Bully doctor "epidemic"

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Based on the title of this person's book, it seems that they are heavily biased towards nurses. The "Heroes of the Hospital" have to put up with Doctor shenaningans and still manage to save lives at the end of the day. I don't know how they do it.
 
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The premise of this article is stupid. If you asked anyone who has worked a full time job for more than a year if they had ever been yelled at by their boss 90% of people would say yes.
 
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tiedyeddog said:
The premise of this article is stupid. If you asked anyone who has worked a full time job for more than a year if they had ever been yelled at by their boss 90% of people would say yes.
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The article also goes on to say "The physician and nurse professions, which should be considered complementary and equal, are instead too often treated as master and servant." Seems like they don't see doctors as their boss, which might be where it stems from
 
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Any one here who's been bullied by a nurse as a medical student or resident please raise your hand.

They should be reflecting on their own behavior before playing martyr. :lame:
 
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Tired said:
In typical fashion, our community remains on the back foot with this issue. As pointed out by better people than me on this board, every instance of the word "physician" has now been replaced with "provider". You are a cancer "provider". I am an orthopaedic "provider". All but one: the "disruptive physician."

There are no "disruptive providers" only "disruptive physicians".

This is micro-aggression, and it's working because we accept the terms that as they have been defined by others.

I liberally fill out patient safety reports when I have bad interactions with nursing staff. I use every left-wing word I can think of when I do them, especially "workplace violence". I encourage other residents to do the same, but they don't, because they are chicken****. Our failure to stand up for ourselves makes this one more area where we are losing, and losing badly.
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I agree with you on all counts save one: residents being chicken ****s.

Such interactions are fraught with career implications, at least during one's residency tenure. Most residents (and perhaps physicians in general) are self-preservationists. While my senior residents would encourage me to file incident reports ("write that bitch up") I was reluctant to do so because I had several more years left there during which I could be tortured and perhaps more importantly, it was not unusual to see faculty taking nursing staff side because it was easier for them to do as well. Very few of our faculty would engage in those battles for us and only if the patient was possibly harmed or if we were doing what was right for the patient.

This is not to suggest that residents shouldn't file reports when patient safety depends on it but that I can understand why your colleagues do not. Surgery especially is a small world and no one wants to come out with a reputation as being difficult.

One of my delights as an attending, and one who is not employed by the hospital, is that I can take a stand for important things like care of my patients and treatment of my medical students and residents, and instead of push back I get apologies. The recognize the power behind assuring my future business.
 
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The article lists a doctor not returning a nurse's call as "bullying."
 
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Winged Scapula said:
One of my delights as an attending, and one who is not employed by the hospital, is that I can take a stand for important things like care of my patients and treatment of my medical students and residents, and instead of push back I get apologies. The recognize the power behind assuring my future business.
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This is my one regret about being a family doctor. We just don't have the pull in admin that you procedure folks do.
 
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Storph said:
The article lists a doctor not returning a nurse's call as "bullying."
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:rolleyes:

I dunno...like maybe they were saving a life or something (or even more mundanely, perhaps they didn't get the page). We had a nurse try to write one of my co-residents up for not responding to her page (for something minor) when we had 9 Level 1 patients in the trauma bays simultaneously. THAT one the faculty did support us on.
 
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Winged Scapula said:
Any one here who's been bullied by a nurse as a medical student or resident please raise your hand.

They should be reflecting on their own behavior before playing martyr. :lame:
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The link to the article posted above talks about exactly that. Surgery residents bullied by nurses.
 
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VA Hopeful Dr said:
This is my one regret about being a family doctor. We just don't have the pull in admin that you procedure folks do.
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Sadly that's true.

All it takes is for me to mutter, "You know I could operate elsewhere" and people start scurrying to fix things. I don't get off on the power, I just want things done right. Its too bad that it has to come to that sometimes.
 
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dnnash said:
The article also goes on to say "The physician and nurse professions, which should be considered complementary and equal, are instead too often treated as master and servant." Seems like they don't see doctors as their boss, which might be where it stems from
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Technically we are not their boss. Nurses have their own chain of command. We don't hire or fire them. Increasingly, nurses are administrators and if anything, they are the physicians boss.

Now, we are still the ultimate authority on patient care, and they have to do what you say (theoretically) but we have no authority over them in terms of chain of command. When was the last time a physician evaluated a nurses or gave them feedback as part of their evaluation process?
 
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Well I read some of it and....this... "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." LMAO
 
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typoncho said:
Well I read some of it and....this... "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." LMAO
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I guess "taking a joke" is yet another skill missing from nursing education these days.



