As the current healthcare workforce ages and retires, staffing shortages will continue to be critical for nurses, physicians, pharmacists, radiology technologists, and so forth. This situation can be expected to continue into the next decade. As a result, finding the next generation of healthcare professionals and retaining our current high-quality healthcare providers will continue to be a major concern for hospitals and other environments of care. Many hospitals have invested heavily in salary increases and additional benefits for nurses and other hospital patient care providers. But will these improvements be enough to recruit and retain qualified healthcare professionals in the future? What else must be done to achieve this goal and whose responsibility is it?

What role does the current medical and nursing staff have in the recruitment and retention of healthcare professionals? I argue that one of the most significant factors is the creation of a collaborative and respectful environment in which to practice. This includes the personal way that nurses and doctors interact with each other and other hospital staff members. This interaction also must extend to those who are future staff members as well, that is, students in healthcare professional clinical training.

We, as healthcare professionals, need to examine our workplace relationships. Much discussion has revolved around creating positive work relationships that include professional collaboration, respect, and effective communication. The American Nurses Credentialing Center (ANCC) "Forces of Magnetism" identify collaboration as key in promoting a positive work environment.

Does collaboration extend to students as well? It is self-evident that we expect students to follow our directions, take orders, and carry them out. But do we involve them in any aspects of the learning that can come from being a part of the decision-making process so that they at least understand the rationale for the plan of care?

Research by Rosenstein1 described the disruptive behavior by physicians and its effect on nurses' job satisfaction. The study results suggest that daily interactions between nurses and physicians strongly influence nurses' morale. The study found that more than 90% of nurses had experienced or witnessed disruptive physician behavior. The respondents including nurses, physicians, and executives indicated that only 2% to 3% of the medical staff exhibited these inappropriate behaviors. However, 31% of survey participants responded that they knew nurses who quit a hospital facility because of a problem with physician conduct. The findings suggest that the quality of nurse-physician relationships must be addressed as facilities seek to improve nurse recruitment and retention.

Some healthcare providers seem to lack an awareness of how they are perceived by nurses and other professional staff. While physicians often express frustration over particular aspects of hospital operations, functioning of the operating room, or other physician colleagues, the key issue focuses on how they express those frustrations and how it affects the people around them. This is especially true in environments, such as critical care, emergency, and operating rooms where physicians and nurses often work closely together for, what can be, quite lengthy and often stressful periods of time.

It is not surprising that nurses have reported patient errors immediately after experiencing disruptive behaviors by coworkers or physicians. So, not only does our behavior have the potential to impact the nursing shortage but also the safety of our patients. As a result, many healthcare organizations have policies in place that provide guidance to the institution in how to handle complaints regarding a healthcare provider's alleged disruptive behavior. These policies must be communicated to all members of the hospital staff. We, as healthcare providers, need to report such behavior-whether it comes from coworkers or physicians-so that, ultimately, patient safety is the outcome.

We all need be aware of how we are perceived by those around us. Our behavior should be of the utmost professional nature with the emphasis on respect, collegiality, clear communication, and control. We all are going to have times of frustration but we need to show restraint and control in difficult situations. To retain high-quality healthcare professionals, we all have to have a zero-tolerance attitude when it comes to disruptive behavior. We also need to ensure that we treat the next generation of healthcare providers with the same respect and professionalism that we exhibit toward all members of our healthcare teams. It is really up to us to set the example and lead the way.

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