptive behaviors and to increase awareness of this risk for both individual workers and healthcare organizations.

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In this article the author reviews the causes and consequences of disruptive behavior for both patients and healthcare workers, discusses initiatives for addressing disruptive behaviors, and provides specific steps for nurse managers and staff nurses to combat disruptive behaviors. The good news is that these disruptive behaviors among healthcare workers have recently come under increased scrutiny.

The American Medical Association (AMA) (2002) has stated: “Personal conduct, whether verbal or physical, that affects or that potentially may affect patient care negatively constitutes disruptive behaviors” (para. The American Association of Critical Care Nurses (AACN) (2005) has noted that collaboration among healthcare providers, which is paramount to establishing and sustaining a healthy work environment, is lost in the presence of disruptive behaviors.

Now all workers are charged with understanding and addressing this necessary culture change within healthcare.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has declared a zero-tolerance policy on threatening, intimidating or otherwise disruptive behavior.

, a guidebook issued in 2013 by the ACS Board of Governors’ Committee on Physician Competency and Health.

The complete document is posted in the General Surgery community’s library in ACS Communities (login required).

Accordingly, hospitals will need to get tough on offenders or risk losing their JCAHO accreditation.

Physicians can expect closer review of conduct that may have been tolerated in the past.

The Joint Commission now charges healthcare organizations seeking accreditation to address these behaviors. Although disruptive behaviors have long been a concern among healthcare workers, they have often gone unchecked, or even worse, accepted as part of the system.

All members of the healthcare team need to be knowledgeable about disruptive behaviors. By not addressing these behaviors, organizations silently supported and reinforced them.

To the uninitiated, James looks like a boy with serious anger issues. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria. “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Dr.