In a New York Times op-ed piece (link here), oncology nurse Theresa Brown recounts a recent situation when a patient “jokingly asked his doctor whom he should yell at” because a test result was late:
Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”
…As we walked out of the patient’s room I asked the doctor if I could quote him in an article. “Sure,” he answered. “It’s a time-honored tradition — blame the nurse whenever anything goes wrong.”
Brown goes on to discuss what many regular readers of this blog know already, namely, that workplace bullying is a significant problem in healthcare and that nurses frequently are on the receiving end of it from doctors.
Brown’s op-ed is sparking responses:
Blame med school
Physician Kevin Pho, in his blog KevinMD.com (link here), acknowledges that bullying is a problem in healthcare but criticizes Brown for blaming doctors. Instead, he notes the prevalence of bullying among nurses and points a finger at medical education:
…blame should be directed towards the physician education system, rather than doctors themselves. The hierarchical culture that perpetuates bullying goes back as far as medical school, when as students, future doctors are trained in a pecking order not unlike the military.
Pho makes a good point: It begins in med school. Indeed, modeling and validation of individual behavior start during one’s socialization into a profession. Whether we’re talking doctors, military officers, lawyers, or professors, messages are sent early in one’s training about the “proper” ways in which to act and work with others.
Offender as victim
Physician Ford Vox, blogging for The Atlantic (link here) is less diplomatic. He suggests that Brown’s concerns don’t add up to a lot:
So in 2011 a New York Times op-ed blaming doctors for sparking negative hospital cultures is rather passé and makes you wonder what makes it worth running such a ho-hum opinion, especially on a Sunday.
He goes on to characterize her concern dismissively, referring to it as a “gripe” and taking issue with her “bland, well-worn generalization” about the status of doctors.
And then Vox lowers the (predictable) boom:
What’s concerning and ethically dubious about Brown’s personal anecdote is its specificity.
Specificity? Huh?! Brown never identifies where she works, either in the text of the article or in the short bio line that follows.
Nevertheless, Vox elevates this into an ethical lapse because he was able to go on the Internet and find out where Brown works. He continues:
She gives enough detail in the column that many people at her hospital, especially “the entire medical team” present at the time, will know precisely whom she’s making an example out of. Using her platform at the Times, Brown just succeeded in royally bullying back the physician she’s just publicly accused.
Voilà!!! Vox manages to turn the offender into a victim and, in remarkable judo-like fashion, flips this into a question of Brown’s ethics.
Of course, had Brown not volunteered enough details to explain the context of the bullying situation she described, Vox might’ve criticized her for being vague and making a mountain out of a molehill. But as those familiar with workplace bullying know, context matters.
If I ever become a nurse, I sure as heck hope that I’m never assigned to Dr. Vox. He sounds like, well, a bully.
The good news
Think about it: A Sunday op-ed piece about workplace bullying in the New York Times, followed by responsive blog posts from the Boston Globe and The Atlantic. If you’re wondering whether the workplace bullying movement has gained traction over the years, this is evidence of its success.
Bullying in healthcare
I’ve written a lot on this blog about bullying in healthcare. For a four-part series of posts on this topic, start here.
Also of possible interest
Hat tip to Katherine Hermes, Connecticut Healthy Workplace Advocates, for the Vox blog post.