Treating patients with respect and dignity is essential to the medical profession. This is true even when the patient lies unconscious in the operating room. It seems unnecessary to stress the importance of creating a secure and comfortable environment to ease the patient’s anxiety and stress and develop confidence. Respect is also crucial to promote successful outcomes. By prioritizing these values, medical professionals can ensure that patients feel valued and cared for, even in the most vulnerable situations.
Every medical care step needs respect for the patient and their welfare. This can be seen in an operating room’s spoken and unspoken expectations. Operating room culture emphasizes precision, efficiency, and teamwork, with each team member playing a crucial role in ensuring the procedure’s success. Effective communication is critical; everyone must collaborate seamlessly to provide patients with the best care. Every precaution is taken to keep the environment clean and safe. Overall, the operating room culture demands the highest professionalism and dedication from everyone involved.
I remember being a second-year physical medicine and rehabilitation resident at the VA medical center, where I witnessed the negative impact of an operating room’s dysfunctional culture. During one of my first orthopedic surgeries as a resident, the leading surgeon encountered a problem with the drill used for a total hip replacement. Although the drill was still operational, it malfunctioned and caused frustration for the attending physician. He shared his concern with the chief operating room nurse, who suggested writing a work order but added that the drill could not be replaced if it still was functioning.
The attending physician was increasingly frustrated as this was not the first time a surgical tool malfunctioned. Despite receiving the same response repeatedly, he resorted to hitting the drill with a metal hammer. The surgeon was yelling and using profanity, and neglecting the patient’s welfare. He derisively asserted that the drill was unusable now and demanded a replacement. The nurse was taken aback and irate. She warned him that she would submit a formal grievance to the Chief of Staff. The behavior mentioned above may have resulted in an extension of the elective surgery, ultimately leading to potential complications.
This anecdote is in no way typical. However, the situation exemplifies the loss in patient perspective that could lead to unsafe environments for patients and health care professionals. A lack of communication, respect, and accountability can result in mistakes and patient harm. Hospitals and surgical teams must strive for a positive and functional culture in the operating room, with the ultimate focus on the safety and well-being of patients. This requires a cohesive and effective team effort.
During my extensive training to become an interventional physiatrist, I observed disrespectful attitudes and conduct while performing outpatient procedures at the surgical center. I witnessed one of the medical professionals present during the procedure behaving in a derogatory manner toward patients. This included making fun of tattooed patients or commenting on their appearance. Often criticizing poor hygiene and foul odors. This behavior can upset patients and worsen their health care system experience. All professionals need to treat their patients with respect and dignity, regardless of their personal beliefs. It was disappointing and concerning to see that some individuals needed to uphold the crucial standards of maintaining a professional and respectful demeanor, despite the significance of doing so. As medical professionals, we must prioritize the well-being and comfort of our patients, and disrespectful behavior has no place in our field.
In recent years, many doctors have expressed concerns that disrespectful behavior in medical settings may threaten patient safety. Some of this rise has been attributed to the COVID-19 pandemic. Reports of pressures from administrative bodies who often have conflicting interests have been discussed among doctors for decades. If this is true, it’s profoundly concerning news. There’s no end to the tug-of-war between financially motivated health care systems, financially motivated insurance companies, and patient welfare, which often sees doctors scrutinized and berated from three directions simultaneously.
The need for professionalism and team cohesiveness applies when speaking to patients and when the patient is unaware of the surroundings. The manner of behavior around a sedated patient matters, though they may not know how they are treated. The commentaries, atmosphere, and music can impact the patient’s well-being. I will admit that there is room to relax and seek relief from stressful situations. But when that informality comes at the expense of the patient, particularly in a disrespectful manner, it does something long-term to the medical provider that carries even to other patients.
The experiences I have shared are a few examples of the importance of the relationship between doctor and patient, even when that patient is sedated. The consistency of attitude under all circumstances and in all medical environments ensures the resiliency and genuineness of character that our patients can feel. This is of great value and worth the effort to develop, maintain, and protect.
The topic of doctors and nurses engaging in seemingly disrespectful behavior when they think patients are not looking has been raised frequently. The “black humor” of the medical profession, which occurs when doctors and nurses joke about devastating diseases to cope with the trauma they witness daily, has become infamous. Some have pointed out that this coping mechanism is necessary for people whose full-time job deals with the worst-case scenarios that most people only have to witness a few times.
But the cases I cite are examples of the exquisite care we must take as health care workers not to allow our coping mechanisms to affect our patients. We must treat our patients how we want our loved ones to be treated in life and death.
Francisco M. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine and can be reached at Florida Spine Institute and Wellness.