Physicians' Bad Behavior Affects Nurse Retention
Library: MED
Description: The quality of nurses' daily interactions with physicians has a major impact on nurses' job satisfaction, according to a new VHA Inc. study. (Am. J. of Nursing, Jun-2002)

EMBARGO DATE: June 6, 2002

Lisa O'Steen
VHA Inc.

Amy Losak, Makovsky and Company for American Journal of Nursing

Article in American Journal of Nursing Pinpoints Sources of Conflict

New York City and Irving, Texas, June 6, 2002 - The quality of nurses' daily interactions with physicians has a major impact on nurses' job satisfaction, according to a new VHA Inc. study published in the June issue of the American Journal of Nursing. The study, "Nurse-Physician Relationships: Impact on Nurse Satisfaction and Retention," was conducted by physicians and nurses at VHA, a national health care alliance that represents 26 percent of the nation's community hospitals. The study finds that disruptive physician behavior, as well as an institution's response to it, is a contributing factor in nurses' morale and their decision to leave their positions. It may have a corresponding influence on patient outcomes and health care costs as well.

"We can't afford to disrespect nurses," said Alan H. Rosenstein, M.D., MBA, vice president and medical director of VHA West Coast in Pleasanton, Calif. "The problem of disruptive behavior is drawing the attention of hospital executives because of the effect it's having on the nurse population." According to the study, 30 percent of nurses knew at least one nurse who resigned because of physician behavior. "If physician behavior is contributing to the nursing shortage, that's bad, because we know the nursing shortage is linked with poorer patient care."

For the survey, "disruptive physician behavior" meant "any inappropriate behavior, confrontation or conflict, including verbal abuse to physical and sexual harassment." The study was built from 1,200 responses from nurses, physicians and health care executives at VHA member hospitals. Overall, 92 percent of respondents said they had witnessed disruptive physician behavior, yet there were significant differences between physicians' and nurses' perceptions on all questions having to do with the results of such behavior and the value and importance of nurse-physician relationships on the morale of nurses.

All respondents saw a direct link between disruptive physician behavior and nurse satisfaction and retention. "It was interesting to note, however, that nurses, doctors and hospital executives differed in their beliefs about responsibility, barriers to progress and potential solutions to this concern," said Dr. Rosenstein.

"VHA and Dr. Rosenstein are courageous for disseminating these findings," said Diana Mason, RN, Ph.D., the editor-in-chief of the American Journal of Nursing. "It is encouraging that some institutions across the country are taking steps to forge a climate and a culture of mutual respect and collaboration, including codes of conduct and programs to build workplaces of choice for nurses."

"Even so," added Dr. Mason, "disruptive physician behavior, with its negative consequences for both nurses and their patients, continues to be an ingrained problem and needs to be creatively and decisively addressed. It is not just a matter of nurses feeling good about where they work - research has shown that nurse-physician communication is one of the strongest predictors of patient outcomes."

About VHA Inc.

Built on the premise there is strength in numbers, VHA Inc. is a nationwide network of 2,200 leading community-owned health care organizations and their affiliated physicians. Based in Irving, Texas, with 18 local offices across the U.S., VHA comprises 26 percent of the nation's community hospitals, including many of the nations largest and most respected institutions. VHA offers member organizations access to products and services that will help them improve financial and clinical performance and achieve market success. As a cooperative, VHA distributes income annually to members based on their participation. In January 2002, for the third year in a row, VHA was named one of the "100 Best Companies to Work For" by Fortune. For more information on VHA, go to
Founded in 1900, the award-winning American Journal of Nursing is the official publication of the American Nurses Association and the largest and oldest circulating nursing journal in the world. It is published by Lippincott Williams & Wilkins, a unit of Wolters Kluwer International Health & Science (WKIHS), which is a group of leading publishing companies offering specialized publications and software in medicine, nursing, pharmacy, science, and related areas. WKIHS also includes Ovid Technologies, Facts and Comparisons, Adis International, and Kluwer Academic Publishing.

Note to Editors: Dr. Rosenstein, other VHA physicians and nurses, and Diana Mason of the AJN are available for interviews.