It’s long been known among nurses that doctors are people, too, and that they have their good days and their bad days—just like us. But there’s a fine line that exists between poorly handled situations and wildly inappropriate behavior, and sometimes, that line is crossed at the expense of nurses—and yes, patients, too.
In the following article, Alexandra Robbins, author of The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital, explores the consequences of doctors being at liberty to abuse the nurses they work with.
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And the extent of it may be worse than you’d imagine :
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A 2013 Institute for Safe Medication Practices survey found that in the year prior, 87 percent of nurses had encountered physicians who had a “reluctance or refusal to answer your questions, or return calls,” 74 percent experienced physicians’ “condescending or demeaning comments or insults,” and 26 percent of nurses had objects thrown at them by doctors. Physicians shamed, humiliated, or spread malicious rumors about 42 percent of the surveyed nurses.
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But nurses are intelligent, strong-willed people—so why are they standing for the abuse?
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Nurses may be afraid to report doctors because they believe administrators will refuse to penalize physicians who generate revenue or garner media accolades. Nurses worry they might lose their own jobs in retaliation, or they fear the stigma of being perceived by colleagues as a whistleblower.
These fears may be justified. A slew of double standards protects physicians’ jobs but makes nurses vulnerable. But when nurses don’t speak up, there’s a risk that people will suffer or die.
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Let’s Explore the Risk
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In hospitals, “intimidating and disruptive behaviors” can lead to medical errors, increase health care costs, and harm patients. These consequences can occur because certain doctors refuse to listen to nurses or because some nurses are too intimidated to ask questions promptly, if at all.
And just how frequently do these consequences occur?
The Joint Commission has found that in health care organizations nationwide, 63 percent of cases resulting in patients’ unanticipated death or permanent disability can be traced back to a communications failure.
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While there are countless horror stories to choose from, here’s just one that the article highlights :
“When a nurse reported to the physician that her patient was highly anxious and had shortness of breath, the physician told the nurse to give the patient some Ativan [anti-anxiety medication] and take some herself. Later that evening the patient was admitted to the ICU [intensive care unit] with congestive heart failure.”
Of course, not all doctors are guilty of bullying, and much of it is rooted in the tension that accompanies life-or-death situations. But there are some areas of the medical field in which abuse is more common than others:
The doctors considered the worst offenders are the specialists whose work is consistently urgent and carries the highest stakes. The hospital departments most likely to host doctor bullying are operating rooms, medical surgery units, ICUs, and emergency rooms. In the OR, surgeons are more than twice as likely as anesthesiologists and nurses to exhibit disruptive behavior.
Interestingly enough, according to a survey conducted in 2011, three-quarters of doctors report signs of concern, acknowledging that patient care is jeopardized by unstable or inappropriate doctor behavior.
Unfortunately, the hierarchy of power hindering equality, most notably between doctors and nurses, is a long-held tradition that’s very often enforced “from above.” The following is a profound example:
When an ER doctor didn’t even try to save a man whose heart stopped in the ambulance on the way to a hospital, the nurses in the emergency room complained to the hospital’s medical director. The way the director dismissed the nurses’ complaints was both insulting and astonishing. He said, “You’re just saying that because she’s young and pretty.”
Not to mention…
At Vanderbilt Medical Center in 2013, in an attempt to cut costs, administrators risked cross-contamination by forcing nurses to perform housekeeping duties, including emptying garbage cans, changing linens, sweeping, and mopping patient rooms and bathrooms, according to WSMV-TV Nashville. At other hospitals, nurses told me that they are charged for parking while physicians and techs park for free.
The conclusion? Too many nurses are being denied the respect they need to step into a role that fosters success and empowerment, and until the relationship between doctors and nurses is redefined, medical teams will continue to function at a clear disadvantage..
This article was republished with permission from SCRUBS Magazine.
I too am a nurse and I empathize with nurses. I would love to write articles exposing the truth about the mistreatment of nurses. It is wide spread. I think until more nurse speak out and more articles address this and more books are written to expose this horror to the public, this will continue as it has since the beginning of nurse/Dr. relationships.
I admire every nurse willing to tell the truth about how nurses are mistreated and exploited. There is always an excuse for a doctor and never an excuse for the nurse. I have reminded more than one doctor: “You would not have a practice and you would not be able to do your job if not for nurses.” I know this is true, but I think most people, doctors, don’t realize it. Maybe they do!
I was told by administration for one large company in Houston , Texas in a meeting: “If you nurses (all RNs) don’t like our policies here we don’t care if all of you quit because we will just go out on the streets and replace you the same day.” We were such a great team; all mistreated, that I was offered jobs because other companies knew how good we were…but not recognized by out employer. All credit and first responder awards go to Doctors, policemen, firefighters but not to nurses although nurses are the unsung heroes more than the others combined. I would love to see the field evened and the inequalities repaired.
I remember my first experience with a surgeon when I was 19 and a new grad – ages ago. The surgeon literally jumped up and down in the corridor of the unit about something he was mad about. He was 5’4″ or less so it looked like a child having a fit and literally that’s what it was.
I did an externship in the OR thinking that is where I wanted to eventually work, I saw so many fits thrown by surgeons and nursing directors who let it continue, blaming the staff rather than the Dr., I decided that was not my area to practice nursing.
I always remember the one incident that iced the cake for me, we were in the scope room and the Dr. had a table behind him he was working off of. During the procedure we realized the suction had not been hooked up, so I slid over, moved his table forward so I could get behind it and connect the suction to the canister, by then he was working off the table in the position I had moved it to, so I debated and decided to leave it there, thinking if I moved it back he would reach back and not find his tools. Thought nothing more of it. As he left the room, when the procedure was done, he stopped right in my face and leaned down, talking thru his teeth to me “if you ever move my table again, you move it back” and walking off. I stood, dumb founded, embarrassed, feeling stupid for not knowing to move it back. Now that I have been a nurse a few hundred years, ok maybe not that long, I realize I should have spoke up when I moved the table, communicating I was moving it to get to the suction and then I should have ask if he wanted it moved back or left where it was. And if he had talked to me that way now, I would say, in private, help me understand what I did so that I can do a better job here, and if he was still a jerk, shrug it off, report it if it was inappropriate, and not let it impact my mood! By the way he was a brilliant surgeon, amazing skill, great bedside manner, but threw fits almost daily….I feel because it was allowed to go on….and it made me feel he was fake with the patients. Just left me a bit conflicted about how I felt about him.