Beyond bacteria, virus, and molds.
Were you a fan of the TV show “House”?
If so, you may have come to accept Dr. House’s rude, uncivil nature because he was such an awesome physician. After all, he pulled off a medical miracle every Monday night!
When it comes to your own medical care, you might tell yourself that you’d rather have a really smart nurse with a “gruff” bedside manner than a less-than-average caregiver with a bright and cheery disposition. After all, what does it really matter if there is underlying conflict, gossiping or bullying going on if it doesn’t affect your care?
And therein lies the problem—a very big problem.
Disruptive and inappropriate behavior between healthcare co-workers does affect patient care. In fact, a brand new book called The Real Healthcare Reform written by two veteran nurses, Linda Leekley and Stacey Turnure, contends that an epidemic of incivility infects most healthcare workplaces. This situation has become so serious that the premier accrediting institution for healthcare organizations, The Joint Commission has spoken out about this issue.
In annual surveys, the public puts healthcare professionals on a pedestal by consistently giving them high marks for honesty and ethics. While nurses are often our neglected “heros” of health care services and are the most compassionate and caring individuals by nature, this does not mean that there may not be trouble brewing under the surface for a variety of reasons.
So, how is it possible that all these honest and ethical people have become so entrenched in a culture of incivility?
Here’s the scoop.
The medical field is fast-paced, competitive and constantly evolving. And, because human lives are at stake, people in healthcare shoulder a heavy responsibility. When you blend all these factors, you get people who tend to feel powerless, stressed out, depressed or even angry. That can lead to a toxic work environment—and “polluted” patient care.
Consider these all-too-common scenarios:
Two nurses, Beth and Karen, have a longstanding feud at work. When one of Beth’s patients asks Karen to tell her nurse she is in pain, Karen conveniently “forgets” to tell Beth. Who suffers because the nurses don’t get along? The patient.
Tom, a nurse, yells at the nursing assistant, claiming she is slow and lazy. Afterwards, the nursing assistant is so flustered that she misreads her patient’s vital signs. The patient’s spike in blood pressure gets missed. Later that day, the patient has a stroke.
When Anne, a nurse, suggests to Dr. Wilson that his patient may be suffering from undiagnosed diabetes, the doctor belittles her and disregards her opinion—because she is “only” a nurse. The patient does have diabetes and it continues to go undiagnosed.
So what can you do about this pervasive problem? Here are a couple of suggestions:
1. Call for a Truce! Don’t tolerate incivility when you witness it. If you notice two healthcare professionals being rude to each other, speak up! Tell them that you know incivility affects patient care and you refuse to be the innocent victim of their bickering.
2. Reward Respect. When people are taxed both emotionally and physically, finding the energy for civility can be tough. So, when you see respectful behavior among healthcare co-workers, offer a bit of praise. Let them know you feel safer because your caregivers make the effort to work well together.
3. Nurture the Nurses. Healthcare professionals are so busy taking care of everybody else, they frequently forget about themselves. I have seen this played out with nurses more than any other healing profession.
If you are in the healthcare field or know of someone who is gently remind them that erratic work shifts and increasing responsibilities can play havoc with circadian rhythms affecting weight, blood sugar and mood. In addition to exercise and stress management (especially mind-body activities like yoga, massage, and meditation), eating protein and fat at every meal and snacks will keep nerves stable.
Supplement wise: All caregivers should consider the adrenals. Adrenal fatigue is very common in the healthcare workplace. Caregivers often prop themselves up with coffee and colas to keep going. Consequently, their exhaustion results in irritability, anxiety, and lack of patience.
To further augment tired adrenals, a high dose, yeast free B vitamin supplement is essential. Consider a formula which features at least 50 mg of each of the Bs including B-6, the precursor to serotonin and norepinephrine, the brain chemicals connected to feelings of well being. For all of my nurses, I also suggest Ultra H-3 to help normalize acetyl choline synethesis—another brain chemical which elevates mood, calms the nerves, helps memory retention, and produces sounder sleep—all of which enhance the ability to cope better with stressful situations of all kinds.
