Public Humiliation In Healthcare
Numerous nurses, nursing assistants, and other healthcare workers have described humiliating experiences during the courses of their careers. The purpose of this article is to discuss the topic of public humiliation in healthcare settings.
Close your eyes for a moment and imagine that you are Denise, a 46-year-old newly graduated nurse who works the night shift on a medical/surgical unit at a 170-bed community hospital. Denise, who had a successful first career as a high school biology teacher for 20 years before having decided to become a nurse, completed a 12-week new grad program at the hospital and has been off orientation for approximately three weeks.
One of Denise's six patients is the very pleasant, morbidly obese 40-year-old male in room 503 who had undergone a bilateral total knee replacement two days ago. Although this patient is pleased that he is going home tomorrow morning, he senses that something just isn't right. He tells Denise, "My right knee feels like it's on fire. It feels hot and it's hurting really bad. The pain medicine isn't working, either."
"Let me take a look," she responds with a reassuring smile. With gloved hands, she gingerly peels the dressing off and is horrified to see that purulent drainage is oozing from the stapled surgical incision. The area around the wound is slightly reddened, swollen, and very warm. She cleanses the wound, covers it with another dry dressing, and applies an ice pack to the area. Denise asks, "Did your surgeon see your incisions this morning?"
"Yes," the patient replies. "He said it looked fine. The knee's been burning since this morning, but he said it would go away in a few days."
She chimed, "I'm going to call your surgeon again to express our concerns. There's even a small chance that he might still be in the hospital since one of his procedures today took a lot longer than he planned." The patient nodded in acknowledgement.
Denise has dealt with this orthopedic surgeon on previous occasions. He is in his thirties, seemingly laid-back, and usually respects the concerns of the floor nurses. She calls his cellular phone number; the automated voice mail message popped on. She leaves a detailed message regarding the patient's right knee.
Suddenly the internal medicine doctor scuttles to the nurses station and slams a chart onto the floor. It is 7:45 in the evening. Several nurses, visitors, and the house supervisor are jolted by the sound of the chart as it struck the floor. With a heavy Spanish accent, she yells out, "Who in the hell is the nurse of my patient in room 303?"
"I'm his nurse," Denise responds with assertion in her voice. "What is the problem?"
The doctor rolls her eyes in disgust. She screams, "You must be the most stupid nurse on the planet! His knee is infected and you haven't done a damn thing about it! He's been complaining about that knee all day!"
Denise takes a deep breath and silently counts to ten while the house supervisor whisks the internal medicine doctor into the patient's room. She had never been publicly humiliated by any colleagues or adults during her years as a teacher. This was new to her. She could feel the rage building up inside.
Humiliation involves the experience of some form of ridicule, scorn, contempt, or other degrading treatment at the hands of others (Klein, n.d.). The humiliated person feels disrespected, lowly, and debased during and after the incident. There are three involved parties: 1) the perpetrator exercising power, 2) the victim who is shown powerless and therefore humiliated, and 3) the witness or observers to the event (Emotional Competency, n.d.) Healthcare workers may experience public humiliation from colleagues, patients, visitors, and others.
Individuals who have been publicly humiliated have several ways in which they can deal with the event. They can call the perpetrator out on his/her behavior and risk further humiliation. Or, they may reassess the public humiliation in a manner that points to one's perseverance in the midst of unpleasant circumstances. The final option is to exit the environment where the public humiliation is taking place.
The most effective way of handling public humiliation is to keep it from happening in the first place. Healthcare providers and workers need to be educated on the damage that humiliation can inflict on the human psyche. In addition, a little self-esteem goes a long way, because it is almost impossible to humiliate the person whose sense of self does not hinge on what others think.Last edit by Joe V on Jun 27, '12
About TheCommuter, BSN, RN Senior Moderator
TheCommuter is a moderator of allnurses.com and has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.
TheCommuter has '10' year(s) of experience and specializes in 'Case mgmt., rehab, (CRRN), LTC & psych'. From 'Fort Worth, Texas, USA'; 35 Years Old; Joined Feb '05; Posts: 36,139; Likes: 64,342.Jun 26, '12 by somedaypedsI am wondering if you were there the day this happened to me! I was a secretary at the time and a doctor I supported was acting in a similar manner. I chose the exit option and it did not go well for me. My boss, who was also the boss of the perpetrator, raked me over the coals. This was when I decided my days at this facility were coming to a close.
