More than half say shortcuts have led to near misses or harm more than a third say incompetence has led to near misses or harm and more than half say disrespect has prevented them from getting others to listen to or respect their professional opinion. 3 This study found that more than four out of five nurses have concerns about dangerous shortcuts, incompetence, or disrespect.
VitalSmarts conducted a further study in 2010 “The Silent Treatment” and showed that a culture of silence in organizations leads to communication breakdowns that harm patients. 2 These conversations correlated strongly with medical errors, patient safety, quality of care, staff commitment, employee satisfaction, discretionary effort, and turnover. For example, the Silence Kills Study that used focus groups, interviews, workplace observations, and survey data from more than 1,700 nurses, physicians, clinical staff, and administrators identified a range of categories of conversations that are especially difficult and especially essential for people in health care. Avoiding difficult conversations in the clinical setting, however, can result in serious negative consequences. 1 While many difficult conversations in health care are between doctors and their patients, other difficult conversations include those that take place among health care workers, including students, about performance and climate in the workplace, such as when colleagues make mistakes or display disrespectful behavior. Clinical supervisors face an array of challenges when the need for “difficult” conversations arises, including the need to manage conflict and relationships.
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