Nurses belligerent towards MDs

[FireStarterRN]

I was talking to one of our hospitalists yesterday. He and another doctor were talking about different experiences they had had elsewhere. This hospitalist said that when he was back in Philly, the nurses were the dominant force in the hospital and routinely yelled at and intimidated the doctors. This was a new twist on things because when I read here, it seems to be nurses complaining about abuse by MDs.

I'm very thankful for the relationships we have with the MDs where I work, which are based on mutual respect and congeniality (usually). Has anyone here experienced what this doctor describes?

[SharonH, RN]

How coincidental.

But more so, I find it appalling that posters on this BB, either make light of this behavior, make excuses for this behavior or try to deny that exists. Blowing it off as a "difference in perception", or that as there is no shortage in hospitalists, that it can't be that bad...is eerily reminscent of the treatment of rape or sexual harassment victims of the old days. Ignoring it just lets it continue.

Some MDs behave badly and some Nurses behave badly. We need to accept that and do something about it amongst ourselves, instead of finding a reason to ignore it.

And the other thing is as nurses, we SHOULD be nurturing new MDs, just as MDs should be teaching and nurturing new nurses. That is because it is a Heathcare Team taking care of the patient.

Oh now really, this is a bit much isn't it? Just because some of us hove not personally observed this behavior on a wide scale (becaue NO ONE denied that it ever happened), to compare it to past treatment of rape victims is quite frankly insulting to rape victims.

Belligerence is a matter of perception. What may be belligerent to one person may simply be someone who speaks their mind to another. That is what we need to accept.

As for nurturing new MDs, nope I won't do it. All I am required to do is maintain a polite and professional demeanor and make sure that patients receive quality care. If a situation arises in which it is necessary to teach a new MD, I don't mind doing it, I've done it before. I will nurture new(and old) nurses' professional development, I enjoy it and as a CNS, it is part of my job. MDs can and will continue to nurture and protect each other.

[leslie :-D]

of course there are nurses that are belligerent towards md's!

we hear/know of "horizontal violence" & "nurses eating their young/ea other".

why would md's be exempt?

nurses who disrespect their own colleagues, will certainly have no problem in disrespecting anyone else, md's included.

leslie

[CRNI-ICU20]

OUCH SHARON! Why is it beneath you to extend a hand of support to a new doctor or resident? Are they cryptonite to your species?? I think the poster was trying to help all of us understand the lack of compassion that some in the nursing and medical profession have for one another toward one another, and that it gets minimized much like the act of rape on a human being sometimes gets minimized as just being "mis-perceieved". I don't think that was out of reach to make that comparison.....and I don't think it is insulting to rape victims to do so....while the act of rape is heinous, the act of devaluing a human being ON ANY LEVEL IS JUST AS HEINOUS....and unless and until people GET THAT, bullying and abuse will continue. This attitude is often rooted in the need to dominate....as is rape....which is, what I took from the poster's notes....

One common denominator in conflict like this is to minimize the other party....this makes them an easy target to bully and exert abuse upon them....on a larger and more dramatic scale, the rapist does not see his victim/s as human, and therefore is able to hurt them without conscience.....this same thinking was rampant in Eastern Europe in the 1940's toward Jews, homosexuals, prostitutes, and handicapped people.

If we do this to one another, albeit on a smaller scale, by saying, "well, I won't give the time of day to a resident, or another nurse, or a brand new grad", then aren't we diminishing their personhood in such a way that they are "less than", and therefore make them a target of bullying and mistreatment? IF the new doctor was your SON or DAUGHTER, would you STILL say, "I won't lift a finger to help you?"

A person who can turn their back on a fellow human being just because of prejudicial perception ,diminishes human potential. WE all have value....and all of us deserve to be respected and treated with kindness and professionalism. I believe in the laws of getting what you give....it has served me well in my life....

When I die, I want to be able to say that I didn't purposefully devalue another...I hope you rethink what you just said in your post.....crni.

[SharonH, RN]

OUCH SHARON! Why is it beneath you to extend a hand of support to a new doctor or resident? Are they cryptonite to your species?? I think the poster was trying to help all of us understand the lack of compassion that some in the nursing and medical profession have for one another toward one another, and that it gets minimized much like the act of rape on a human being sometimes gets minimized as just being "mis-perceieved". I don't think that was out of reach to make that comparison.....and I don't think it is insulting to rape victims to do so....while the act of rape is heinous, the act of devaluing a human being ON ANY LEVEL IS JUST AS HEINOUS....and unless and until people GET THAT, bullying and abuse will continue. This attitude is often rooted in the need to dominate....as is rape....which is, what I took from the poster's notes....

