A doctor-bully epidemic is jeopardizing both nurses and patients. In news reports and hospital break rooms, stories abound of physicians berating nurses, hurling profanities, or even physically threatening or assaulting them. Doctors are shoving nurses in the operating room; throwing stethoscopes, scissors, pens, or surgical instruments. In Maryland, a surgeon yelled, “Are you stupid or something?” at a nurse and hurled a bloody surgical sponge at him. A surgeon threw a scalpel at a Virginia nurse, who told me, “He was angry because I didn’t have a rare piece of equipment he needed, so he endangered me and several others by throwing a tantrum.”
Many things surprised me during the reporting for my new book, The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital, which follows the stories of four nurses and is based on interviews with hundreds of other nurses across the country. But this disturbing problem was one of the more shocking discoveries when nurses pulled back the curtain. Most nurses have witnessed or been the victims of doctor bullying. 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. A New York critical care nurse told me, “Every single nurse I know has been verbally berated by a doctor. Every single one.”
Why is doctor bullying veiled in organizational silence? 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.
The doctor-nurse hierarchy is rooted in the past, in remembrances of outdated traditional roles. Up until the mid-20th century, nurses, almost always women, were expected to stand when a doctor, almost always a man, entered the room. Nurses were to offer him their chair and open the door so that he could walk through first, in chivalric reverse. Nurses were expected to await instructions passively without questioning the physician. By the 1960s, nursing schools were still teaching that, as one nurse described it, “He’s God almighty and your job is to wait on him.”
In 1967, psychiatrist Leonard Stein described the nurse’s role in an essay titled “The Doctor-Nurse Game.” The object of the game, he said, was for a nurse to “make her recommendations appear to be initiated by the physician. … The nurse who does see herself as a consultant but refuses to follow the rules of the game in making her recommendations, has hell to pay. The outspoken nurse is labeled a ‘bitch’ by the surgeon. The psychiatrist describes her as unconsciously suffering from penis envy.”
Today, some hospitals perpetuate what the ISMP calls a “culture of disrespect among healthcare providers” rather than treating nurses like the heroes they truly are. 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.
Hmmm..... I'd really love to read an article for doctors that can slam these damning "accusations."