Some insist that you cannot control the obnoxious behavior of your doctors and your colleagues. They say that the only thing that you can control is your own reactions to such conduct.

This passive sentiment calls to mind the (slightly amended) biblical passage:

"The rain falls on the Just and the Unjust,
but the Just get wetter,
because the Unjust have just stolen the Just's umbrellas."

Being passive in the face of uncivil manners causes your outpatient facility atmosphere to be psychologically damaging. A mature, strong and appropriate response can alter that rude behavior. Haven't you gotten tired of being meek? Of being taken advantage of by the unjust?

I don't mean for you to be rude, mean or uncivil yourself. I don't want the Jedi Knight in you to go over to the Dark Side. You must learn how to stand your ground, and calmly insist on being treated in a polite fashion. You need to take the time necessary to teach your physicians and coworkers civil behavior.

Why should you bother?
Much of the responsibility for our ongoing nursing shortage, after low wages and erratic schedules, comes from incivility amongst the medical staff. Heated nurse-physician interactions depress nursing morale (Rosenstein, 2002) and contribute to staff shortages and departure from careers in medicine. Meanwhile, civil units have an easier time retaining their staff.

In addition to safeguarding our own welfare, we need to take control over rude behavior in our surgical centers for our patients' sakes as well. As studies in the ICU setting by Shortell (1994) and Knaus (1986) reveal, uncivil behavior amongst staff harms our patients. Patients in uncivil units experienced higher death rates or longer lengths of stay in the hospital.

I do not preach that insistence on respectful conduct will transform your associates' overall behaviors, enhance their personality forever or give them fresh, minty breath. However, "medical people"" are smart. And they are trainable. The pharmaceutical industry demonstrates this daily with their pens and pads of paper, subliminally schooling doctors to write their medications.

You will not be able to affect a life or a persona change, but you should be able to tutor your colleagues to act in a consistently appropriate manner when around you. You must simply begin to stand firm and be resolute that you will be treated civilly.

Meek for moxie
We need to teach outpatient surgery staff behavior modification techniques, both subliminal and overt, to cure our incivility epidemic. We deserve a sane, courteous, collaborative workplace.

Trade meek for moxie today. Take back your umbrella.

Dr. Raymond (PLRaymond@RxForSanity.com), a practicing gastroenterologist in Chesapeake, Va., invites you to visit her Web site (www.RxForSanity.com). Her book, "Bedside Manners: How to Cure the Incivility Epidemic in YOUR Hospital," is due out next year.