One common denominator in conflict like this is to minimize the other party....this makes them an easy target to bully and exert abuse upon them....on a larger and more dramatic scale, the rapist does not see his victim/s as human, and therefore is able to hurt them without conscience.....this same thinking was rampant in Eastern Europe in the 1940's toward Jews, homosexuals, prostitutes, and handicapped people.

If we do this to one another, albeit on a smaller scale, by saying, "well, I won't give the time of day to a resident, or another nurse, or a brand new grad", then aren't we diminishing their personhood in such a way that they are "less than", and therefore make them a target of bullying and mistreatment? IF the new doctor was your SON or DAUGHTER, would you STILL say, "I won't lift a finger to help you?"

A person who can turn their back on a fellow human being just because of prejudicial perception ,diminishes human potential. WE all have value....and all of us deserve to be respected and treated with kindness and professionalism. I believe in the laws of getting what you give....it has served me well in my life....

When I die, I want to be able to say that I didn't purposefully devalue another...I hope you rethink what you just said in your post.....crni.

Please go back and read what I actually wrote. I did not state it was beneath me to extend a hand of support. I clearly stated that I would be glad to teach when needed, and I have done so before. I actually work with some wonderful physicians who have welcomed me with open arms; we are all on a first name basis, we often go out for lunch together and when they need something, it is my pleasure to assist and help them and vice versa. It is what a professional, respectful relationship should be. I would appreciate if you didn't put your own twist on my words. There is a long, long journey from my not feeling responsible for nurturing new residents to "bullying", "mistreatment" "abuse" and "devaluing" a human being. A very long way. It makes me sad when people read what others write and make some over the top interpretation.

And NO, me not wanting to baby a resident is not the same as the humiliating, dehumanizing treatment that rape victims have suffered in the past and sometimes in the present. You won't get me to go along with that. Oh and I loved you throwing in the treatment of Jews during WWII, that is a real gem. Can we please put this in a more reasonable perspective?

[SharonH, RN]

I was being sarcastic. There was a recent study done that stated that one of the reasons for the nursing shortage was due to poor doctor/nurse relationships. If I can find the link, I'll post it for you.

This isn't the article, but it's on target:

http://www.nursingspectrum.com/CareerManagement/Articles/nursephysician.htm

Here's the article:

http://findarticles.com/p/articles/mi_m0843/is_6_28/ai_94590407

Point is, there is no shortage of hospitalists and I have never heard of any c/o nurses who quit medical school or jobs or careers over maltreatment by nurses, but I have heard of nurses who have quit jobs, changed specialties, or left nursing altogether because of the way they were treated (at least in part) by doctors.

I did a quick, alebit superficial search on PubMed for articles to try to understand the depth of the problem of nurses abusing doctors, since some here insist it is a real problem and my denial of it is akin to the treatment of rape victims.

I used several search terms using the words nurses, nursing, physicians, residents, medical students, abuse, verbal, aggression, violence. I got dozens of results and studies referencing abuse of nurses by physicians. No big surprise there. It is a worldwide problem cited in low morale, affecting patient safety and is a contributing factor to the nursing shortage. Nurses abusing other nurses is also a big problem with the same results affecting morale and worklace retention, again no surprise. But I found NO articles referencing the huge problem of nurses abusing physicians. There were a couple which mentioned nurse abuse of medical students, and by a couple, I mean 2. The biggest issue for medical students is abuse and belittlement by attendings and residents. But sexual harassment and gender discrimination is apparently a HUGE issue for medical students and resident physicians also which is very sad to read in this day and time.

So if abuse of physicians by nurses is such a huge issue, then apparently they aren't worried about it, I don't know why we are.

[MAISY, RN-ER, BSN, RN]

Posts are a little ugly, I would imagine the saying "you reap, what you sow" applies here and anywhere a little common courtesy applies. Anytime someone needs help, it would be nice to oblige. Is everyone worth it....no. However, when a patient's outcome is involved, it is definately worth it to their health. People are only human, so imperfection is guarenteed! So be responsible for yourself and your own behaviours-let young mds and nurses learn how to be good workmates and human beings!

Of course, I have had bad experiences, but I have also had great experiences! I prefer to remember them, and continue to work on the others.

Peace,

Maisy;)

[SharonH, RN]

Posts are a little ugly, I would imagine the saying "you reap, what you sow" applies here and anywhere a little common courtesy applies. Anytime someone needs help, it would be nice to oblige. Is everyone worth it....no. However, when a patient's outcome is involved, it is definately worth it to their health. People are only human, so imperfection is guarenteed! So be responsible for yourself and your own behaviours-let young mds and nurses learn how to be good workmates and human beings!

