Perceptions of Disrespect in the Hospital Workforce During the COVID-19 Pandemic: Analysis and Implications for the Future

Abstract

Abstract Background The COVID-19 pandemic brought disruption and uncertainties to hospital settings. The objective of the study is to expand our understanding of how the intensity and stressors of the pandemic impacted perceptions of disrespect among the United States (US) hospital workforce. This investigation focuses on three core dimensions. First, the study seeks to shed light on how perceptions of disrespect during the pandemic varied by job category, including physicians, nurses, clinical specialists, supervisors, and non-clinical support staff. Second, this analysis looks at the effect of having direct patient interaction on the likelihood that hospital workers perceived disrespect. And, lastly, this research compares worker perceptions of disrespect during the early versus later pandemic timeframes. Methods This study uses logistic regression and bivariate comparative analysis of publicly available data from the US Agency for Healthcare Research and Quality’s (AHRQ) 2021 and 2022 Hospital Surveys on Patient Safety Culture 2.0, spanning survey years of 2020–2022. Results Perceptions of workplace disrespect during the COVID-19 pandemic varied across job categories. Nurses and support staff are found to perceive the most disrespect, and physicians are much less likely than nurses to perceive disrespect (-.53 OR, p < 0.01). For both nursing and support workers, direct patient interaction did not play a role in the likelihood of perceiving disrespect. By contrast, for physicians, clinical specialists, and supervisors, directly interacting with patients is found to significantly impact the likelihood of perceiving disrespect. Physicians are also the job category with the greatest percentage shift (20–25%) in increased perceptions of disrespect from early to later stages of the COVID-19 pandemic. Conclusions Removing blind spots to experiences of disrespect within the workforce is essential to reducing it. Equipping workers with multiple pathways to safely report perceived disrespect without fear of retribution is the first step that can enable healthcare institutions to address it. Heightened accountability at all levels of an organization, conflict management and communication training, and team and individual interventions such as one-on-one coaching and peer support programs may all be useful strategies for improving cultures of respect.