Toward an effective code of conduct.

Some facilities have had a code of conduct for years, and managers say it works well. At others, nurses still are too intimidated to remind physicians to wash their hands. In a lively discussion at the Managing Today’s OR Suite conference in October 2008 in Washington, DC, it was clear many organizations still have a ways to go in dealing with bad behavior. The discussion was timely. New Joint Commission requirements for curbing bad behavior go into effect Jan 1, 2009. Under the new Leadership Standards, facilities must have a code of conduct and a process for managing disruptive behavior. Though the issue of disruptive behavior has been discussed for years, one nurse consultant in the audience said she finds a lot of nurses are still too fearful to address it. “They will not stop a surgeon who goes from the unclean area up to the belly during a GYN case because they are afraid of being called names. The advocacy for the patient is not there,” the consultant, Mary Lou O’Grady, RN, told the audience. “When you ask why, they say, ‘I don’t want to see in my performance appraisal that my skills have gone down. The surgeon reported that to my superior.’” She’s found senior leaders don’t want to take action, and the code of conduct is often sketchy and not enforced. Many in the audience nodded in assent.