A good policy will explicitly convey expectations, establish the correct reporting lines, and demonstrate the vision of healthy, collaborative relationships as set forth by senior leadership. Expectations should not only state the behaviors that are disruptive, but also the behaviors that are desirable. Most importantly, a code of conduct must be universal across the organization.
An effective code or standard will contain a list of desirable behaviors such as:
- Identify and report quality concerns
- Give clear instructions for patient care
- Respectfully discuss concerns in a private setting
- Cooperate and participate in quality improvement activities
The code of conduct must explicitly define unprofessional behaviors such as:
- Demeaning behavior to staff or colleagues
- Inappropriate displays of anger or berating individuals
- Profane or disrespectful language or comments
- Condescending tone of voice in discussions or when answering questions
In other words, any behavior that makes you feel less than the competent, caring professional that you are and that inhibits your ability to speak the truth at any time is a disruptive behavior.
The code must clearly spell out behaviors that are considered disruptive and that will not be tolerated, such as:
- Criticizing staff or care in front of patients or families
- Throwing instruments, charts, or equipment
- Sexual comments or innuendos
Different rules for different roles will never produce the desired outcomes. Many organizations continue to have separate expectations, education, and interventions depending on whether the individual is a physician or a nurse, a member of the medical staff or a hospital employee. Even if someone is not an employee of a hospital, if he or she has the privilege of walking through the doors, then the same rules apply.
Kathy Bartholomew, RN, MN