Abstract
Purpose (limit 100 words) Previous research has demonstrated that social-relational factors are instrumental to employee voice. An essential aspect of this relates to notions of respect or disrespect. Although nurses commonly report experiencing professional disrespect in their interaction with doctors, earlier studies have focused on how the professional status hierarchy and power imbalance between doctors and nurses hinder speaking up without considering the role of professional disrespect. Addressing this gap, we explore how professional disrespect in the doctor-nurse relationship in surgical teams influences the willingness of nurses to voice legitimate concerns about threats to patient safety. Design/methodology/approach (limit 100 words) Fifty-seven (57) semi-structured interviews with nurses drawn from a range of specialities, ranks and surgical teams in three hospitals in a West African Country. In addition, two (2) interviews with senior representatives from the National Registered Nurses and Midwifery Association (NRNMA) of the country were undertaken and analysed thematically with the aid of NVivo 12. Findings (limit 100 words) Disrespect is expressed in doctors’ condescending attitude towards nurses and undervaluing their contribution to care. This leads to the safety concerns raised by nurses being ignored, downplayed, or dismissed, with deleterious consequences for patient safety. Feeling disrespected further motivates nurses to consciously disguise silence amidst speech and engage in punitive silence aimed at making clinical practice difficult for doctors. Originality/value (limit 100 words) We draw attention to the detrimental effect of professional disrespect on patient safety in surgical environments. We contribute to employee voice and silence by showing how professional disrespect affects voice independently of hierarchy and conceptualise the notion of punitive silence.
| Original language | English |
|---|---|
| Journal | Journal of Health Organization and Management |
| Publication status | Accepted/In press - 4 Mar 2024 |
Bibliographical note
Acknowledgment:The authors are grateful to participants for sharing their personal experiences on the topic. We are also grateful to our Anonymous Reviewer and the Guest Editor for their very constructive feedback which significantly improved the paper. The first author (Emmanuel K. Mawuena) is thankful to his PhD supervisors (Dr Jean Kellie and Dr Nicholas Snowden) for their immense contributions to his development as a researcher. Russell Mannion is in part funded by the NIHR Midlands Patient Safety Research Collaboration (PSRC).
Keywords
- Disrespect
- Patient Safety
- Surgery
- Voice and Silence
- Doctor-Nurse