Disclaimer: only kidding. I agree that's pretty un-called-for
 
I was a nurse before going to medical school, and I did a literature review and write-up regarding lateral violence in the nursing profession. There is extensive data and research to suggest that the nursing profession has the highest rates of intraprofessional bullying. Now of course that doesn't address the is-there-or-isn't-there inter- professional bullying between doctors and nurses, but it does demonstrate that there is an underlying culture consistent with the old adage of "nurses eat their young," and while nurses may indeed be victims of bullying by some physicians, they absolutely engage in bullying behavior as well.
As a nursing student and then as an actual nurse, I experienced both good and awful treatment from both doctors and nurses. I met some awesome nurses and doctors, and some real dinguses. I think they're in every field and no one gets to claim their field is free of them, unfortunately.

The most important thing it serves us well to remember is that regardless of how we're treated by any member of the healthcare team as we're training is not to someday engage in such behavior ourselves because "it was done to us, and now it's your turn."
 
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As a medical student, I've been ignored, fetched coffee, been called the wrong name or just responded to "medical student" by residents and attendings. Not fun, but not malicious as they are generally too busy to come up with the time and energy it takes to be an all around b****.

NOW NURSES: nurses (mostly women, except in one case) go out of their way and take the extra time and energy to insult and belittle the med student or resident, or, on occasion, the attending. The bigger audience the better. They have waaaaaaay too much time on their busy schedule of "saving lives" so they tear down each other and everyone around them. As long as they their lunch break. God forbid they don't get their lunch break.
 
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"The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital"

eghas.jpg
 
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lazymed said:
Technically we are not their boss. Nurses have their own chain of command. We don't hire or fire them. Increasingly, nurses are administrators and if anything, they are the physicians boss.

Now, we are still the ultimate authority on patient care, and they have to do what you say (theoretically) but we have no authority over them in terms of chain of command. When was the last time a physician evaluated a nurses or gave them feedback as part of their evaluation process?
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Agreed, unless you own your own practice and hire a nurse then your never the nurses boss.

Historically hospitals are the domain of nurses. I think this gets confusing for a lot of medstudents/premeds now because there are so many hospitalists that work on X unit day in a day out, but historically doctors would be separate from any administrative aspects of the hospital. I talked to an old family doc who put it in a good perspective by saying that you don't admit patients to the hospital because they need doctoring, you admit them to the hospital because they need nursing.
 
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Armadillos said:
Agreed, unless you own your own practice and hire a nurse then your never the nurses boss.

Historically hospitals are the domain of nurses. I think this gets confusing for a lot of medstudents/premeds now because there are so many hospitalists that work on X unit day in a day out, but historically doctors would be separate from any administrative aspects of the hospital. I talked to an old family doc who put it in a good perspective by saying that you don't admit patients to the hospital because they need doctoring, you admit them to the hospital because they need nursing.
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Yup- unfortunately, owning your own practice is becoming less and less common/realistic.
 
Armadillos said:
Agreed, unless you own your own practice and hire a nurse then your never the nurses boss.

Historically hospitals are the domain of nurses. I think this gets confusing for a lot of medstudents/premeds now because there are so many hospitalists that work on X unit day in a day out, but historically doctors would be separate from any administrative aspects of the hospital. I talked to an old family doc who put it in a good perspective by saying that you don't admit patients to the hospital because they need doctoring, you admit them to the hospital because they need nursing.
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Well, even today California bans non-physicians from supervising physicians under the ban on the corporate practice of medicine. Hence why even the vertically integrated giant Kaiser doesn't directly employ physicians (they contract with various Permanente Medical Groups).

Also, while patients are admitted for nursing care (I mean, sure, I guess you could sit at bedside and provide complete care to the patient... but it's not efficient), nurses don't admit patients to the hospital, physicians do.
 
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Siggy said:
Well, even today California bans non-physicians from supervising physicians under the ban on the corporate practice of medicine. Hence why even the vertically integrated giant Kaiser doesn't directly employ physicians (they contract with various Permanente Medical Groups).

Also, while patients are admitted for nursing care (I mean, sure, I guess you could sit at bedside and provide complete care to the patient... but it's not efficient), nurses don't admit patients to the hospital, physicians do.
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Thats the point, we can work up and treat patients/surgerize them/do procedures, etc. all as an outpatient, the reason patients need the hospital is if they need 24/7 monitoring by nursing or specialized equipment operated by nurses. Historically you would have all your independent docs out in the community doing their own thing who might have a couple patients in the hospital at any time with a hospital full of nurses and no permanent in house docs. so it makes sense that hospital administration would be more slanted towards nursing historically b/c physicians were separate from the actual hospital. Hospitalists and changes in who employees physicians are obviously changing this situation though.
 
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For what it's worth as someone with 3 weeks left of being chief resident, I can't count the number of times I've had to have discussions with junior residents along the lines of "Do you want to win this battle, or do you want this service to run smoothly?" when it comes to interactions with nursing etc. Surgeons tend to be the worst at this, so it's not surprise that they're the ones brought up in the thread the most, but WAY too many physicians young and old have no concept of how to communicate and interact with other health care providers, as if the concept is below them or something.

