The Healthcare Hierarchy

[Pallspice_NP, MSN, NP]

Hey guys! I am a NP in the Dallas area with about 3 years of experience. I absolutely love the field of hospice and palliative care, and including my RN experience, have been happily employed in the field for about 6 years.

Throughout my work, I have experienced what many of you may have, the not so good effects of the "healthcare hierarchy." You know, where physicians believe they are superior to other members of the healthcare team...RNs superior to LVNs....NPs superior to RNs...the whole nonsense. I have been portrayed as incompetent or a "MD wannabee" by physicians, but also as "stuck up" by other nurses. I am an African-American female, and sadly, most of the judgement and harsh treatment stemmed from other African-American individuals. I am a HUGE advocate of each member of the healthcare team being supportive of one another, being leaders, fostering growth, and just rooting for everyone to reach their highest potential.

As a result, I have created a Facebook group where healthcare professionals, regardless of their role, can collaborate, network, chit chat, and be supportive of one another. If it is of interest, the group is called Minority Healthcare Professionals. The original intent was to bridge together the minority community, where I and many other colleagues, have experienced the most lack of professional support. But, I'm thinking about making it accessible to all healthcare providers in general, as I believe it would allow many more people to benefit. What are you all's thoughts? I hope I am not being offensive, or making generalizations. This has just been my personal experience for several years now, and I'd really like to impact the minority community in a positive light. Thanks for the feedback.

["nursy", RN]

My 2 cents is it would be helpful to open to all professionals, as this is not unique to minorities. I do find that a lot of that is influenced by the culture of wherever you work. If people higher up in the pecking order are allowed to be abusive (yelling, throwing things, being insulting, etc), with no repercussions, that behavior then trickles down. The abused become the abusers. But if the culture demands respect among all professionals, and there are repercussions for disrespect, that changes the environment where people are supportive of one another. I worked in an ICU where the cardiovascular surgeon was talented, but extremely difficult to work with, and it got so bad that he was mandated to have anger management classes and a life coach. It did a lot for the other employees' morale to know that admin had their backs, and the work environment in this particular hospital was pretty collaborative. But I know that in a lot of other facilities, someone who brings in the big bucks can get away with unprofessional behavior. And that engenders the type of behavior that you describe.

[magnoliablush, BSN, RN]

Firstly, I think it’s terrible that you’ve been dealing with this. I’m so sorry. I agree with what you said about “fostering growth” and each profession helping the other to be better. I’m an RN. Without more experienced RN’s, NP’s, and so on...I wouldn’t have been able to even make it through school. That support is key!

I would maybe open it to others, because it does happen in other groups as well. It’s awful, and what is allowed to continue, will continue.

Also, I see an NP. I think she rocks! ?

[Pallspice_NP, MSN, NP]

59 minutes ago, KierstenElizabeth said:

Firstly, I think it’s terrible that you’ve been dealing with this. I’m so sorry. I agree with what you said about “fostering growth” and each profession helping the other to be better. I’m an RN. Without more experienced RN’s, NP’s, and so on...I wouldn’t have been able to even make it through school. That support is key!

I would maybe open it to others, because it does happen in other groups as well. It’s awful, and what is allowed to continue, will continue.

Also, I see an NP. I think she rocks! ?

You're absolutely right and I love your thought process. It's just horrible how some people always feel the need to compete. With that, we lose sight of who we are supposed to be serving in the first place...the patient. And, their care becomes compromised when we are no longer working as a team. I'm so glad to hear of your wonderful experiences. There are definitely some good ones out there ? I appreciate your input. I will change the group name and allow all members of the healthcare team to join. You're right, the harsh treatment is definitely not specific to just one group.

[Pallspice_NP, MSN, NP]

@"nursy"

For some reason, I'm not able to quote your post. You could not be more correct about the work culture. The physicians, by far, are excluded from disciplinary action. I have experienced that time and time again with different employers I have seen it "nipped in the bud" on a very rare occasion when several employees voiced how negatively patient care was affected. So sad. I'm glad to hear that administration took a stand and listened to the employees in the ICU. That speaks volumes to employees! And, they are able to perform their role soooo much better.