Why Chewing People Out For Mistakes is a Bad Idea

I had a conversation recently with a few friends about chewing people out for mistakes that I wanted to share.

My med school friend had been observing a surgery where the surgeon had asked a nurse to get a specific item from the storage closet for use in the surgery. When the nurse got to the closet she found that they had ran out of this particular item, so she had to go all the way across the hospital to retrieve the item. She rushed back quickly, but it still took about 10 minutes – which is an eternity during surgery when the patient is already “open”, because it increases the risk of infection.

After the nurse returned, the surgeon went off on the nurse, berating her for failing to get the item back sooner and threatening the safety of this patient – even though it was not her fault that the storage closet was not properly stocked (that job laid with some third person who was not present). The surgeon chewed out the nurse so hard that she started crying and had to leave the room for almost the entirety of the surgery – meaning the operating team had make do with one less person available to help.

Some disagreement ensues

I felt that the story really underlined the reputation that surgeons have for being assholes and that his behavior was destructive and uncalled for. Surprisingly, both my trader friend and engineering manager disagreed. Their opinion was that the nurse (who was not a newbie by any measure) should have double checked all the supplies prior to the surgery and by getting chewed out, she’d learn her lesson and never let this happen again. Thus, even though the surgeon brought the nurse to tears and caused her to be ineffective for the rest of the surgery, he ultimately did the right thing in terms of maximizing patient care in the long term.

I strongly disagreed with their assessment and spent some time unsuccessfully trying to explain why.

I was so distressed by this conversation that it’s still on my mind now and I decided to write this post. So here are the 4 reasons I feel that yelling, belittling, insulting, threatening, and otherwise chewing someone out for a mistake is a really bad idea.

1. Stress inhibits initiative/creativity and encourages mindless obedience

The number one issue I have with this situation is that the nurse wasn’t even in charge of stocking the storage closet. That was someone else’s job. The surgeon wanted the nurse to take extra initiative and double check the closet – which is a great thing to encourage.

But you can’t berate some into taking initiative.

Sure, they might double check next time, but in general, when you are afraid of making mistakes, you are unlikely to take initiative to try new things. This nurse is less likely to go above and beyond the call of duty – not more. As a data point: it’s been shown that innovation efforts struggle after a firm announces restructuring efforts (a known stressor).

If you want your people to take initiative, putting them under a ton of stress for “screwing up” is not going to work.

2. When you lose control, you lose respect

When you chew someone out – it is often because you are pissed off and unleash your anger on anyone who is involved in the situation (and sometimes even unrelated people!) When you lose control of your emotions as the leader or most senior person on the team – you lose the respect of your team. You lose credibility and you lose influence.

How are you supposed to have the discipline to make the tough-but-important calls when you can’t even discipline your own emotion?

If you’re upset, it says much more about your character if you can stay calm and collected when discussing then incident – which will earn the respect of your team, making them more likely to follow your directions in the future.

3. You breed resentment which leads to turnover & passive aggressive behavior

Besides inhibiting creativity, chewing people out and making them feel bad leads to resentment, which leads to a host of negative consequences. When you resent someone, you tend to resist helping them and look for little ways to screw them. I’m sure you’ve all seen this sort of passive-agressive behavior play out in your home or work. It is toxic – you don’t want that in your workplace.

Additionally, resentment leads to people quitting. This nurse had been working at the hospital for many years – she was no dummy and had a wealth of valuable experience that can make a huge difference for patients in many ways. But if she left due to resentment or just plain burn out, that is a net negative for the hospital and for patient care.

4. You don’t get to the bottom of the problem

When you yell at someone for making a mistake and simply tell them to “never let this happen again” you are demonstrating a lack of intellectual curiosity. Most problems don’t have simple solutions – or else they would have been solved already. You need to get to the root cause of the problem.

Instead of chewing people out, a better approach might be to use the 5 Whys – a technique developed by the founder of Toyota. As the architect of the Toyota Production System describes it:

“the basis of Toyota’s scientific approach . . . by repeating why five times, the nature of the problem as well as its solution becomes clear.”

Chewing people out assumes that the problem lies with their intelligence or motivation – and if that’s really the issue – you have a bigger problem on your hands.


I guess now I have to write a post about the right way to deal with mistakes or problems with people – that will come in time but in general, two good tips would be: ask a lot of questions and work hard to set clear and agreed upon expectations.

Chewing people out doesn’t work and it’s unprofessional. So don’t do it.

UPDATE – A med school friend of mine has written his thoughts on the surgeon’s behavior: Further Thoughts on Chewing People Out

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7 comments
jasonshen
jasonshen moderator

@WestonLudeke @ESWAT Thanks for commenting guys. You made some great points. Sometimes in a clear cut, highly regulated situation, there is pretty much no room for error and it's really important to do whatever it takes to avoid mistakes. And perhaps sometimes yelling at people can help make sure those mistakes are avoided. We also don't know what the full context of their relationship was.