4. Spread the Word! If you work in healthcare of you know someone who does, visit www.embracingcivility.com or check out The Real Healthcare Reform book for targeted, action-oriented information and specific exercises to help “detox” the work environment.
Is this truly something that has gone under the radar or is it something you are aware of and have experienced?
Dear Judy,
It’s unfortunate that you had such an unpleasant experience while you were in the hospital last January. Obviously, I can’t speak to the nurses’ behavior…only you and the nurses involved know what happened.
However, I am saddened that you feel so strongly about the nursing profession in general. Nurses are like everyone else—people with flaws and strengths. But, most physicians will tell you that they would be lost without nurses by their side. Here’s what one physician, Dr. John Flannery, wrote about the nursing profession:
“Medicine without nursing would be a violin without bow and rosin. They are the contact point of caring.
Medicine without nursing would be breath without air. They are the breath of medicine.
Medicine without nursing would be like trying to fly with one wing. Nurses provide balance to medical care.
Medicine without nursing would be like trying to fly without radar. They are the watchful eye of medicine.
Medicine without nursing would be body without soul. Nurses are the spirit of healing.
I take my stethoscope off to nurses.”
Obviously, in any profession, there are people who are excellent at their job and people who struggle at work. My co-author, Stacey Turnure and I, wrote our book, The Real Healthcare Reform, to support our fellow healthcare professionals, many of whom are doing their best in a stressful work environment and who feel overworked and underappreciated.
Personally, I have never known a nurse who intentionally caused harm to a patient. And that includes the times that I have been the patient, not the nurse! Ann Louise’s blog article points out the potential safety issues that can arise when nurses are stressed to the max…a very common situation in today’s healthcare workplaces.
Please consider these facts: The average age of a nurse in the US is about 45. And the majority of nurses are over 50 years old. That means that within the next decade or so, America will lose about 55% of its nurses to retirement. This will create a critical shortage of nurses. We need 1 million more nurses by the year 2020!
It is important to encourage and support people who devote their life to nursing. By providing current nurses (and nursing students) with the tools and strategies they need to create a more harmonious workplace, we can help reduce some of the extraneous on-the-job stresses and let them get back to their passion: high quality, safe patient care.
SarahB says: I’ve only been in a hospital as a patient twice: for my two ceseareans. This was two decades ago. I remember today the care I got from my nurses. My first pregnancy went sour and I had toxemia and ended up with a breech labor which my doctor decided needed to terminate in a cesearean because my baby was in distress. My labor nurse held me while I received the epidural, she was there to check me constantly and make sure that i was OK, she allayed my fears. My baby girls was born with the chord wrapeed aroundher neck and she was dark purple when she came out of me. They revived her. I was in hte hospital for five days and my nurses taught me everything: how to take care of my baby, they made me walk and cough to get my body working on its own again and they took care of me. They gave me the kind of care I would like to have received from a mother if I had a loving one (I don’t). I cannot imagine life without nurses. Years later, as a nutritionist, I have had a number of nurses as clients. Hoepfully, I have paid back a little of what I have received. Nurses on shift work suffer greatly. As Ann Louise Gittleman said, they have really stressed adrenals and it is unfair. The ones I am really mad at are the HMOs and many of the doctors. A doctor never needs to be rude to a nurse! Nurses give far more care to patients than the doctors do. HMOs have been the downfall of everything. I spent 5 days in a hospital after my cesearean. That was standard then. A few years ago, my mother, who had triple by-pass heart surgery, was sent home after two days, to be cared for by my father, who was dying of cancer. This is a great shame and a blight on our country to have been driven into a situation where healthcare has a “bottomline” and that is the most important consideration. Healthcare in this country is shameful. Worse than many third world countries. But not becasue of nurses! Because of the restrictions and limits and paperwork put on them due to the greedy corporations that run hospitals and HMOs. I am guessing a lot of nurses would love to be able to proactice nursing and much more so than filling out the endless paperwork they have to do.
