The study, “The Impact of Rudeness on Medical Team Performance: A Randomized Trial,” which was published in the September issue of Pediatrics, shows that a rude comment from a third-party doctor decreased performance among doctors and nurses by more than 50 percent in an exercise involving a hypothetical life-or-death situation.

“We found that rudeness damages your ability to think, manage information, and make decisions,” said Amir Erez, an author on the study and a Huber Hurst professor of management at the University of Florida. “You can be highly motivated to work, but if rudeness damages your cognitive system then you can’t function appropriately in a complex situation. And that hurts patients.”

Rudeness has dramatic negative effects including struggling to cooperate, communicate, and do their jobs effectively, all of which caused their performance to plummet: They misdiagnosed the illness; they forgot instructions; they didn’t ventilate the patient well; they didn’t resuscitate well; they didn’t ask for help when they needed it; doctors asked for the wrong medication, and nurses mixed the wrong medication. Overall, the rude comments appeared to cause a 52 percent difference in how well teams diagnosed the disease, and a 43 percent difference in how well they treated it.  In the real world, as Erez pointed out, these performance discrepancies could have made the difference between the tiny patient living and dying.

When disruptive behaviors cause these mental resources to fail, medical teams are putting patients at risk because they are physically unable to focus past the rude comment. These doctors and nurses are making mistakes, and then they can’t recognize or adapt to those mistakes. And as a result, the study authors suggest, rudeness could contribute to many of the preventable deaths caused by medical error in U.S. hospitals each year, which, according to a Journal of Patient Safety study, is between 210,000 and 440,000 people.

Erez and Porath both say that hospitals need to take a more aggressive stance against rude behaviors among medical staff, and doctors need to consider the long-term effects of acting rudely toward one another. Because, as it turns out, these everyday slights could be catastrophic for patients.

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