Hospital bullies affect patient safety

snowfreeze, BSN, RN · Jul 11, 2008

Humm, what a refreshing idea. I would love to be backed by the administration for this.

Screen play for JACHO training film.

Doc sits down and starts softly cussing and tossing charts.

nurse "Hey doc, might we discuss this in the report room?"

Cussing gets louder and charts fly

nurse "this is unacceptable, please stop"

Cussing gets even louder and more charts fly along with a few nurses clip boards.

nurse " OK now we are heading to the medical directors office and we are inviting the DON" ( nurse tugs doc along by his hand which is trying to flail along with his other hand)

nurse ;as she is slowly walking down the hall, offending doc in hand..."Everyone please give me a signed statement of this event and get one from every patient and family member who witnessed this and fax it to #### medical directors office ASAP."

Whew, wiping brow....I liked that one!! LOL

mianders, RN · Jul 11, 2008

I have witnessed several doctors throw things over the years and nothing was done about it, but I have only seen one nurse do it and she was fired. The facility I am at does go out of its way to stop any kind of physician abuse, but it is still there. There is a zero tolerance for it from the other members of the healthcare team though.

SEENIT · Jul 11, 2008

Looks like good ole JACHO is going to step in, after 150 years of abuse. (That was sarcasm, btw.) This is an interesting article, but it is one of those "I will believe it when I see it."
http://www.msnbc.msn.com/id/25594124/
The thing I have found MOST disturbing is the place at the bottom where it asks readers if they have been abused in the healthcare system and many have replied it was NURSES who were the worst offenders. Tell me what you think.

I see some nurse managers participate in abusive behavior. If a doctor or a patient complains about a nurse the manager attacks the nurse not even allowing them to give their side. A good manager looks for the root of a problem and attempts to change the culture that led to the problem. In my opnion most errors are administrative based on poor administrative decisions such as poor nurse to patient ratios, lack of equipment, poor scheduling, poor communication, etc.

SEENIT · Jul 11, 2008

I have witnessed several doctors throw things over the years and nothing was done about it, but I have only seen one nurse do it and she was fired. The facility I am at does go out of its way to stop any kind of physician abuse, but it is still there. There is a zero tolerance for it from the other members of the healthcare team though.

I think staff Nurses who behave badly are more apt to be reported on than doctors or administrators. Higher ups tend to intimidate and staff may feel their will be negative consequences if they report abusive behavior. I can think of ne Doctor in my facility who has a reputation of treating staff poorly however he is rarely repremanded because he brings in a lot of income to the hospital.

ShayRN · Jul 11, 2008

I can think of ne Doctor in my facility who has a reputation of treating staff poorly however he is rarely repremanded because he brings in a lot of income to the hospital.

But, I have a theory about this...The doctor is making money at the hospital too. He makes his money by doing surgeries, procedures and rounds there. So if he doesn't have the ability to work at the hospitals because of abusive behavior he either doesn't make money or he changes his ways. The problem is, the hospitals need to be CONSISTANT, so that the bad ones can't move from one to the other. There are more than enough doctors to go around, surely if one can't control himself then they can find one who can. I feel the same way about nurses! If they are abusive to each other and/or to their patients- they need to go. I would never overlook abusive behavior from co-workers, it just isn't acceptable.

miko014 · Jul 11, 2008

You know what is my biggest obstacle to providing safe pt care? Too many high acuity pts at one time, and pts/visitors who step completely over the line of accetpable behavior. Picture it - your pt has a hgb of 6, and you're trying to hang some blood. Halfway through the process, you hear "Hey mikko014! I need you for a minute!" You turn around, and standing in the doorway is the pancreatitis pt's husband from down the hall. She wants to know why she has to be NPO, and he thinks it's ridiculous that she can't eat even though she is hungry. All this despite the fact that you just spent half an hour explaining it. He stands there looking in the doorway, watching what you are doing. You tell him you will be there as soon as you can, and tell him that for pt privacy, you need to shut the door now. After you're finished hanging the blood, you walk out into the hallway, where he is waiting for you, and he starts yelling about how dare you shut the door in his face, his wife needs you, blah blah blah.

