The topic of bullying between doctors and nurses has exploded in the internet this week. Over the weekend Theresa Brown an RN and nurse writer wrote an Op-ed for the New York Times Well Blog, where she is a regular contributor, that has gotten quite a lot of feedback from medical and nursing professionals alike. Here is a sampling of the commentary out there:
Kevin MD, a blog written by Kevin Pho, an internist in New Hampshire, has posted about this op-ed twice-
Ford Vox, a physician in Boston, wrote an article for The Atlantic commenting on the article as well.
and Kristen Ziegler has blogged about this exact topic for advanceweb.com.
To figure out just why conversations and interactions like this take place, I think you have to start by examining the culture that was built and established in health care a long time ago. This culture of hierarchies still plays out in TV (which is where patients will very honestly tell you they get their medical information from). The doctor is at the top, nurses are in the middle, and assistants and janitors are at the bottom. The doctor is the boss, the nurse does their orders. While this is the way our healthcare system was established it still functions relatively the same way today though the participants and practitioners are of a completely different generation. Even as new generations of doctors and nurses transition into healthcare, the teaching is slow to adapt. The concept of interdisciplinary practice teams has been a big development over the last 10 years, but the doctor is still seen as the leader of the team.
I feel like everyone, doctors and nurses alike, are fighting to be relevant and appreciated for our intelligence. The part that is so important is that we aren’t fighting for the same practice. Medicine and Nursing have developed and differentiated into two completely different specialties. Nursing has established its own research topics and concerns separate from medicine. Medicine and nursing have different philosophies of practice, different methodologies of treatment, and completely different educational paths. Together they are part of making patient care holistic. Neither specialty could exist or function successfully in today’s health care system independently.
I can understand why Theresa Brown wrote about this topic, it would have been a very professionally challenging interaction for me as well. I didn’t read this article as “doctor-bashing” at all, I really read it as the beginning of a discussion on how we can all do better in health care, both doctors and nurses. She has a very large and wide-reaching forum to start a discussion like this-and did it successfully.
On the flip side, I can understand how this article can be viewed as a form of bullying back at the physician. He very possibly could have read this in the New York Times and I would assume, know immediately it was about him and feel very publicly attacked.
The one thing we really should take away from this heated discussion is a brand new awareness. To be excellent healers to our patients, we have to take care of ourselves and each other. It is the expectation of all of as human beings that when we know better, we will do better.