Of course, I have had bad experiences, but I have also had great experiences! I prefer to remember them, and continue to work on the others.

Peace,

Maisy;)

Absolutely. We are all there for the good of the patient, no? Shouldn't their safe and effective care be our utmost concern? i don't know why it should be so hard....

[CRNI-ICU20]

I did read what you said, Sharon, and you said:

Oh now really, this is a bit much isn't it? Just because some of us hove not personally observed this behavior on a wide scale (becaue NO ONE denied that it ever happened), to compare it to past treatment of rape victims is quite frankly insulting to rape victims.

Belligerence is a matter of perception. What may be belligerent to one person may simply be someone who speaks their mind to another. That is what we need to accept.

{As for nurturing new MDs, nope I won't do it.] All I am required to do is maintain a polite and professional demeanor and make sure that patients receive quality care. If a situation arises in which it is necessary to teach a new MD, I don't mind doing it, I've done it before. I will nurture new(and old) nurses' professional development, I enjoy it and as a CNS, it is part of my job. MDs can and will continue to nurture and protect each other. }

Your writing is confusing....on the one hand you say you "won't nurture" and then in the next sentence you will offer to teach "if the need arises"....but that you are only going to do "what is required"....

So, maybe you could be more clear on your stance, because it's contradictory.

To clarify for you: I was not comparing the ACTS of genocide or rape with the acts of workplace bullying or devaluation as the same....I was comparing THE ATTITUDE underlying much of those acts as being rooted in the same place...ie, a workplace bully devalues another just as adeptly as a genocidal maniac devalues the lives of homosexuals, Jews, or people who were born with disablities. So my point was focusing on the ATTITUDE or spirit of meanness, if you will, and how it is remarkably similar in intent and agenda, to illicit pain and humiliation on another....I am sorry you seemed to have missed that point.

I am worried about the relationships between doctors and nurses, because I know alot of nurses and doctors who have had terrible workplace environments, and have left their respective professions because of it....we are in a nursing shortage and hospitalist shortage, you know....and we should do all we can to keep and maintain the goodness of our professions for the sake of health care in general....who, after all, will take care of us when we are old and infirm, if we run them all out the door? I don't agree that doctors aren't worried about how we treat them....I think they are hurt sometimes by the nasty rumors that are spread about them, which they can't even qualify with a response because it just makes them look more guilty, etc....I think some nurses among us are brutal with our mouths....and we should be honest enough about that to clean it up.....otherwise, we are no better than someone who beats their spouse....because it's the same attitude that motivates and perpetuates that meanness, it just comes out in a different action. If you disagree, that's your opinion....but I won't tell you that your opinion is "over the top", because to me, that sounds belittling and I refuse to growl at another that way.....

In your stated view, "belligerence is a matter of perception....what may be belligerent to one may not be to another, this is what we need to accept." :

This kind of mind set is EXACTLY the same mind set of: "well boys will just be boys..." "You were asking to be raped, just look at the clothes you were wearing..." "you deserve to be slapped, beaten, stabbed, because you are a stupid, fat cow and I have to teach you how to behave" Is that just a "matter of perception" on the part of either party?

No...I don't think I have to accept that belligerence is "just a matter of perception"....I believe we need to honestly call bullying, abuse, etc. just what it is....otherwise, as long as we white wash it, it will never get addressed and it will continue...

In my first nursing job, I was hauled into a room in the ICU by a clique of nurses on night shift. They placed a tape recorder on the floor, and told me that I was going to be taped, and that the manager approved of their tactic. This was because THEY perceived WRONGLY that I had/expressed some sort of lacking in my critical care thinking skills, and they decided I needed to answer for them...they ganged up on me...and it was allowed....because their belligerence was labeled something else....it was called "collaboration"....

I didn't perceive that they were collaborating WITH me....because they planned on trying to trip me up with their insurrectionist approach to cross-examination....they had already decided I needed to run their gauntlet...and by golly, they were determined to "make me pay"....the price was to bring me to tears....so they could all laugh and pat one another on their backs....as they left the room, one said, "see, I told you I could make her cry".....that was 15 years ago....and the bullying went on and on....until I moved to another city and state....

I don't think I mis-read belligerence here...nor do I miss it when I see it...and I CERTAINLY will never accept it when I see it happening to another....it's just wrong...

crni

[SharonH, RN]

Your writing is confusing....on the one hand you say you "won't nurture" and then in the next sentence you will offer to teach "if the need arises"....but that you are only going to do "what is required"....

