Disruptive Behavior: The Arterial Stick

Ron Wyatt, MD, MHA, Staff Physician, Huntsville Hospital, AL; George W. Merck Fellow, Institute for Healthcare Improvement
Learning Objectives: At the end of this activity, you will be able to:
  • Give an example of a disruptive behavior within a health care setting.
  • Describe how disruptive behavior can harm teamwork and communication within a health care setting.
  • Explain how disruptive behavior can lead to harm for patients.

Description: A resident tells a medical student to do a blood gas on a patient. The student says, “I don’t know how.” The resident is annoyed — and he says something that he’ll regret for years. Physician Ron Wyatt reflects on what he said (and wishes he had said) to the student.

Discussion Questions:
  1. Why do you think Dr. Wyatt ordered the medical student to perform 12 blood gas procedures?
  2. Imagine you are the student who was just ordered to perform the blood gases. How would you have reacted to the order?
  3.  What do you think was the dynamic of Dr. Wyatt’s relationship to the medical student in subsequent days?
  4. Would you want to have been a patient in Dr. Wyatt’s care when he was a resident? Why or why not? How about now?
  5. Have you ever seen an example of a disruptive behavior in a health care setting? What happened? How did you react?
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