Summary
What can you do when your attending physician is a bully? Hear from two nurses, Melissa and Laura, about their experiences being bullied by a physician. For Melissa, it was notifying an on-call physician that a baby was ready to be delivered, only to be scolded for calling too soon. For Laura, it was being reprimanded by a physician who questioned her abilities as a nurse in front of a patient.
So how do you respond to a bully, especially when the bully is in a position of power? Connie spoke with Carolyn Smith, an associate professor and associate dean of research, and author of “Standing Up Against Workplace Bullying Behavior: Recommendations From Newly Licensed Nurses” for insight. Carolyn, Melissa, and Laura all weigh in on standing up for yourself, calling out bullying, and sticking to your boundaries.
Episode Guest
Carolyn Smith
Carolyn R. Smith is an associate professor and director of occupational health nursing graduate programs at the University of Cincinnati College of Nursing. She conducts research examining worker health and safety with a focus on issues of workplace aggression, bullying, and violence experienced by healthcare workers.
Transcript
DDx SEASON 8 | They Don’t Teach That in Nursing School, EPISODE 4
When the Doctor is the Bully
Melissa: He started to advance towards me with this angry look on his face and says, “Why didn’t you do what I told you to do!?” And all of a sudden the hallway just stopped. I just felt like time stopped and I froze and I felt myself shaking a little because this doctor was several inches taller than me. He looked like a powerlifter. You could see the ridge of each of his arm muscles kind of poking through his scrub top. And I just started to back up towards the wall because I was afraid that he was going to punch me.
Laura: As I was coming in with the insulin, the doctor, the endocrinologist, came in and he’s like, “What the hell are you doing? Do you know how insulin works? Where were you educated? Do you need to go back to school and learn how to actually give insulin?” This is in front of the patient and he wouldn’t listen to anything I had to say.
He goes, “It’s obvious you don’t know what you’re doing.” And he walks out of the room. I walked out of the room, got my charge nurse and told her what happened. I just started crying and I could not stop crying. And it just came out because I just, I couldn’t believe someone would just, yell, it just was so embarrassing and just, oh, I never, ever imagined that happening to me as a nurse.
Connie: Today we’ve brought you a tale of two nurses.
Both were bullied by their attending physicians.
But each story has a drastically different ending.
This is They Don’t Teach That in Nursing School.
A podcast from Figure 1 about how nurses think.
I’m Connie Levie.
After 16 years at my hospital in the nuclear medicine department, I was ready for a change.
COVID had just hit.
I saw my nurse friends struggling.
I decided to go to nursing school so I could help out.
After years in medicine, I’ve learned that the most essential lessons are those you learn on the job.
And that’s exactly what this show is about.
This is a show where we provide unique practical solutions to some of the most challenging problems nurses face.
From learning how to operate a ventilator during the height of COVID, to dealing with that attending physician who’s a bully.
We’ll be sharing the secrets of the trade from nurses, doctors, medical researchers and the professionals you wish you could consult but rarely have the time or opportunity.
You’ll feel seen, gain wisdom, and be better equipped to respond to all the unpredictable stuff that gets thrown at you.
Today’s cases come from two nurses, Melissa and Laura.
That last voice that you heard was Laura’s. Let’s continue with her story before we get to Melissa.
Laura couldn’t stop crying when reporting the bullying incident to her charge nurse.
When she finally composed herself, she looked up and saw the same doctor standing over her.
He wanted to talk.
Laura: He said to me, “I have classes for this and I can teach you how to understand insulin and diabetes better.“
Connie: Laura knew how to correctly administer insulin.
But she didn’t focus on correcting him.
She had something more urgent to say.
Laura: And I said to him, “When you yell at me in front of the patient it is very disrespectful and you embarrassed me, you embarrassed the patient, and you embarrassed yourself. And I would appreciate you next time taking me out of the room and being professional, if you have a problem with what I’ve done.“
Connie: The doctor looked taken aback.
But then he brushed her words aside and left the room.
Laura: I believe that he wasn’t used to someone taking him aside and confronting him with his behavior.
Connie: Laura’s response certainly changed the way her fellow colleagues saw her.
Laura: And the nurses in the room, I think they were all aghast. All that day, the nurses were coming up to me and just kinda looking at me and giving me like a, “Good job.” That’s something they probably wish they could do.
Connie: Two years had passed without Laura seeing this doctor.
But then one day, she heard his voice.
Laura: It just made me sick and just brought back memories of just that guy yelling at me and yelling at me. I thought, oh God, I hope I don’t have any of his patients today.
Connie: Laura didn’t have any of his patients that day.
But the doctor still approached her.
Laura: He took me aside in another room and he said, “I was very rude to you and disrespectful to you two years ago. And I want to apologize.” And so I’m like standing there and I said, “Yes,“ I go, “you were. And okay, I accept your apology.” But I was just really shocked. I had no idea. I thought he was going to yell at me for something else.
Connie: Although this story sounds like it has a positive resolution, it was still incredibly stressful for Laura.
Laura: I knew I did the right thing, but it just, it just gives you an odd feeling of what’s going to happen next. And you just don’t like to confront people and cause a scene. So it’s just very uncomfortable.
Connie: Now, let’s hear from Melissa, the nurse who was cornered by a doctor and was concerned he was about to become violent.
At the time, she was working in obstetrics, with a patient in labor.
Melissa: Her labor was going very smoothly and the intending physician covering her said, “Don’t call me until the head is on the perineum.” So we get to the point where it’s the second stage, patient is pushing, everything’s going really well. So at a certain point when I started to see the baby’s hair coming down the birth canal and it looked like, you know, things were really moving along, I decided this is a great time for me to call this physician and let him know that it’s time to come in for delivery. So I did that. I stepped out into the hallway just to see if the doctor was coming, and he happened to be coming down the hall.
