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. Nurses Relations Article

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.

work-cited.txt

Commuter - - 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?'

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Somthing doesn't sound right, Hmmmmm. Oh yes now I see it. I can't picture an IM physician who gives enough of a crap to get upset over anything except being inturupted during a nap. Certainly can't picture that physician caring if a patient has been neglected (in her view).

I find the best way to deal with physicians is to right away give them them impression, without actually ever saying so, that I would be happy to catch them alone in the parking lot and teach them a lesson if they mess with me. A stratagy that has worked well for me for many years.

Specializes in Emergency/Cath Lab.

Two words....Sack up. Oh you mean I dont have to be walked all over and treated like crap? Duhhhhrrrrrr

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I think the "point" of this ARTICLE, is to keep rmeinding us that if we aren't trying to be a part of the solution, we are a part of the problem.

Personally I think manners and behaving appropriately are missing from the public in general.

Whether or not a person has made a mistake, there's no excuse for that kind of public humiliation behavior. I'm interested to hear other's methods or response phrasings for both undeserved public humiliation AND the times when the person being humiliated actually has underperformed and/or made an error. I haven't yet had to deal with being humiliated in either situation, but it seems like it's only a matter of time in the current culture.

I am currently a pre-nursing student and have previously worked in the construction industry where there can be alot of disrespect and butting of heads. I learned from a retired California Highway Patrol Officer how to deal with angry, yelling people. I expected him to put the lady in a choke hold and yell back, but he didn't. He squared up to her, looked her in the eye and told her that she didn't need to yell and to calm down. He softly,but firmly told her that we would get this misunderstanding figured out.

It didn't quite work in that situation, the lady called her husband and threatened to have him beat us up. Luckily, the husband turned out to be a real nice guy.

The point is to not worry, remain calm, don't feel humiliated, be strong and do the right thing. Above else, please don't lose your professional nature and yell back. You will appear stronger to your co-workers if you don't shrink to that level. Yelling doesn't benefit anyone unless they are 50 yards away and you are giving them your lunch order!

So here's my question, when you see this happening to a colleague, do you:

a. Duck into a room-quick

b. Offer no comfort at all, these new grads need to toughen up! Nobody ever helped me.

c. Talk in the break room with other staff, critiquing this new nurse's performance.

d. Go and stand next to your colleague while Dr. Tempertantrum carries on. Offer your support and reassure the nurse of your confidence in his/her abilities.

So here's my question, when you see this happening to a colleague, do you:

a. Duck into a room-quick

b. Offer no comfort at all, these new grads need to toughen up! Nobody ever helped me.

c. Talk in the break room with other staff, critiquing this new nurse's performance.

d. Go and stand next to your colleague while Dr. Tempertantrum carries on. Offer your support and reassure the nurse of your confidence in his/her abilities.

Is your answer different if it's an experienced nurse being verbal abused/humiliated?

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.
so here's my question, when you see this happening to a colleague, do you:

a. duck into a room-quick

b. offer no comfort at all, these new grads need to toughen up! nobody ever helped me.

c. talk in the break room with other staff, critiquing this new nurse's performance.

d. go and stand next to your colleague while dr. tempertantrum carries on. offer your support and reassure the nurse of your confidence in his/her abilities.

at this level, i mus admit i always been the type that stands up for the underdog even when they have committed a wrongful act. having said that, the multitude of occasions in which i have witness this behavior which is called "lateral abuse" i have intercept on behalf of the victim and maybe because of my physical statue the offender tends to back down. however, i'm the first one to inform the victim to make sure that he/she needs to stand up for their rights, because no one has the right to belittle us in any shape or form. with that said, i will quote the following... "no one can make you feel inferior without your permission" eleanor roosevelt

Specializes in Emergency & Trauma/Adult ICU.

One thing I notice in the article is the presumption that the nurse will feel "humiliated" by the individual doing the ranting, instead of that nurse (and others present) feeling shocked and disapproving of the unacceptable behavior occurring on the part of the out of control adult professional.

And this is what continues to puzzle me about healthcare workplaces.

Why is it that healthcare attracts the subset of the adult population that seems not to have learned somewhere around age 3-4 that it is unacceptable to demonstrate tantrum behavior? That subset includes both the trantrum-throwers and those who tolerate it.

I have to say I very rarely encounter this type of scenario. I believe my age and overall demeanor have a lot to do with that - I do not present an easy target. The overall cultures of the places I have worked as a nurse have also not supported that behavior. We had one physician with some self-control issues where I used to work, but everyone pretty universally ignored him when he began raising his voice or slamming papers around.

What would you do if your child began throwing a tantrum in pulic? Approaches vary, but what they have in common is letting the child know in no uncertain terms that the behavior will not be tolerated.

Specializes in telemetry, ICU, cardiac rehab, education.

I had a surgeon yell at me to make a patient get out of bed--in front of the patient. I had just medicated her and we were working toward getting out of bed (for the first time post op, a sweet 80+ y/o woman). Then he yelled at her that she was going to die if she didn't get out of bed?? She burst into tears and he left the room. I calmed her down, got her out of bed then called him to come back to see her sitting in the chair. Surprisingly enough, he did come back and apologized to her but of course, not to me. This is after he had completed his hospital mandated anger management class. HAHA right!?!

So here's my question, when you see this happening to a colleague, do you:

a. Duck into a room-quick

b. Offer no comfort at all, these new grads need to toughen up! Nobody ever helped me.

c. Talk in the break room with other staff, critiquing this new nurse's performance.

d. Go and stand next to your colleague while Dr. Tempertantrum carries on. Offer your support and reassure the nurse of your confidence in his/her abilities.

A colleague of mine called a doc about a patient, she suggested getting a lab, he gave a very non-committal answer and said he was finishing up in ICU and would be over. She asked all of us what we thought about going ahead and getting the lab, and she made the very good point that he might want more bloodwork than just that, so we all agreed that waiting until he got to the floor wouldn't affect care significantly but could avoid an extra stick. (And in peds respiratory distress, avoiding extra sticks is actually important, we don't want to freak out the kid and tire them out more than necessary.)

So he comes over finally and asks if we got the labs, and she explains she wasn't sure if he wanted it and does he want other labs along with it. He gets smart with her. I was sitting there and turned to her and said, "So now you know for next time that you'll need to read his mind, so work on your ESP skills." He immediately changed his tune after that.

Point being, yes, sticking up for our colleagues is important. But she didn't actually even need me to, as she remained completely together and professional despite his being an idiot. I imagine he'd have not gotten very far even if I hadn't said something.

I really liked what Altra said:

One thing I notice in the article is the presumption that the nurse will feel "humiliated" by the individual doing the ranting, instead of that nurse (and others present) feeling shocked and disapproving of the unacceptable behavior occurring on the part of the out of control adult professional.

There's no reason to be humiliated by someone being an idiot. THEIR behavior is wrong. Stick up for yourself. My usual line of defense is a smart aleck response. I like others who say things like, "We can continue this conversation when you can do so in a professional manner."

Instead of worrying so much about bullying and lateral violence, we need to worry more about how we each carry ourselves. Be a strong, confident human being that won't accept someone treating you in that kind of manner. If we all did that, the "bullies" would have nobody to successfully pick on and will die off or change their behavior.

But instead of working on being confident and strong, a lot of people seem to find more comfort in playing the victim and complaining about lateral violence and bullies and NETY, instead of plain just not accepting it.