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In not one of the references cited in TJC Sentinel Alert is there any objective evidence or study directly linking "disruptive" behavior to any documented adverse patient event.
Nurses in particular are very well aware who the "disruptive" physicians are, and I dare say many nurses will make sure there is always a "Plan B" in effect to ensure patient safety when one of those physicians is on call after hours.While violence is easy to identify and should result in immediate termination, intimidating or threatening conduct is often less clear, poorly handled and goes unreported due to fears of worsening the situation or because of an established workplace hierarchy.It is important employers are aware repeated intimidating and threatening behaviour can constitute workplace bullying and harassment.The link between so-called "disruptive" physician behavior and adverse patient outcomes is fossilized dogma and has in fact, spawned a whole industry of psychological testing and behavior-changing programs that health care corporations have embraced as it allows them to dis-employ physicians considered lacking in corporate docility.There are a number of obligations on employers to provide a safe workplace free from behaviour that is classified as violent, threatening or intimidating.
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In my own case, I've learned to document potentially dangerous interactions with said physicians with great detail and care.