Intended for healthcare professionals


Rudeness at work

BMJ 2010; 340 doi: (Published 19 May 2010) Cite this as: BMJ 2010;340:c2480

It's rude to argue?

Rhona Flin describes disagreements and aggression in the operating theatre as though these are the same thing.1 I am not suggesting scrub nurses should have to tolerate surgeons’ bad temper and tantrums. But the example she gives of two airline pilots becoming so engrossed in a heated discussion over airline policy, when, as far as I can see, there is no evidence that the two pilots were being rude to each other, highlights the difference between disagreement and rudeness.

Abuse, rudeness and incivility should have no place at work. However, this does not mean that disagreements can be eradicated. In fact, the proposal for harmony apparently suggested by Flin would suit the command and control style of management that has caused problems in the NHS,2 and avoid any challenges to it. As the Francis report has recently reinforced,3 staff need to feel confident that they can raise genuine concerns and that these will be taken seriously. Fear of being called rude, or worse, in such circumstances also poses a threat to patient safety and quality of care, as does rudeness itself.

1. Flin R. Rudeness at work BMJ 2010;340:c2480 (31 July 2010) [Full text]

2. Ham C. Improving the performance of the English NHS. BMJ 2010;340:c1776 [Full text]

3. Francis R. (Chair) Independent Inquiry into care provided by Mid Staffordshire NHS Foundation Trust January 2005 – March 2009 [Full text]

Competing interests:
None declared

Competing interests: No competing interests

02 August 2010
D B Double
Consultant Psychiatrist
Victoria House, 28 Alexandra Road, Lowestoft NR32 1 PL