1. Hader, Richard RN, CNA, CHE, CPHQ, PhD, Editor-in-Chief

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The results are in!! Research demonstrates that poor relationships among healthcare providers can significantly impact patient care outcomes. Although we've surmised this finding for decades, new evidence proves that poor communication between physicians and nurses or amongst nurses themselves can prove deadly for patients. (See page 18 of this issue.)

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We must infuse into our healthcare culture zero tolerance for actions that threaten, intimidate, or harass. Policies and procedures that reflect an organizational commitment to effective and collaborative relationships are essential first steps in the process. Human resource and medical staff polices must contain behavioral standards to which all employees adhere. Communicate and repeatedly reinforce these standards to your staff to ensure ongoing compliance.


Investigate allegations regarding inappropriate behavior to determine their validity. If a breach in behavioral standards has occurred, take immediate action. For minor disruptions, consider referring staff members to an employee assistance program or a professional counselor. Don't rule out termination of employment or practice privileges for behavior that's more serious and/or endangers patient care.


Implement education, team-building, and effective reward and recognition programs, and set expectations to minimize or prevent inappropriate actions in the work setting. Since most incidents of disruptive behavior stem from interpersonal conflict, consider making available educational programs to help staff develop and effectively employ positive communication techniques. Good communication can reduce the risk of problems when tensions run high.


As a result of the nursing shortage, many of us must precept or mentor new nurses. Many nurses object to this increased responsibility and unintentionally retaliate against new staff members. We need to develop and implement preceptor programs that require additional training for preceptors and reward and recognize them for their efforts.


Nurses and physicians must also work as a team. Organize patient rounds so that the physician and nurse can collaborate on the patient's treatment plan, facilitate an enhanced relationship between colleagues, promote open communication, and improve clinical outcomes.


Nurses should recognize physician colleagues who best exemplify professional teamwork. At my institution, we hold a celebration during Nurses Week to acknowledge physicians for their efforts in collaborating with the staff. This recognition fosters positive interdisciplinary relationships that promote a culture of respect.


A leader must set staff expectations by providing appropriate resources and modeling affirmative behavior. Take building and sustaining positive relationships seriously-a patient's life might depend on it.