Do rude parents mean worse care for babies?

(Reuters Health) - The stress of having a sick baby in the hospital can be enough to make even the nicest parent take some of their fears and frustrations out on the doctors and nurses.

But a new study suggests infants may receive better care if their parents take a deep breath and try harder to be nice. That’s because rudeness by parents was linked to worse performances by medical teams that care for babies in the neonatal intensive care unit (NICU), researchers report in Pediatrics.

Lots of previous research has shown that exposure to even mildly rude behavior can cause individuals to perform poorly on cognitive tasks, become less creative and flexible, and act less social and helpful, said lead study author Dr. Arieh Riskin of the University of Tel Aviv in Israel.

“However, this current study is the first to demonstrate – what we all feel and know from our experience in our daily practice – that exposure to rudeness inflicted on medical teams by patients or families of patients significantly harm medical teams’ performance,” Riskin said by email.

“Rudeness had adverse consequences not only on diagnostic and intervention parameters of medical care, but also on team processes – such as information and workload sharing, helping and communication – that are central to patient care,” Riskin added.

For the study, 39 NICU medical teams participated in training workshops including simulations of care for critically ill newborns and preemies.

The teams were told they were participating in a training exercise in debriefing techniques to discuss team performance. They didn’t know the true purpose of the experiment was to test their response to rudeness.

In each workshop, two teams were randomly assigned to experience one of two scenarios, played by actors: a mother making rude comments unrelated to the clinicians’ performance or a mother making neutral inoffensive remarks.

Another two teams were randomly assigned to first participate in computer-game exercises or writing-and-discussion exercises designed to help them deal with rudeness, before being exposed to the rudeness scenario.

Researchers tested scenarios that are common in the NICU like treating babies with severe jaundice, shock tied to life-threatening bleeding, or potentially fatal breathing difficulties or reduced oxygen flow to the brain.

Judges observing the workshops rated how well teams performed tasks like diagnosing problems, creating treatment plans, sharing information, helping one another with patients, and communication.

Teams exposed to rude mothers did worse at diagnosis, treatment planning, information and workload sharing than when they experienced mothers making neutral remarks, the study found.

Teams that did computer exercises designed to help them understand and cope with rudeness before they went through the scenario with the rude mother did better than teams that did the discussion-based exercises.

Beyond its small size, limitations of the study include the possibility that clinicians might perform differently in real-life situations than in workshops.

Even so, the findings offer fresh evidence of the ways rudeness can have an impact beyond just the person it’s aimed at, said Dr. Sandy Hershcovis, a business researcher at the University of Calgary in Canada who wasn’t involved in the study.

“As in all contexts, rude behavior is an ineffective approach to getting the best service,” Hershcovis added by email.

The findings also highlight the need for doctors, nurses and other clinicians to be mindful of how they communicate and learn how to be respectful and deal with difficult patients, said Christine Porath, a researcher at Georgetown University’s McDonough School of Business in Washington, D.C.

Parents, too, should mind their manners even when they’re frustrated and upset.

“People – including your child’s doctors, nurses and other clinicians – can’t focus or process information as well when they are even around rudeness,” Porath, who wasn’t involved in the study, said by email.

“Your best shot at great care is to convey your message respectfully,” Porath added. “Express your concern and wishes passionately and compassionately; don’t insult, belittle, or demean them.”

SOURCE: Pediatrics, online January 10, 2017.