Perhaps the confusion arises from the use of the words "nurture" and "teach". As I stated before I will not nurture. Nurturing to me indicates something far more involved than teaching a clinical skill or apprising residents of an institutional policy and procedure. It suggests personal and professional development, support, encouragement perhaps. I don't feel an obligation to go that far in assisting new physicians. They need help, I'll help I have no problem with that, but nurturing, no. And from that, you went to agendas, intent, bullying and humiliation. Sheesh. Who stated that it was okay to bully or humiliate anyone?

I don't feel a need to rethink anything. I am very comfortable with what I wrote and while you may not have stated that I personally have an attitude of meanness and bullying which invokes the spirit of genocidal maniacs(thanks for that at least), I resent that we are even going there.

[leslie :-D]

crni, what you encountered was mental abuse.

it goes beyond belligerence, and was incredibly cruel.

they should have been fired, period.

when sharon said that belligerence is a matter of perception, i have to agree with her.

there are nurses that may be naturally abrasive, or aren't wearing their 'smilie faces', that could be perceived as belligerent by those who may be timid, hypersensitive, nonassertive, etc.

yet if someone grunted at me, it wouldn't bother me in the least.

and so, it is a matter of perception.

there are so many personalities with whom we deal.

yet i have seen doctors and nurses with behavior so appalling, that i'm surprised they were still allowed to work there.

and so, i'm not talking about those with personality flaws.

i'm talking about behaviors where everyone's heads turn, mouths open, eyes widened.

i'm so sorry about your experience.

if i was there, i would have knocked them to the moon.

leslie

[CRNI-ICU20]

Okay....

I just wonder though, why you blasted the one poster who compared the attitudes of dismissal of these issues as the same that were reminicient of days gone by with rape victims....and then me when I also concurred that these same attitudes exist in many other areas of human experience, ie genocide, etc....I am thankful that you didn't take from my comparisons that there was some personal slant on you...because clearly there isn't.....I wonder what your resentment is about....why would you resent that comparison? It has nothing to do WITH YOU....it is comparing a similar, if not exactly the same, attitude....I do not understand your resentment of that, or even it's discussion....

For some of us here, who have been on the receiving end of bullying, mistreatement, victims of vicious gossip, it's helpful to not only understand the core of where this comes from, but it helps to be able to recognize it's tentacles. It is far reaching...

I don't understand why you would resent the comparisons....it isn't to diminish the trauma or the pain a rape victim experienced above that of someone who has experienced workplace belligerence...it is to try to help people see that many of the attitudes that people employ to control or dominate others is rooted from the same basic place....I don't understand why you would find that something to resent...

I look back on the many many many times that Doctors took the time to nurture me....to encourage me in my quest to become an RN and beyond....they didn't just do the minimum requirement....in fact, one physician group actually financed my last year of nursing school as a gift....I guess I feel differently about giving back....I was nurtured...and despite some of the bullying, many along the way were very very good to me....and, for me, I am not only happy to help a resident, new doctor, or even an older one with whatever it is that they need, but I am happy to stick up for them if someone is being really mean with their words or actions toward them....

I know this breeds good collaboration between us, and it ultimately provides good care for our patients.....

crni

[CRNI-ICU20]

Thank you also, Leslie,

You are right, it was mental abuse....and it was meant to control and humilliate me....those nurses were part of a "tradition"...much like the hazing that goes on in some frat houses....who were allowed, enabled, etc. to just do what they wanted....this hospital was a "union" shop...so firing someone would have been miraculous....the night shift was particularly unprofessional....they would give each other back rubs...sleep.....and even gave one another hair cuts while on the job!

The manager just looked the other way...and then they promoted her to director of nurses! go figure! The carnivore attitude there was awful....and I vowed I would not ever become like them...

In my exit interview, I had in the last year before moving, lost about 50 pounds....and had received many kudos for my weight loss....the coup de grace for me was in the interview, the manager said, "well, I must say that your weight loss is remarkable.....and it shows in your patient care!!!???" I almost fell off my chair....apparently, some are so detached from self-awareness they actually believe a statement like that is okay! Last I checked, commenting on someone's weight in an interview setting is grounds for labor law violations....

I agree, some people can be oversensitive....

However, I don't think people who mistreat or gossip or backstab someone should get a pass with, "just perception".....to me that's just labeling abuse as something other than ABUSE....and until nurses and doctors OWN their behaviour toward one another, that kind of stuff will continue....jmo.