Judy says: I’m sure there are good nurses out there. I’m not saying there are not.
I had the misfortune to work at the board of nursing in my state, and there was always
a “doctor-wanna-be” when dealing with state wide licensing issues. and THEY WERE IN CHARGE. While in my office, they would tell me this. The presumption that they were going to exercise their so called “authority” while in my office. I had to follow state rules in licensing, and I could NOT change the rules JUST FOR THEM.
I trained for the exams for massage therapist, and THE ABSOLUTE WORST CLIENT, WHILE IN TRAINING WAS A CONTROLLING, PISSED OFF nurse in training(in the same building at the same school). She wanted to talk “shop” while on the massage table. It took me a while to get her to come down off her “trip”, and just try to relax and enjoy relaxation, the peaceful flute music going on in the back ground, and not to “take charge”…….I have 10 more stories like this one. But I sincerely don’t have the time or desire to reiterate what I already know.
For whatever reason, nurses at every turn keep driving home their need for control, manipulation, and yes even beligerence. I’ve met so few nice ones, that I cannot speak to an example as sighted by our friend who was glad to have a nice and supportive nurse
during her difficult pregnancy and delivery.
I request that you stop trying to talk me into believing what you believe by siting your own stories and sources. I’ll site mine, you site yours, and I’ll let you know if I ever meet a nice nurse! I’ pretty sure I know what plays in the back ground here!
Katie, RN-BSN says: Proud Nurse,
I am a nurse. that is proud to say, “I love my patients’, even those that hate us. Because if I can get through to just one of those people that swears up and down that we are harming rather than helping them, then I know I have made a difference.”
We wake you at all hours 24/7/365. We poke and prod you for blood. We make sure you take your medicine, crushed or whole. We stick tubes where I would rather not say. And all while we are doing this we try to make you smile, and distract you from the worst time in your life.
Because who wants to be in a hospital? Who wants to be sick for days without being able to fix it themselves? Nurses are there to help you through all of this and more.
I will say that nursing for me is a selfish career. I feel a wonder come over me every once in a while that we are able to help people with such debilitating diagnoses. And that when you look up at me and I see in your eyes how grateful you are because I just cleaned the vomit from your hair, or stopped your pain, or made you smile at the end of a harrowing day, that is when I feel wonder.
I hope that one day you meet a nurse and do not automatically be a pessimist. The glass is half full, if you let it be.
Sincerely,
Nurse Katie
I have some stories about personal experiences that would curl your hair if it is straight, and straigten your hair if it were curly. I had my lap band removed this last January (2012) at a local, so called, wonderful hospital. At about 3:30 in the am I had three nurses wake me up, stand around my bed, tell me they were only doing their jobs, etc.
While there is quite a lot to this story, the ends did not justify the means. and the three nurses who were yelling at me, were absolutely NOT doing their jobs.
I told them I would get up and leave, which I did at 4 am. I was finally able to get a cab and get back to my house.
I did call their floor supervisor and told him in detail what happened. He was appauled.
He did encourage me to write a letter to the administration, and to the board of nursing (the state regulatory agency that dispenses license to practice, and also disciplines these sorts of violations.).
I talked to a friend of mine who encouraged me to not pursue any further action.
I did opt to follow his advice since he is a health care professional himself.
I’ve questioned my decision since. When I saw my doctor at my next routine check up for post surgery, I told him in detail what happened. He was also appaled by this outrageous behavior.
I don’t know what type of disciplinary action was taken. I guess I’d like to know, ultimately. But I will never return to that hospital and I will most likely follow through if there should ever be a next time, in regards to this outrageous behavior.
I hate nurses and everything about them, and when someone tells me they are a nurse, I am for sure looking to see what level of “bitch” factor they are operating at. I find a lot of nursing are controlling, rude, even obscene.
I can’t imagine the hatred nurses have for the people they claim to “serve”.