Those details were tweaked, but it's not that much of a stretch anymore, sadly. Allowing the increasingly bad behavior from pts and their visitors contributes to the stress and anxiety on the unit. I try so hard to keep my temper under control, but it is very hard sometimes. I have had docs blow up at me or act like jerks, and I have told them what I thought about it. They aren't my boss, and they aren't better than me. But what can I say to a visitor who is way out of line, when the whole place is based on customer service? And how can I convince them that 5 pts it too many when it includes a brand new leuk, a plt count of 3 who won't stop bleeding, an IV push chemo, and a confused, climbing houdini?? I do the best I can, and if I blow up every now and then, well, I apologize.

Jo Dirt · Jul 11, 2008

I can only go by my few experiences as a patient. Most of the nurses were great, but it was the two who weren't that stick in my mind. One roughly jerked me around and talked to me like I was a terrible inconvenience and the other was a control freak purposefully restricting my pain medication when I hardly asked for it in the first place. Man, she was just plain old mean.

Maybe this isn't the right thing to remember about being a patient but I'd say most other patients are the same way: it's the bad one's that skew their whole memory of what their experience was like.

Jeffthenurse · Jul 11, 2008

Doctors are independent contractors, nurses are hospital employees. The doctors bring in the money and the nurses are easier and less expensive to replace. If all nurses worked for an agency or registry and became independent contractors, we could avoid the nonsense, be paid at a higher rate, and work elsewhere whenever we wanted.

Ruby Vee, BSN · Jul 12, 2008

i've seen a lot of abusive behavior over the years, most of it from physicians and surgeons. i've seen physicians smash a nurse in the face with a chart ("i wasn't aiming for her, i was aiming for him", pointing at another physician), chase a nurse down the hall with a bedpan attempting to throw it at her (ok, that was me and my preceptor), throw contaminated sharps at a nurse (the nurse, a former football player met him in the parking lot later, and the physican's manners were much improved) and yank a nurse's skirt off ("i was just trying to get her attention.")

but there was the assistant nurse manager who shoved me across the room and into a bedside table -- i had those bruises for months. there are the nurse managers who speak to their staff in condescending tones, refuse to listen to the nurse's side of any disagreement and even call their staff names.

and there was the respiratory therapist who had a meltdown at work, left the building and was last seen (by me, anyway) standing in the middle of a bridge screaming at traffic. there was the nurse who (probably under the influence of some controlled substance) screamed at her co-workers that they were all female dogs who were going straight to the hot place for being judgemental then aborted herself at work with a coat hanger and left a bloody trail from the staff restroom to the front door of the lobby. (she was put on administrative leave, with pay.)

it should be noted that all of these incidents were at least five years ago and not at my present place of employment.

bad behavior isn't limited to one discipline, but hopefully with increased attention on the side effects of the bad behavior, management will take it more seriously and put some standards into place. and then maybe we can all work in a safe, comfortable work environment and not have to put up with this negative behavior.

miko014 · Jul 12, 2008

I can only go by my few experiences as a patient. Most of the nurses were great, but it was the two who weren't that stick in my mind. One roughly jerked me around and talked to me like I was a terrible inconvenience and the other was a control freak purposefully restricting my pain medication when I hardly asked for it in the first place. Man, she was just plain old mean.
Maybe this isn't the right thing to remember about being a patient but I'd say most other patients are the same way: it's the bad one's that skew their whole memory of what their experience was like.

I work with a nurse who is notorious for refusing to give pain meds if she thinks the pt is seeking. I say if it's ordered and it's time, you can have it. I'm not going to be the one who says you can't have your meds - what if you really are in pain and are just stoic?? I would hate to have karma throw that back in my face! Sorry, I guess that's a little :offtopic:

woody62, RN · Jul 13, 2008

I find this thread very interesting because it is a topic on another message board I visit. The individuals there have expressed some what a disbelieve in the article. And one, who works for the National Health Service of Great Britain, went into detail about the ability of staff and others to report abuse and have action taken on it, without fear of retrobution. She find it difficult to believe that we did not have the same type of system set up here. Or that we are abused as much as the article stated.

Go figure!

Woody:twocents: