Day 3: The Fear of Speaking Up

A powerful activity that we performed today was the Domino Game. During this game, one student played the role of the “physician,” where they described an arrangement of dominoes to the “nurse,” who was supposed to arrange the dominoes how the “physician” described them without looking at the image. An “administrator” oversaw the activity but couldn’t provide any input or guidance. To make the activity more complicated, the nurse couldn’t ask the doctor to clarify/repeat the instructions. Without feedback, communication quickly broke down and the nurse’s final arrangement did not match the physician’s image of the domino arrangement. However, when the nurse was able to ask questions and clarify instructions, the nurse’s arrangement perfectly matched the physician’s arrangement.

As I was performing this activity, I couldn’t help but draw a parallel with real-life situations where nurses and residents were afraid to speak up to an attending physician, and the communication breakdown led to errors. This highlights that the culture needs to change so that everyone can communicate efficiently to avoid mistakes. Nurses and residents should not fear speaking up and stopping an activity in order to clarify an order without being seen as a “weaker member” on the team. My friends in nursing and residency have told me countless stories where attendings would retaliate against individuals who spoke up by questioning their competency. Many of my friends have noted workplace bullying when they did try to speak up, and this needs to change. The job of caring for patients can be accomplished without bullying, and we need to challenge the status quo for the sake of our caregivers and patients.

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