Nurses being bullied by doctors has become an epidemic

Nurses are all too often bullied by physicians, which not only negatively affects them, it can be detrimental to patients.

The practice of doctors mistreating nurses has been going on for a long time, Alexandra Robbins pointed out in an article for Slate. This includes verbal abuse and sometimes even physical threats.

In her new book, The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital, Robbins tells the stories of four nurses after she spent time interviewing hundreds of other nurses around the country. She says that the prominence of doctor bullying was the most surprising and disturbing thing she came across during this process.

She spelled out some of the statistics:

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.”

So why do nurses not report these doctors more frequently? As Robbins acknowledged, there is a justifiable fear that nurses will lose their jobs or that others will see them as a whistleblower, which would inevitably affect their experience at work. It’s not entirely unreasonable because it does actually happen.

This isn’t purely about how inappropriate and demeaning doctor bullying can be, it can also be disruptive and potentially very dangerous for patients. “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,” according to Robbins.

Robbins included some information from an annual meeting of the Pacific Coast Obstetrical and Gynecological Society where researchers described some disturbing issues among labor and delivery staff:

  • “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.”
  • “A nurse reported that the ?nal sponge count was incorrect after a dif?cult tubal ligation. The physician was sarcastic and said that an expensive x-ray would be ordered because the nurse obviously suffered from obsessive compulsive disorder. A sponge was found in the patient.”
  • “Doctor’s behavior has been hostile, aggressive, threatening, and escalating in the past months … including raging at charge nurses and unit director …  nurses are working in a hostile environment and fear for their safety and well-being.”

As Robbins makes sure to mention, not all doctors are bullies. And this type of behavior does seem to be more frequent in departments with particularly high stress, like the ICU, OR and ER. Not that that excuses it, but life or death situations can perhaps stifle ones ability to think before they speak.

The mentality that nurses are below doctors in the medical hierarchy is a concept that has been maintained throughout the decades to a certain degree. Robbins speaks for equality, and not for the sake of it, but because nurses have extremely important, crucial jobs. A doctor couldn’t do what he does without nurses.

Instead of just supporting nurses after the fact, after verbal or physical abuse has taken place, the problem needs to be fixed from the start. How and when will that happen? Robbins suggests this:

By reframing doctor-nurse relationships so that providers view each other as part of a team, managers would convey that every team member deserves to be empowered as they work together toward the ultimate goal: better patient care. And then, finally, the majority of bully doctors—and projectile surgical instruments—can remain the past where they belong.