Nursing group backs call for culture change in cardiology

A new position statement has been published by the British Junior Cardiologists’ Association (BJCA) and the British Cardiovascular Society (BCS) on bullying, harassment and discrimination in cardiology.

Backed by 19 other professional cardiovascular bodies including the British Association for Nursing in Cardiovascular Care (BANCC), it points to a “high prevalence” of these issues in the workforce.

The position statement said evidence suggested that bullying, sexism and racism were all common within cardiology departments.

While data was mostly focused on doctors and trainee doctors, the statement said it was “reasonable to expect” that nurses had also witnessed, and been affected by, inappropriate behaviours.

It urged every cardiology team member to call them out when they saw them.

Other recommendations were put forward in the statement, including the introduction of “behaviour leads” for cardiology teams and ensuring the presence of Freedom to Speak Up Guardians.

It also suggested that previous incidents of inappropriate behaviour should be taken into account when decisions about promotions and research grants were being made.

Helen Eftekhari

Helen Eftekhari, president of BANCC, spoke to Nursing Times about why the statement was backed by the nursing organisation.

She said: “We felt it was important to identify that the behaviours that [BJCA and BCS] were raising have impacts on the wider healthcare team, including nurses.

“Nurses are bread and butter, we’ve got lots of specialist nurses, cardiac cath lab nurses, nurses on the ward, coronary care unit, and we’re looking after those patients.

“And even if we’re not necessarily the direct recipients of that, if those instances occur then we’re observing them, you’re part of that atmosphere and that culture,” she said.

“So, we felt very much it was important from that perspective to support it,” said Ms Eftekhari.

In terms of why such a culture exists, the statement noted a view among some cardiologists that using intimidating language or actions helped to “build character” – a concept that the authors of the statement described as “anachronistic and flawed”.

Ms Eftekhari, who has worked in cardiology since 1998, said the “very high pressure” environment and “life and death” nature of the work could also play a part in behaviours.

She backed the call in the position statement for nurses and their colleagues to speak up when they witness poor behaviours – and she said staff needed support and systems to do so.

In terms of the cardiac nursing generally, Ms Eftekhari said nurses were currently “under a lot of pressure” and that attrition rates were high, with many specialist nurses choosing early retirement.

She welcomed the position statement as a “first step” to “engendering a good workplace culture” and ensuring that cardiology was seen as a “good specialty to work in”.

“I’ve thoroughly believe in cardiovascular nursing, and cardiology as a specialty,” Ms Eftekhari told Nursing Times. “It saves lives, and that’s a really important valuable thing to contribute in your career.

“And I think [the position statement] has sowed the seeds so that people can start to feel more confident that if they see something, they’re not on their own.

“And that actually, if you see something, then don’t be scared to talk and check with other people,” she added.

Following publication of the position statement, BANCC was considering its next steps, noted Ms Eftekhari.

These could include conducting research to garner more evidence about nurses’ experiences of the culture in cardiology, she added.