Believe me, my primary site has some really piss poor nursing, but acting like a d-bag toward them isn't going to make them work any harder. You've gotta be able to give and take with them, even if it bruises your ego if you want things done. I can't tell you the number of MDs/DOs who just don't get that, and the quality of care suffers for it.
 
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I just finished an ED rotation, and those nurses were generally the most immature, emotionally stunted group of people I have ever worked with. That said, they did a good job when it came to actual patient care but as coworkers they were beyond irritating.

As far as the article itself, how much of this "doctor bullying" happens to other people that aren't nurses? The way this is portrayed makes it sound as if this is a problem unique to nurses. Sadly I don't think that's the case. I'm sure she would find equally bad if not worse anecdotes from medical students, residents, and hell, even other attendings. It's an unfortunate aspect of the medical culture.

I'll also say that the worst "mistreatment" (if you can call it that) came at the hands of procedure nurses, in particular circulating nurses. I would routinely get yelled at for things no one else in the OR would and for no real reason. I just accepted the fact that I was the punching bag since I had no recourse, unlike residents to some degree and certainly attendings.
 
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NickNaylor said:
I just finished an ED rotation, and those nurses were generally the most immature, emotionally stunted group of people I have ever worked with. That said, they did a good job when it came to actual patient care but as coworkers they were beyond irritating.

As far as the article itself, how much of this "doctor bullying" happens to other people that aren't nurses? The way this is portrayed makes it sound as if this is a problem unique to nurses. Sadly I don't think that's the case. I'm sure she would find equally bad if not worse anecdotes from medical students, residents, and hell, even other attendings. It's an unfortunate aspect of the medical culture.

I'll also say that the worst "mistreatment" (if you can call it that) came at the hands of procedure nurses, in particular circulating nurses. I would routinely get yelled at for things no one else in the OR would and for no real reason. I just accepted the fact that I was the punching bag since I had no recourse, unlike residents to some degree and certainly attendings.
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I just started scribing recently, and now I've had some time to get to know the nurses. It's a testament to the fact that pretty much anyone can become a nurse; actually, they remind me of my old Starbucks coworkers. I kind of expected.. more from them. At least they were nice to me.
 
To play the devil's advocate I am currently an ICU nurse and have seen some pretty bad unprofessional behavior from docs and nurses alike. Oh well. Oddly enough the detest I have seen from posters on here regarding nurses is rarely translated to the
workplace (at least where I have been). Have doctors been short with me before? Have I been short with them? Sure. I work with mainly pulmonologists/neph guys who are all mostly great. When I call in the middle of the I make sure I know my **** so I don't waste their time while they cover 5 hospitals. The same goes for the ACNPs who pull call for the intensivists.

However if someone hangs up on me or refuses to intervene when I implore them too, you can bet it will be charted in the mostly tactful manner.
 
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Dranger said:
To play the devil's advocate I am currently an ICU nurse and have seen some pretty bad unprofessional behavior from docs and nurses alike. Oh well. Oddly enough the detest I have seen from posters on here regarding nurses is rarely translated to the
workplace (at least where I have been). Have doctors been short with me before? Have I been short with them? Sure. I work with mainly pulmonologists/neph guys who are all mostly great. When I call in the middle of the I make sure I know my **** so I don't waste their time while they cover 5 hospitals. The same goes for the ACNPs who pull call for the intensivists.

However if someone hangs up on me or refuses to intervene when I implore them too, you can bet it will be charted in the mostly tactful manner.
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It's cuz as a med student, intern, or a junior resident, when someone treats you like crap you smile and keep your pie hole shut.
 
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AlexMack12 said:
I was a nurse before going to medical school, and I did a literature review and write-up regarding lateral violence in the nursing profession. There is extensive data and research to suggest that the nursing profession has the highest rates of intraprofessional bullying. Now of course that doesn't address the is-there-or-isn't-there inter- professional bullying between doctors and nurses, but it does demonstrate that there is an underlying culture consistent with the old adage of "nurses eat their young," and while nurses may indeed be victims of bullying by some physicians, they absolutely engage in bullying behavior as well.
As a nursing student and then as an actual nurse, I experienced both good and awful treatment from both doctors and nurses. I met some awesome nurses and doctors, and some real dinguses. I think they're in every field and no one gets to claim their field is free of them, unfortunately.

The most important thing it serves us well to remember is that regardless of how we're treated by any member of the healthcare team as we're training is not to someday engage in such behavior ourselves because "it was done to us, and now it's your turn."
Click to expand...
Cry me a river. That's part of the job description. They are supposed to serve physicians. Ain't no way a doctor is changing diapers. That's for the nurse to do. Physicians do the thinking.
 
