Doctor Bullying and ‘Ward Rage’: The Challenges Faced by Nurses Every Day
Nursing is not an easy profession. (Photo: Corbis/Helen King)
Most people would agree: Nurses are the unsung heroes of the hospital system.
Emphasis on the word unsung.
Not only do they put themselves in danger every day — they’re at the front lines of illness, after all — but they also face risks such as violence by patients or visitors, and burnout from too-long shifts that don’t allow time for snack or bathroom breaks.
Award-winning author Alexandra Robbins shared with Yahoo Health some of the surprising truths she uncovered during the reporting and writing of her new book, The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital.
What is it that prompted you to want to delve deep into the topic of nurses in your new book? Was there a specific impetus or inspiration?
Nurses asked me to write the book because they wanted their stories and their secrets told in the kind of nonfiction book that’s fun to read on the beach. So I followed four nurses — Molly, Lara, Juliette, and Sam — for a year to give readers “main characters” and storylines they could sink their teeth into, interviewed hundreds of other nurses, and also included some undercover reporting to get the real scoop on what goes on in hospitals behind-the-scenes.
You uncovered some not-so-pretty things that nurses face, like doctor bullying and “ward rage.” Can you explain?
Many doctors exhibit a blatant disrespect for nurses: berating them, ignoring their calls when a patient needs help, and even throwing scalpels and other instruments at them. Doctors mistreating nurses can harm patient care. Studies have shown that communications breakdowns between health team members are responsible for a significant percentage of unanticipated patient deaths or injuries. Certainly there are wonderful, caring physicians out there, too, but doctor bullying is a major problem that one physician described as lurking in the “shadowy, dark corners of our profession.”
Molly, one of the four nurses I followed, was physically assaulted by an infectious patient, which led me to look into “ward rage.” Violence against nurses by patients or visitors has increased in recent years. Nearly nine out of 10 ER nurses say they were assaulted at work during the last three years. Several nurses told me that every nurse they know has been physically assaulted by a patient. This is distressing as is, but what’s just as bad is that many workplaces, administrators, and lawmakers make nurses feel that being punched, spit on, scratched, bitten, kicked, or shoved is just “part of the job.” It would not be so difficult for hospitals to install metal detectors at entry points, bulletproof glass in triage, extra security personnel, or computer software that flags patients known to be belligerent. But unfortunately, protecting nurses does not appear to be high-priority at many of these institutions. That has to change.
What is the biggest misconception people have about nurses and what they do every day?
TV shows get the picture completely wrong, portraying doctors pining away for hours by patient bedsides while nurses just flit around in the background fetching things. Nurses actually have a much broader scope of practice than the general public assumes. In 21 states, nurse practitioners can practice independently. In hospitals, nurses are the ones who coordinate patient care. In schools, nurses are responsible for hundreds of patients at once. Nurses are the unsung heroes of the hospital and they deserve our respect and recognition.
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What is the biggest struggle nurses face that you found in your reporting?
Understaffing. California is the only state in the country that has safe staffing nurse:patient ratio laws. Anywhere else, hospitals can assign nurses many more patients than the safe maximum, and many do (and nurses tell me that some California institutions skirt the rule by cutting aides/assistants, which piles more work on the nurses). This is a disaster that affects all of us. When nurses have fewer patients, not only do the nurses have better health, but also the patients are less likely to die, get infections, suffer complications or falls, or be readmitted to the hospital. It seems like a no-brainer, simple answer to improving healthcare: Hire more nurses and treat them well. But too many hospitals cut corners, putting nurses and patients at risk rather than prioritizing health and safety.
During the Ebola scare last year, nurses’ safety and rights were thrust into the spotlight. In your reporting, have you found that anything has changed on that front since then?
Even if some hospitals have put measures into place to try to prevent nurses from contracting rare diseases like Ebola, that doesn’t even begin to touch the surface of the rights and safety precautions that nurses deserve but still don’t get. Getting nurses fitted for spacesuit-like gear so hospitals can say they are prepared for the extremely low chance they treat an Ebola patient seems silly when you consider that nurses are regularly the frontline responders to patients who include gang members, inmates, addicts, arrestees, and other potentially dangerous people. Every day, nurses are physically assaulted. Every day, nurses are assigned more patients than is safe. Every day, nurses are expected to work long shifts without breaks to eat or even to go to the bathroom. Where are their basic protections? The public needs to know about this because if nurses aren’t protected, then neither are we.
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