Every doctor depends upon the nursing staff. It serves as a widely dispersed “sensory network,” extending the doctor’s eyes, ears, and fingers into every room of the hospital. The nurse is, de facto, the “face” of medicine the patient most often sees. An experienced, competent nurse is worth more than all the digital monitoring equipment in the world. Conversely, if a nurse really has it in for you as a doctor, they can make your life (and that of your patients) an absolute misery. Sometimes this may seem the only way a nurse can get a doctor to change behavior.
I’ve seen plenty of abusive behavior towards nurses by physicians that would make anyone blush with embarrassment. Surgeons flinging stainless steel instruments—even scalpels--around the operating room in fits of rage. A doctor cupping a nurse’s rear end or breasts as casually as if he were fondling fruit in the produce section. Physicians ruthlessly tormenting nurses with guilt, leading the nurse to believe that he or she was entirely responsible for whatever calamity befell the patient. Too many male physicians take advantage of vulnerable women in the nursing profession for mere sexual conquest. Some doctors publicly humiliate nurses till they have brought them to the edge of emotional collapse. Heck, I heard about one attending who started demonstrating his judo moves to his residents by flipping one of the nurses down onto the linoleum floor! I am not exaggerating when I say that there’s virtually no form of abuse that has not been perpetrated on nurses by physicians.
Now please don’t start sending me e-mails about how could I think bringing cookies could in any way make up for such inappropriate and abusive behavior! It doesn’t. The way we stop physicians from behaving like brats, bullies, and criminals is to bring ‘em up on charges. Make them accountable for their behavior. Bring them up in front of the hospital executive committee. Discrimination, harassment, and abuse are not just bad, they’re crimes! I’ve brought my own faculty members up on sexual abuse or discrimination charges in front of our University Office of Equal Opportunity. There is simply no other way to stop such behavior than to call each and every individual out into the open and hold them responsible for how they behave at all times, under all circumstances, and with every type or group of individuals.
Edmund Burke wrote: “The only thing necessary for the triumph of evil is for good men to do nothing.” The last thing any of us in the medical profession can afford to do is stand by while the evils of harassment and abuse go unchecked. I would want to severely punish anyone who harassed or abused my own daughter or wife. Why should I feel different about anyone else’s daughter or wife?
A basket of cookies does not undo evil. I mean “bringing cookies” in the sense of doing something personal to show the nursing staff how much they mean to us, as physicians. I was present when a disturbed male nursing student went on a shooting rampage in our own College of Nursing at the University of Arizona, leaving three of our best and brightest nursing school faculty members dead. The killer stormed into the building, shooting his teachers as he moved through the hallways. He left some final notes behind to be read after his suicide. Much of his muddled ravings were dedicated to expressing his seething resentment of these “women teachers” who were in a position to judge and grade his performance during class. It drove home some of the quandaries that exist for the nursing profession: the hesitation so many nurses feel between possessing power and exercising it. No such restraint is expressed to physicians. On the contrary, we tend to excessively groom doctors for command. Hesitation is discouraged as we’re inclined to see it as weakness, indecision. Our motto: “Seldom wrong. But never in doubt.”
I’m concerned about the future of nursing being sucked into “downward spiral” of twenty-first century Medicine. For so long, the sphere of the nurse was distinct and different from that of the physician. As pressures built to garnish higher salaries for physicians in a market place that’s been ratcheting down reimbursement for more than a decade, we find ourselves at risk for substituting the nurse to fulfill the doctor’s duties. In turn, the nurse’s real responsibilities are being “dumbed down” so that direct patient care jobs can be handed out to individuals with no other qualifications than a high school diploma. It strikes me that this essential ingredient of human touch and contact cannot be delegated to the unprepared, the unaware, and the uneducated. All of this has to also be depicted against the largest shortage of nursing personnel and the highest level of unfilled nursing positions ever experienced in America. For the first time, modern medical institutions must wrestle with acquiring nurses or being forced to close their doors.
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