I learned from this though. I think more could be added to this article about how to deal with this situation. How to keep it from happening.
I also think that every nurse should plan strategies for what to do WHEN this happens to you. Unfortunately, the likelihood of it happening is better than not.Jun 26, '12 by SirJohnnyAll this for a lousy $20/hour (starting pay for graduate nurses in central & western Pennsylvania).Jun 26, '12 by merleeWhat is the point of this thread? Most of us are completely aware that these things happen far too frequently, and the perpatrators usually go unpunished and uneducated about their inappropriate behavior.
I have only worked in one place where docs were called on the carpet for their behavior. And that hospital had a husband and wife as the head of medicine and the DON!!!
As a group, we have allowed despicable acts to continue. Some places have established a 'code' situation where everyone on the floor gathers and stands behind the person being yelled at, to offer support and to show the bully that his (or her) actions are not going to be tolerated.
As soon as someone raises their voice, the immediate response needs to be 'when you can calm yourself, then you can speak with me.' And turn to walk away!!! We allow this to continue every day. So sad.Jun 26, '12 by kcmylornThis not only happens to new grads but also seems to be the entertainment of the MA's, receptionists and LPN's toward an older RN in orientation in a new job. This is currently happening to me on a daily basis since I started this new job one month ago. I am seriously considering quiting. I am finding it harder and harder to be civil to these new coworkers.
Like I posted in another thread- mean crabby old nurses are groomed and molded.Last edit by kcmylorn on Jun 26, '12Jun 26, '12 by TheCommuter, BSN, RN Senior ModeratorQuote from merleeThe point of this thread is to discuss public humiliation in healthcare settings. Contrary to popular belief, we are not so powerless as to do nothing about bad behavior. Power perceived is power achieved.What is the point of this thread?
My personal way of dealing with a potentially humiliating situation is to call it out at the very moment that it happens. If you become openly defensive at anyone who screams, hurls insults, or disrespects you, I've found that the person will be less likely to mess with you again because you're making yourself a difficult target. Perpetrators like easy targets, but they shy away from difficult targets who will openly challenge the bad behavior.Jun 26, '12 by kcmylornCommuter I'd like to agree with you and you have valid advise: however, My fear is that those who are bold enough to cross the boundary into someone's dignity by assaulting it, will also may any attempt for one to defend themself look like a complete(butt) !.. I have seen this alot. I have never had this behavior come from a physician and don't get me wrong - I am not saying they don't do it. I have found this behavior to be more common coming from co-workers.
My enthusiam for nursing is about all gone at this point. As soon as I can think of a decent job- non nursing to do- I'm out of it all for good- 32 yrs of this crap, I have had it.
It is my firm belief- that those who conduct themselves in such a way as to assult the dignity of others, are very much lacking in the knowldege, skills and abilities they really need for their jobs- in other words are very stupid nurses and this is what they do to compensate for lack of intelligence.Jun 26, '12 by suannaWouldn't it be great if schools of Nursing and employers offered an inservice to all staff about how to handle/react to this situation. Often times the person attacked is so shocked by the behavior it is impossible to make an appropriate response at the time. A class with role playing and clear policy support to make sure staff know what lengths the hospital is willing to go to to support the staff and keep this from happening. How about every staff nurse has the ability to suspend a surgeons privliges pending review if they feel they are being attacked. If a customer spoke to a cashier at ACME like I'm spoken to on a daily basis, the customer would be thrown out of the store and possibly arrested. The day I can have doctor Bob Jones arrested and dragged out in handcuffs for asault or aggrivated menacing with the support and encouragement of my employer, then we will be on the road to solving this issue. I'm not counting on it any time soon.Jun 26, '12 by TheCommuter, BSN, RN Senior ModeratorQuote from suannaIf a traveler makes the pilot on a major airline feel uncomfortable, the air marshall will keep the person in line or escort them off the plane before it takes off. If a customer verbally abuses the bank teller, security will tell the person to leave the bank. If a patron threatens the waitress at the pancake house, management might call the police.How about every staff nurse has the ability to suspend a surgeons privliges pending review if they feel they are being attacked. If a customer spoke to a cashier at ACME like I'm spoken to on a daily basis, the customer would be thrown out of the store and possibly arrested. The day I can have doctor Bob Jones arrested and dragged out in handcuffs for asault or aggrivated menacing with the support and encouragement of my employer, then we will be on the road to solving this issue.