I said, “Great, you know, she should, you know, a couple more pushes and, and she’s ready to deliver.” All of a sudden, he just looked at me with this angry look on his face. He said, “The head’s not on the perineum?” And I said, “Well, no, but she’s doing really well and you know, she’ll deliver soon.” “Didn’t I tell you to call me when the head is on the perineum? Why didn’t you wait?”
Connie: And this is when — for Melissa — time stopped.
Melissa: When I say I froze, everything froze, my throat froze. I couldn’t say anything for a few seconds. My body froze. I couldn’t even move.
Connie: She watched as the doctor approached her.
But it wasn’t as if he was simply walking towards her.
His body language told a much different story.
Melissa: So as he started to advance towards me, that’s when I saw his body is tensed up. He’s standing over me. He just looks so angry.
Everything just stopped and I had tunnel vision and am I going to be hit? What do I do if I am? Where am I going to go? I, you know, everything just sort of runs through your mind and nothing runs through your mind at the same time if that makes sense … because you are just frozen.
For a few seconds I did not say a word I just looked at him because I was afraid he was going to punch me. So, I just took a breath and somehow collected myself and said, I apologized. And to this day, I don’t even know why I apologized, but I think it was to try to calm the situation down and just said that she is ready to deliver.
Connie: The delivery went well.
Mom and baby were in good shape.
But Melissa felt shaken to the core.
She reported the incident to her charge nurse.
Melissa: I went to her and I said, you know, “This doctor, he, he just yelled at me and backed me against the wall and he was so mad because I called him to deliver and he’s the one who’s on call to deliver.” And the charge nurse said, “Oh, you know, maybe he’s just having a bad day or, you know, I’ve never really had any bad interactions with him.” So it was kind of, yeah, well, if he’s upset, you must have done something wrong and that was kind of the culture there.
Connie: And no further action was taken.
Melissa was on her own.
Melissa: It bothered me because, you don’t forget it. This happened quite a few years ago. You don’t forget it. And it just chips away at your self esteem. And it kind of chips away at the idea that who’s going to look out for you when you’re in a situation that you need support and you need some assistance and you need a very bad behavior or situation corrected so that it doesn’t keep happening.
Connie: She doesn’t remember working with him much after that.
Melissa: For the longest time I thought about confronting him and then I would get scared again. If you can understand that. I was so afraid in the moment, that the thought of confronting him even made me more afraid because I said, well, he didn’t punch me. If I confront him, I think he really might punch me and then no one’s going to help me. Like you just feel it’s just this downward spiral of maybe you just shouldn’t say anything because it’s going to be worse.
It almost felt like an impossible situation. And you do have to get to a point where you decide, is this something you can continue to endure, or do you remove yourself from the situation and look for an environment where, it’s kind of like planting yourself in new soil where you feel like you can thrive and do much better than, than what’s happening with, with you right now.
Carolyn: It’s sad but a lot of the stories I have, end up with, you know, people just leaving. Like, that was their best solution, was just to leave that position or transfer to a different unit.
Connie: Carolyn Smith is an associate professor and the associate dean for research at the University of Cincinnati College of Nursing.
She’s the author of “Standing up against workplace bullying behavior: Recommendations from newly licensed nurses”.
Carolyn: A lot of times, people just feel like, I have control of what I do, and sometimes the best choice for them is to just remove themselves from the bullying situation, by transferring to a different unit or finding a new job altogether. Ideally, the onus is not on the individual person who’s experiencing the bullying to have to make the change. It should be the environment and the organization in which they’re employed that really is the one that helps to promote the solution.
Connie: But more often than not, the onus is on the individual to respond to a bully.
Laura: They’re not going to teach you this in nursing school, but you’re going to have to deal with very complex personalities and you are going to have to stick up for yourself.
Connie: All three of our guests have thoughts on how to do that.
Carolyn: Recognize that something wrong is occurring and speak out about it. Own how you’re feeling and let people know what you will and will not accept.
Laura: Sticking up for yourself, it feels very uncomfortable. You think to yourself, oh my gosh, what are they going to think? But I learned in the long run, fighting against bullies is actually the right thing to do because you are setting boundaries that people will know they cannot cross and if they like you or not, they still need to treat you professionally.
Carolyn: Stand up when you witness something like that occurring, even if you’re not the target of the bullying behavior, being able to stand up and recognize it and call it out, is only going to help us to be able to work together to be able to minimize any type of bullying that’s taking place within our profession.
Laura: Take them out of a situation where they’re among other people and so as not to embarrass them, which I try to model good behavior because that’s how I would want to be treated. And I would look them in the eye and I would, say to them, “This is not appropriate behavior.” Explain to them the situation in a calm manner. And, just stand your ground and don’t be like, “Oh, I’m sorry,” or nothing like that. Just state the facts, when you’re confronting a bully, do not apologize.
Melissa: If I had seen my colleagues stand up to physicians who were bullying them in a consistent way, I would have been 100% more secure and comfortable and confident to stand up for myself when I was being bullied. And I also would feel empowered to stand up for my colleagues if I were to witness a situation of bullying.
It takes a lot of internal strength to stand up to a bully and that is not something that we’re taught in nursing school for sure.
Connie: Thanks to Melissa, Laura, and Carolyn Smith for speaking with us.
This is They Don’t Teach That in Nursing School, a podcast by Figure 1.
Figure 1 is an app that lets healthcare professionals share knowledge to improve patient care.
I’m Connie Levie, your host and partner on this journey.
Thanks for listening!