One of the hardest parts of being a nurse? Some say it’s the doctors…

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Most people would agree that doctors and nurses are collectively “the good guys.” But what happens when the good guys aren’t exactly on their best behavior?

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. And extent of it may be worse than you’d imagine:

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.  

But nurses are intelligent, strong-willed people—so why are they standing for the abuse?

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.

Let’s explore the risk:

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.

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.

Feel like this article hits a little too close to home? You can check out the full piece here, and then please—share your own thoughts with us in the comments section below!