The Toxic Wake of Rudeness: Why It Matters

In the midst of a good workday, you walk past 2 colleagues conversing in the hallway and are quite sure that you overheard a disparaging remark about you, especially when their conversation halted while you passed by. You didn’t say anything to either, but returned to your patients, feeling a bit piqued. As your shift continues, do you forget about the remark? Or is it still circling in your subconscious, then reappearing in alternative self-defensive comebacks, retaliatory strategies, or even forms of revenge? Was that what you were ruminating about when you nearly overlooked your patient’s dressing change? Did you approach either of those colleagues to confirm or disconfirm your impression? No? Have you actively avoided contact with either of them since that perceived slight? Behold the toxic wake of rudeness— even misperceived. Rude behavior and utterances are so pervasive today that it is sometimes difficult to find a serene environment for work or leisure devoid of the verbal and visual intrusions that bombard us. The increasing prevalence of rudeness within our work environment poses particular challenges when the substance of our work is supposed to be therapeutic. In an acute care, progressive care, or critical care setting, the aftermath of rudeness can be toxic to us as individual critical care nurses, to our relationships with peers and team members, to our unit and facility. Rudeness can flow into ever-expanding spheres like a toxic waste that contaminates all it reaches. Prior research on management dynamics identified the problem of rudeness within many organizations, including health care. Those findings were underscored more recently with a study revealing that rudeness impairs the diagnostic and procedural performance of neonatal intensive care unit physician-nurse teams, potentially leading to “profound, if not devastating effects on patient care.”2(p491)