Zero tolerance, Zero Empathy?

zero tolerance signHospitals and government services like to put large posters up that list all the things they do not tolerate.

  • Abusive language
  • Acts of violence
  • Inappropriate behaviour
  • Harassment
  • Bullying
  • Yelling
  • Profanity
  • Verbal threats

Zero tolerance seems a good solution for all kinds of social problems. Whenever anyone wants to say they really don’t support something, they say they have a zero tolerance approach. Here are some example from the headlines:

Hospital leadership adopts zero tolerance policies to support staff. Policies plus proper doors, panic buttons and modern approaches to security best practices help protect an organization’s most valuable asset.

But for some, zero tolerance means zero empathy.  That angers patients.  Upset patients act poorly and make staff feel unsafe. Staff cry out for stronger zero tolerance, and the cycle continues.

Should professionals, trained at managing the emotions of all kinds of emergency situations, need to have giant posters telling patients what they will not tolerate? Is there a chance that zero tolerance promotes callous and pitiless treatment of patients?

In schools, zero tolerance fosters the opposite approach that behavioural concerns require. In Kicking the Nasty Habit of Zero Tolerance, Julia Steiny reports that some teachers say:

I teach the good kids.  I don’t give the bad kids the time of day.  They shouldn’t be here.

When students need to hear:

I care about you.  It is my job, if for no other reason, to invest in your success…

A recent article in Nursing Times suggests the same thing: Do Zero Tolerance Policies Deskill Nurses? Zero tolerance policies assume that dealing with aggression is not part of a healthcare professional’s job.

Zero Tolerance For Staff?

Instead of advertising what we won’t tolerate from patients, why don’t hospitals advertise what patients won’t have to tolerate from staff? Why don’t we adopt a zero tolerance for staff and post that on huge posters in hospital waiting rooms? We could adopt zero tolerance for

  • Staff talking about vacations while ignoring new patients
  • Sneering skepticism
  • Snide remarks and innuendo
  • Condescension
  • Patronizing remarks
  • Unnecessary delays
  • Being bothered by interruptions
  • Abandoning patients to go on breaks
  • Profanity
  • Anger

The worst of zero tolerance attitude tends to seep in and change culture. It takes huge effort to maintain excellence, teamwork and a positive attitude . Ignore excellent behaviour for just a short time and culture risks becoming callous, pitiless, dismissive and cruel.

Healthcare requires professionals trained to handle patients at their worst. Even nice, polite, otherwise normal people can scream and swear when in unbearable pain. Professionals know this. Professionals pay attention to safety, but then they manage bad behaviour with grace and magnanimity.  Zero tolerance posters should be beneath them.

[photo credit: amazon.com]

 

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