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Jagon said:
Cry me a river. That's part of the job description. They are supposed to serve physicians. Ain't no way a doctor is changing diapers. That's for the nurse to do. Physicians do the thinking.
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nothing to see here, move along.
 
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Tired said:
I was a CNA for many years prior to medical school. I can affirm that workplace verbal abuse by nursing is not limited to physicians and medical students.
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Word. The 'suggestion box' in the staff workroom in our ER is one giant gripe-fest between the nurses and the CNAs regarding who does more work and who can be more passively aggressive and self-aggrandizing at the same time. Enlightening doesn't begin to describe it.

NickNaylor said:
...I'll also say that the worst "mistreatment" (if you can call it that) came at the hands of procedure nurses, in particular circulating nurses. I would routinely get yelled at for things no one else in the OR would and for no real reason. I just accepted the fact that I was the punching bag since I had no recourse, unlike residents to some degree and certainly attendings.
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My "favorite" story involves my resident (only resident on the service since the chief was on vaca) being ten minutes late to first case in the OR because there was a code on the floor. (Incidentally, the attending was caught in traffic and was twenty minutes later than the resident so the case couldn't have started anyway). After the case was over the nurse chewed out, berated, and humiliated the resident for being late. The actual words "I don't care if there was a code, it's your job to put on the SCDs" were used. I kid you not. God forbid the circulating nurse stoop so low as to do measly resident work of putting fancy socks on the patient. And when the resident nicely mentioned that, you know, a patient was actively dying, the nurse's response was "We expect you to help down here. We evaluate you, you know." True story.
 
WinslowPringle said:
Word. The 'suggestion box' in the staff workroom in our ER is one giant gripe-fest between the nurses and the CNAs regarding who does more work and who can be more passively aggressive and self-aggrandizing at the same time. Enlightening doesn't begin to describe it.


My "favorite" story involves my resident (only resident on the service since the chief was on vaca) being ten minutes late to first case in the OR because there was a code on the floor. (Incidentally, the attending was caught in traffic and was twenty minutes later than the resident so the case couldn't have started anyway). After the case was over the nurse chewed out, berated, and humiliated the resident for being late. The actual words "I don't care if there was a code, it's your job to put on the SCDs" were used. I kid you not. God forbid the circulating nurse stoop so low as to do measly resident work of putting fancy socks on the patient. And when the resident nicely mentioned that, you know, a patient was actively dying, the nurse's response was "We expect you to help down here. We evaluate you, you know." True story.
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Oh no... don't write me up for that! No! My PD is going to have to meet with me for 3 minutes! the horror!
 
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WingedOx said:
Oh no... don't write me up for that! No! My PD is going to have to meet with me for 3 minutes! the horror!
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Our hospital started a policy in the fall where nursing staff are required to write up at least one person per week in the interest of "patient safety".

Our PD reads the complaints aloud during meetings for comedic value.
 
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Tired said:
And this is exactly the point where I fill out a patient safety/workplace violence complaint. If one of our juniors berated a nurse for not being at a case due to a code, I would crush them. There is no reason this should be tolerated.
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Agreed. The resident didn't and, given the seniority of the nurse and her favored status with the attendings, I can't blame her tho. One of the many reasons I didn't interview there....
 
Winged Scapula said:
:rolleyes:

I dunno...like maybe they were saving a life or something (or even more mundanely, perhaps they didn't get the page). We had a nurse try to write one of my co-residents up for not responding to her page (for something minor) when we had 9 Level 1 patients in the trauma bays simultaneously. THAT one the faculty did support us on.
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Nurses can WRITE up residents? That seems like a recipe for disaster. How can the population expected to carry out orders from another group simultaneously hold such authority over them.

You'll have to forgive me, at my school we only have 1 residency program, most clerkships are at non-residency sites so I am still not up on how academic programs work for the most part.
 
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VisionaryTics said:
Our hospital started a policy in the fall where nursing staff are required to write up at least one person per week in the interest of "patient safety".

Our PD reads the complaints aloud during meetings for comedic value.
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Wow, administrators just making sh@! Up to justify having a job or what? What a total waste of time.
 
VisionaryTics said:
Our hospital started a policy in the fall where nursing staff are required to write up at least one person per week in the interest of "patient safety".

Our PD reads the complaints aloud during meetings for comedic value.
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"Ahhh we have sort of a problem here....yeahh you apparently didn't turn in your weekly write-up. Yeahhh you see we're writing up somebody every week now, did you see the memo about the write-ups? If you could just go ahead and make sure you turn those in from now on that would be greatttt"
 
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This is a pretty good thread for our weekly nurse hate session. Thanks guys.
 
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The fact that students, residents etc are usually at any one institution temporarily while the attendings have to deal with the d-bag nurse the rest of their careers (@ that location) is part of the reason why we are told to "shut up & bear it" in a lot of cases
 
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