This article in @watoday by @nathanhondros about senior medical staff accused of bullying has been held up by some as illustrating the harm that #OperateWithRespect is causing.

Some comments-
https://amp.watoday.com.au/national/western-australia/generational-war-rages-at-rph-with-dozens-of-senior-perth-doctors-accused-of-bullying-20200612-p5524o.html

#OperateWithRespect focuses on behaviours, not personal characteristics such as age, race or gender. To frame this as a generational divide buys into false stereotypes and is disrespectful to medical staff of all ages and stages who believe in respectful behaviour.

Length of practice is not any guarantee of quality. Teaching students is a privilege, and good educators engage in #LifelongLearning. To consider essential #MedEd upskilling as a punishment is... telling.

I am perplexed by these quotes. If they are accurate, calling anyone a 'tosser' or 'couldn't give a shi*t' is disrespectful. It is curious that they are said in the context of *asking to be respected*.

We will not achieve respectful behaviour by being disrespectful ourselves.

However, 'zero tolerance', while cognitively appealing and understandably human, does not recognise the complexity of healthcare nor the importance of context in judging how behaviour is perceived.

Zero tolerance is neither fair nor equitable. @RogerCookMLA

This is exactly why we developed #OperateWithRespect. Because many complaints systems work like an on-off light switch. The barriers to reporting are higher *because* the penalties are severe. Small issues are not reported because no-one wants to be blamed for scuttling a career.

So, small things go unreported for years and the aggressor receives no feedback at all... until the moment that they receive THE feedback, at which point old incidents resurface. Years, sometimes decades, of accumulated slights get reported, emboldened by safety in numbers.

Is it any wonder, then, that the aggressors frequently feel suddenly victimised, while the recipients frequently say that everyone knew, but nothing was ever done?

The tragedy, of course, is that disrespectful behaviour impairs team performance and #PatientCare.

It's the PATIENTS who suffer when disrespectful behaviours remain unaddressed.

Here's where #OperateWithRespect aims to add the dimmer dial to the on-off light switch. To address disrespectful behaviours earlier, more fairly, and less severely (at least initially).

2 principles-

1. None of us is an angel. Everyone has moments that we regret. There must be opportunities to reflect and improve.

2. None of us is a devil. A 'bully' has a behavioural issue, but also intelligence and experience. Address the behaviour, don't waste the good.

The aim of #OperateWithRespect is to encourage everyone to #SpeakUp either at the time or shortly afterwards- collegially, confidentially, considerately. #TheStandardYouWalkPast #BeKind #CupOfCoffeeConversation

If we can institute #OperateWithRespect, behaviour becomes a collegial responsibility. It is not something done 'to' doctors 'by' admin. By making it a frequent topic of conversation, it moves out of the #HiddenCurriculum and becomes culture- the way we do things. #CultureChange

It might seem counterintuitive, but scrapping 'zero tolerance' will improve the ability to address disrespectful behaviours by making it OK to discuss it, to recognise that it is not always clear cut, to provide ways for aggressors to reflect and change.

No-one comes off well in the current system. At the end of reports, recriminations, many meetings, the hiring of lawyers- there usually remains- one aggressor career abruptly curtailed, one or more recipients permanently damaged, a unit culture in shreds, and the poor patients.

I do not know the details of this case and cannot comment specifically.

But I can say that by the time disrespectful behaviours hit the news, there is a tendency to paint it in polarities. Older vs younger. Admin vs doctors. Bullies vs victims.

The real world is not like that.

If we've learnt anything in 2020, it's that nothing is black and white. Bushfires can't be controlled by human will alone, pandemics will defy prediction, #BlackLivesMatter because culture matters.

Let's change. Let's add more shades of grey.
Let's #OperateWithRespect