Respect protects - tools to help you tackle unprofessional behaviour

Our outreach teams are piloting new training sessions to help doctors tackle unprofessional behaviour. The sessions aim to help doctors to identify and understand the impact of these unprofessional behaviours on patient safety, and more importantly to help develop skills to deal with these behaviours that have the potential to cause harm.

Here we share a taster of two of the tools used in the sessions to help you develop or practise skills in addressing unprofessional behaviour that you've experienced directly, or that's been reported to you.

There will be times when you need to refer this behaviour elsewhere, such as through existing HR or speaking up processes. Go back to our steps to speaking up for more advice.

Read more about our Professional behaviours and patient safety programme.

Dealing with unprofessional behaviour that you have experienced or witnessed yourself

In cases where it's appropriate to deal with this situation yourself- such as having a difficult conversation with a colleague, CUDSA is a tried and tested model of structuring a conversation in a thoughtful and neutral way. Everyone has their own style and personality - adapt this so it works for you, and if possible, practice.

CUDSA stands for:

Confront the behaviour

Understand each other's position

Define the problem

Search for a solution

Agree

Confront the behaviour

Concentrate on the behaviour not the person.

Example phrases to use

I feel uncomfortable when you say...

Understand each other's position

Take the time to understand the other's position. Is it a real issue, or is it based on misunderstanding? Have you got all of the information, or only part of the story? Respect their position and ask them to respect yours.

Example phrases to use

What do you think the issue is?

Here is my take on the issue.

Define the problem

Get into the detail, but try not to react by becoming defensive, aggressive or other negative behaviour. Repeat back to the other party, your understanding of their side of the story.

Example phrases to use

I understand that you feel... and that you have an issue with... and that the reason behind this is...

Is this correct? My position is...

Search for a solution

This involves cooperation. Search for a win-win solution wherever possible. The best solution is one where each party feels that they have gained at least part of their point if not all.

Example phrases to use

I suggest that I will agree to... if you are happy to give me...

This way we both gain something positive.

Agree

Get an agreement - even if it is an agreement to differ. Make sure any agreement is stated clearly and unambiguously. If necessary, write it down.

Example phrases to use

In these (...) circumstances, I agree to... and you agree to...

If things substantially change then we will review this agreement.


Dealing with unprofessional behaviour on behalf of someone else

In cases where someone else approaches you about unprofessional behaviour they've experienced or seen, use AID as a feedback tool which maps on to the 'effect not blame' model. It is best used for situations where the behaviour has affected somebody else rather than you personally.

This model of feedback is not about getting a resolution or an apology. It is just about giving your colleague the opportunity to have insight into their own behaviour and the impact it has had on somebody else. The vast majority of us don't intend to upset or offend anyone. There is strong evidence that often all we need to change our behaviour is the chance to reflect on the effect it has had on somebody else.

AID stands for:

Action

Impact

Desired behaviour

Action

Feed back on the action you observed or heard about - don't second guess their intentions. This feedback is based on fact so is less likely to be challenged.

Example phrases to use

I wanted to share some feedback with you...

I wanted to let you know that I heard/observed...

Impact

Encourage them to reflect on the effect their behaviour has had on someone else. Avoid judgmental or emotional statements.

Example phrases to use

The other person felt that...

What do you think the effect of that was on the team?

Desired behaviour

Discuss what happens next and how they can develop the desired behaviour. Don't necessarily expect an apology or resolution - encourage them to reflect.

Example phrases to use

What can we do to move forward?

Have a think about what we've discussed.


Expect pushback - how will you respond?

Stay focused on your goal: deliver the message.

Encourage them to reflect.

Example phrases to use

Why don’t you take this away and have a think about it?

Reinforce why this matters.

Example phrases to use

This isn't in line with our organisation's values.

This isn't the kind of behaviour expected of us.