But I do believe that in most situations, simply following the rules is not going to be enough. Most situations require everyone to be fully and enthusiastically engaged, acting with initiative to achieve a goal that is larger than can be reached with a command-and-control style.

Even in the US military, there is a huge effort made to push decision making down as far down the chain as possible because the leadership believe it produces better results.

WestonLudeke
WestonLudeke

I'd have to disagree Jason.

Consider the context of the situation: This is a surgery. This is a very delicate and specific situation. There is no room for margin of error.

The doctor doesn't care if the item is missing because of that specific nurse or another nurse; the excuse doesn't matter. What matters is she didn't do her due diligence and check either way. You state above, "She isn't a newbie by any measure." Then why make excuses for her incompetence?

I would also assume that the doctor wouldn't have time for the feelings of the nurse while the patient is currently being operated on. The well being of the patient is the doctor's #1 priority. If the patient dies, excuses aren't going to matter to the family of the patient.

What we don't know is the context of the relationship: Meaning, we don't know if the doctor had given the nurse repeated warnings before. We also don't know the full procedures that are in place and if she didn't follow them. Most importantly we don't know what the doctor said when he yelled at her (this matters because he may have yelled something like, "I've told you 3 times to check that!") That would change the context of our discussion radically.

My immediate analogous thought was to football. Imagine a football coach yelling at his player on the sideline. Imagine the player just made a huge mistake that he's been preparing his entire professional career in practice and other games not to make. The coach would be pretty pissed off, and rightfully so. Luckily football isn't life or death.

Some people learn by constructive criticism. Other people don't learn until they get challenged. Other people don't learn until they get humiliated. Everyone is different.

I'll take the asshole, perfectionist surgeon operating on me any day over one who is more concerned about being politically correct.

ESWAT
ESWAT

This was a great read and a timely one, Jason. While I mostly agree, an experience I had this week makes me wonder if—as much as I hate the sound of it—some scolding can actually work in the right context.

I’m taking an accelerated class that requires hard work to keep up but has otherwise been very laid back in the classroom. However, earlier this week the professor had started to become more aggressive and berate students individually—in-front of all their peers—if they tried to ask their peers questions about something while he was talking. He didn’t yell, more like using a more interrogative form of the 5 Whys.

Not talking over your superior is understandable but I was a distraught at the sudden change in attitude and I thought momentarily that I and the students getting put on the spot had lost respect for him. But if anything the reverse happened—it was a wakeup call that this class requires being attentive to do well in, and me and the rest of the class were more alert during that class and also asked the professor for more input, including the troublemakers. I can’t say what the longterms effects of that day will be, but everything was fine the next day and the people that were berated didn’t seem to have been negatively affected by that day at all.

This is also the type of class where creativity would probably hamper progress more than promote it—it’s just about rote memorization and doing a lot of work everyday and being an accelerated course you don’t really have a lot of time to find creative ways to learn the material on your own. This is one case where simply following the leader will probably lead to the best outcome for everyone. I’m ignorant as to whether you’d want a medical team to be creative during an operation (would be helpful if things don’t go according to plan, otherwise?).

Could the professor be more subtle and gently straighten up the people talking over him? From my experience, no, especially with introductory courses that are composed of mostly freshmen used to the rowdy environment of high school.

That was a lot longer than I would have liked. But tl;dr: Not every team endeavour requires or would be successful with creativity, as sad as that sounds. If there’s a situation that requires everyone to follow the leader for everyone to succeed, chewing people out could probably help and waste everyones time less than politely questioning.

jasonshen
jasonshen moderator

@chris_sun Glad you liked the article. The responsibility ultimately boils up to the highest person in the situation. I also rarely yell at people - in fact I've only been in one yelling match in the past 3-4 years that I can remember. There are just better ways to communicate - even if you are competitive.

@usabilitycounts Thanks for the thought. It's true that some mistakes are more important than others, but I think most of the time you still don't need to yell to make a point. Otherwise I'd imagine senior management at large companies or everyone in Congress would be yelling at each other all the time. If there is an issue with understanding the magnitude of the mistake/action, that should be correctable without raising your voice 99% of the time.

usabilitycounts
usabilitycounts

It really depends on the situation. What the surgeon did wasn't the appropriate time, because of the nature of the situation. Some mistakes cost thousands of dollars, or can kill someone, and people have reminded of that.

chris_sun
chris_sun

Totally agree with your assessment. The surgeon's yelling was wrong. Referring to your point #4 (The 5 Whys), why didn't the surgeons have every item they needed (or possibly needed) in the room BEFORE the surgery was started? That would have made the nurse's task unnecessary. Maybe the problem is not having a proper checklist of things needed for the surgery. And ultimately, that could be the surgeon's responsibility.

Growing up, there was so much yelling in my household. My parents fought often and yelled so much that it made me a non-confrontational person. I am put off by people who are regularly angry or have blown up at times. When I have a family, I won't yell at them, simply because it doesn't help. And although I try to avoid yelling, it doesn't mean I'm soft. I love sports and am very competitive. I just choose get my point across without a high volume or insulting people.

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