However, nursing staff is expected to put up with public humiliation because our 'customers' are sick, doctors are stressed, and families are in crisis. This mentality is wrong on so many levels. All people need to be held accountable for their behaviors and actions.Jun 27, '12 by elprupThere are over 600,000 allnurses members....just think, if we truly banded together, oh the things we could change!Jun 27, '12 by GitanoRN, BSN, MSN, RNQuote from elprupthere are over 600,000 allnurses members....just think, if we truly banded together, oh the things we could change!
needless to say, it would be a day of reckoningJun 27, '12 by JZ_RNHad called an MD (the medical director) about a possible infection like this once. (at a tube site) Called 2 times, paged, faxed. tried everything, no answer, no return phone calls despite leaving a message. Documented in the chart about the symptoms, wound, what I did with the dressing, and that I'd contacted the doctor (who was the attending and the only one that services that unit, and also is the medical director, who were are supposed to call if all else fails.) Called the manager and told her about the issue and she told me to try to call again in the AM before I left, which I did, then documented, and I also documented that I'd called the manager and explained the situation, and that I'd told the oncoming nurse about the situation, which I did. I then went home. She started screaming at me about the infection 3 days later, (I'd been off since that day) calling me incompetent, etc., etc. I told her I had called her and left the message, faxed her (I stuck the copy of the fax and the confirmation page in the patient's paper chart file), paged her, etc., that I called my manager, that I'd passed on the situation on in report, etc., and to read the chart (which she can access from home) and see what was done and what was going on. I then stated, "I did my job and won't be treated disrespectfully by a person who failed to do theirs." What am I supposed to do? Figure out where the MD lives and drive to her house after my shift for the orders? I can't give meds or treatments without orders. Anyways she never yelled at me again. I did everything I could and was required to do, and that I could do. I also covered my butt through documentation, so... That's the way some doctors treat nurses, sad but true. Poor patient is the only thing I could think.Jun 27, '12 by merleeCommuter - - It was not a bit clear from your original post where you wanted to go with this. The fact is, behavior in the healthcare setting has gotten worse, not better, over the years. Many many years ago I was floated to an ortho floor, totally unaware that a particular MD had 'standing orders' for his post-op patients. They were written on a piece of paper that the head nurse had in her drawer. She was off that day, and I was the only RN on the floor. So a patient came back from the OR with NO ORDERS. I called repeatedly to the OR, and to the supervisor, for orders. The supe apparently knew the situation but didn't know where these orders were kept. Long story short, the patient was 4 hours late getting her first dose of post-op antibiotics and this doc starting screaming at me in front of the patient and up and down the hallway. I wrote a letter of complaint about the way I was treated. The letter ended up in MY personnel file!!! However, the supe didn't write up an incident report against me that I was ever aware of. And I refused to float to the ortho floor ever again.
Years later, I watched an angry doc hang up a wall phone in anger - so hard that the phone came off of the wall. And nothing was done.
I taught for a time at a small school, and on payday our checks didn't arrive. I called the person who was supposed to take care of that, and he was not at work that day. So I asked to speak to his boss, who was not happy that I 'bothered' him. Ten minutes later, the person responsible called me back, screaming at me. I held the phone up so everyone could hear this, and calmly stated for him to call me back when he could speak to me in an appropriate tone, and I hung up. He called right back and spoke through clenched teeth. Our checks arrived the next day. But obviously our relationship was broken.
Why do we allow our peers and superiors to treat us so poorly? Why are so many of us afraid to say 'STOP'?
Why are people allowed to be preceptors without appropriate training?
What has happened to plain old civility???
If I get incorrect change in a store, I was taught to say 'Can you recount this for me, please?' Not scream and shout at the cashier.
As Rodney King once said - 'why can't we all just get along?'
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