Baby’s Are Exposed to Too Much Radiation

A story broke in today’s NY Times that infants are being exposed to too much irradiation. The radiologists at Downstate Medical Center in Brooklyn are exposing our most vulnerable patients to whole body irradiation (called babygrams) without a seconds thought and often without shielding their gonads! What’s even worse, is that in many cases the CT scanners are improperly set, often exposing the infants to dangerously high doses of irradiation. And, in many instances, babies weren’t properly positioned making the scans useless.

“I was mortified,” wrote  Dr. Sclafani, the chief of radiology, on July 27, 2007. “Worse, technologists had given the same baby about 10 of these whole-body X-rays. “Full, unabashed, total irradiation of a neonate,” he said, adding, “This poor, defenseless baby.”

The radiology department concluded that a failure by doctors to report mistakes made by radiation technologists was the cause of these errors. Dr. Sclafani’s greatest disappointment was directed at residents and supervisors for not speaking up about the improper X-rays. “Every film, all dictated, and no one brought this to my attention,” Dr. Sclafani said. Dr. Sclafini, there’s a reason it wasn’t brought to your attention: fear!

As we discussed in previous posts, healthcare organizations operate in a culture of fear. Fear of litigation, blame, accusations of incompetence, and retaliation creates unresolved conflict throughout the organization. A culture of fear blocks open communication and collaboration which are necessary to resolve workplace conflict and provide a safe working environment. Rather than learning from medical mistakes and resolving conflict, healthcare managers and leaders place blame for errors squarely on doctors’ and nurses’ shoulders. With unresolved conflict, mistrust persists, anxiety grows, and conflict and mistakes escalate, creating an unsafe, hostile environment. If hospitals are to significantly reduce the number of medical errors, working conditions must change; the culture of fear that infects healthcare must be replaced with one of trust.  

To successfully address conflict in the workplace, change must start at the top of the organization. Healthcare managers and leaders (including hospital boards) must be willing to change their behavior and work collaboratively with all healthcare workers to minimize the effect conflict has in the workplace. In a new environment of trust, healthcare providers will be empowered to openly communicate  and collaborate and to learn from mistakes, which will result in a spiral of trust and, as a consequence, better patient care. Without change from the top of the organization, mistrust will persist and mistakes will continue to be made.


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