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Your Attitude Is Everything in Getting Quality Care for Your Baby

Photograph by Twenty20

Snapping at medical staff may cause bigger problems than patients realize, especially when it comes to the quality of care their children receive. Researchers from Tel Aviv University found that rude parents in the neonatal intensive care unit create a wider margin for medical error and misdiagnosis. Insensitive comments also lower effective communication between medical team members.

The results, which should shock literally no one, prove that treating people poorly can have seriously negative consequences, especially for the most critically ill children.

The study, led by Dr. Arieh Riskin, NICU director at B'nai Zion Medical Center in Haifa, and co-authored by Dr. Peter Bamberger, the associate dean for research at Coller School of Management at Tel Aviv University, used NICU crisis simulations with actor parents and plastic babies. (The fact that real NICU babies weren’t harmed in this study should give us all a sigh of relief—sort of. )

Although the research didn’t impact the care actual babies in the NICU received, real babies have likely been victims of lower-quality care because of their parents’ bad attitudes.

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While the staff participating in the study did not know what they were being evaluated for, they were instructed to provide the same type of care as if they were in a true emergency situation, while also dealing with family members—something all NICU medical providers deal with on a daily basis. What the researchers found was a measurable difference in how the nurses and doctors cared for the plastic babies, based on how the parents interacted with them.

Even more shocking: the effect lasted the entire day and didn’t just impact the child of the unkind parent.

“We weren’t looking at angry parents, we were looking at rude parents,” Dr. Bamberger told the New York Times. “It wasn’t anything horrible, they [parents] weren’t going ballistic, they weren’t violent. They just said things that weren’t so pleasant for doctors to hear.”

One actor-mom at the Israeli hospital where the study was performed was told to say, “I knew we should have gone to a better hospital where they don’t practice third-world medicine” during a simulated crisis event with her child. What followed was a decline in the medical staff’s teamwork, as well as their individual care for the child. Even more shocking: the effect lasted the entire day and didn’t just impact the child of the unkind parent.

This result was markedly different from the level of care provided by staff who interacted with more neutral actor-parents, who may have expressed concern or worry but weren’t rude.

Interestingly, the team dynamic between the medical staff also suffered. "All the collaborative mechanisms and things that make a team a team, rather than four individuals working separately, were damaged by the exposure to rudeness," Dr. Riskin said.

Some outside the medical community may think a study using simulated babies and faux-crisis situations is easy to discount, but they shouldn't. Simulation study and training has been used for years in professional fields like aviation and, more recently, in the medical community, because it is believed to save lives and lessen the likelihood of professional error.

It seems like these studies have reinforced one important childhood lesson—the Golden Rule: “Treat others how you wish to be treated.”

Although not "real life," simulated experiments give researchers valuable data on how staff respond to certain stimuli and, in this case, the evidence that a parent’s bad attitude affects the medical care of a child is frighteningly overwhelming.

Parents aren’t the only ones who can negatively impact the medical care of a patient, however. A previous simulation study led by Dr. Riskin showed that even when a doctor is rude to their staff, it can hamper the quality of care provided to a patient. His findings revealed nearly 12 percent of the diagnostic and procedural mistakes performed by the staff could directly be attributed to rudeness alone.

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The medical team that participated in the study showed that after a negative comment from a doctor, their ability to ventilate and rescuscitate a baby during a simulated crisis was noticably impacted. The findings showed that rudeness had a greater impact than even sleep deprivation on the job.

With neonatal death in the U.S. estimated at four in every 1,000 births, the handling of our children in an intensive care setting is of utmost importance. Why would any of us want to hinder the outcome for a child in such a fragile state?

It seems like these studies have reinforced one important childhood lesson—the Golden Rule: “Treat others how you wish to be treated.”

Or, perhaps more applicably, “Treat your children’s doctors and nurses as if your child's life depended on it.”

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