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Upend the Hospital Hierarchy

Alexandra Wilson Pecci, for HealthLeaders Media, March 19, 2013

In less than a week, I've read two newspaper stories that told tales of doctors behaving badly. The first, from Kaiser Health News, recouned how a surgeon accidentally broke a surgery tech's finger because she was so angry the tech had given her an incorrectly loaded device to use.

In another, a nurse wrote a blog post for The New York Times about an incident in which a doctor, known for his bad temper, yelled the word "Why?" in her face when she questioned his judgment about a patient.

"This was intimidation, plain and simple," the author, Theresa Brown, wrote. "But it was also an example of a doctor's abusing the legal, established hierarchy between doctors and nurses."

The fact that doctors sometimes don't take nurses seriously, and that doctors sometimes rebuke nurses for questioning their judgment, isn't news. Both of these stories are among the many that describe doctors yelling at nurses who second-guess them, doctors berating nurses for paging them in the middle of the night, and doctors causing (or nearly causing) patient harm or even death because they didn't bother listening to their nurse colleagues.

In reading the post, titled "Healing the Hospital Hierarchy," I found myself thinking, not only about the terrible position these nurses find themselves in when physicians refuse to listen, but also about the word "hierarchy" itself. Is a hierarchal mentality among physicians and nurses really the best way to care for patients?

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5 comments on "Upend the Hospital Hierarchy"


Deborah Andrews (4/26/2013 at 2:45 PM)
It really is high time that nurses are viewed as the eyes and ears of the physician when they are not available versus as enemies. Nurses, especially seasoned nurses, have brains and are able to think critically. It's time that nurses receive the respect they deserve from the administration, patients, families, and physicians.

Jim (3/25/2013 at 11:34 AM)
why are there no jobs for RN's with no nursing experience?

Bruce Moskow (3/21/2013 at 3:50 PM)
Really? The US government with full on gridlock as a model for patient care? Was this intended as satire? Dr: Please hand me a 5-0 nylon suture so I can sew up this laceration. Nurse: I think the other Drs use a 4-0 prolene suture for this type of injury. Dr: Lets call a committee meeting and have hearings before a judge to decide this. Or perhaps the clerk at the front desk can be the tie-breaker.