Historical Challenges in Nurse-Doctor Relationships
In the early 1800s, people did not think nursing was a good job. Many nurses were women from low-income families who did essential work and had little training. They had to do what the doctors told them without asking questions (Bostridge, 2008).
Nightingale started nursing during the Crimean War. After the war, Nightingale kept working to improve nursing. In 1860, she started the Nightingale School of Nursing in London. It taught them about cleanliness, watching patients, and caring for them with kindness (Selanders, 2010).
Nightingale also tried to change how nurses and doctors worked together. She wanted nurses to gain knowledge and make decisions regarding patient care, not to follow doctors orders. She told nurses to watch patients and tell doctors what they saw, which would make them work more like a team (McDonald, 2001).
In her book Notes on Nursing, Nightingale wrote about the need for nursing education. She also wrote about treating nurses as professionals (Nightingale, 1860). Her work made nursing more respected. It helped future nurses earn respect when working with doctors.
The relationship between nurses and doctors has changed since Nightingales time. However, her work still inspires nurses to speak up for their patients and their jobs. Today, we see nurses as an essential part of healthcare. They work with doctors and others to give patients the best care possible (Dingwall et al., 1988)
Despite Nightingale's efforts, we still have a power imbalance today. One of the major problems noted is the dynamic between nurses and physicians. Hierarchy disparities are a significant issue in nurse-physician relationships. The hierarchy stops nurses from questioning or challenging doctors. This is true despite their nursing school knowledge.
Power Dynamics and Hierarchy
People perceive the medical profession as more prestigious and influential than nursing, leading to a significant power imbalance. Healthcare dynamics favor doctors.
Doctors have a higher position in the healthcare hierarchy.
Emilys Demeaning Experience
In an instance documented in a case study, a nurse named Emily encountered verbal mistreatment from a physician during a tense scenario in the emergency department. The physicians conduct left Emily demeaned and disrespected, leading her to question her competence. Emily refrained from sharing information with the physician for fear of further mistreatment. This communication breakdown resulted in delays in the patients treatment and the potential occurrence of an event (Kahya & Oral, 2020).
Addressing Verbal Abuse
Verbal abuse has a detrimental impact on nurses and their ability to offer quality care. It harms their mental and emotional well-being and endangers patient safety. Acknowledging the issue can empower nurses. Support mechanisms like counseling and reporting systems can be used to speak against abuse. Everyone must understand the results of their words and must work to create a safe and respectful space.
Set up strict rules and policies:
Set strict rules and policies that set consequences for abuse and state what will happen to those who engage in it (Alshehry et al., 2019).
- Develop guidelines that prohibit the abuse of healthcare workers, including nurses.
- Make sure that these rules discuss verbal abuse.
- Involve nursing and medical staff representatives in creating, implementing, and evaluating these guidelines. Make sure they commit to fostering a culture of respect. They should have zero tolerance for abuse (Alshehry et al., 2019).
Empower nurses and enhance their voices:
- Offer a safe and confidential platform for nurses and other healthcare staff to report incidents of verbal abuse.
- Encourage staff to speak up about their experiences and concerns.
- Involve nurses in decision-making processes related to their work environment and policies addressing verbal abuse.
Ensure accountability among healthcare professionals:
- Hold doctors accountable for their conduct towards nurses and other support staff.
- Carry out a system for investigating and addressing reported incidents of verbal abuse.
- Enforce consequences for those who engage in abusive behavior, such as disciplinary action or mandatory training.
Creating a safe and respectful work environment should promote communication, teamwork, and respect among healthcare staff (Averbuch & Avni, 2021):
- Foster a culture of open dialogue, respect, and support among healthcare professionals.
- Offer training for both doctors and nurses in respectful communication and conflict resolution. Conduct workshops, simulations, and interprofessional learning opportunities. Refine the skills needed to foster positive working relationships, as highlighted by Averbuch and Avni (2021).
- Encourage collaboration and teamwork between doctors and nurses to promote a positive work environment.
Give support and resources to affected nurses:
- Offer support for abused nurses. This includes counseling, debriefing, and mentorship. (Averbuch & Avni, 2021)
- Offer counseling and support services for nurses who have experienced verbal abuse.
- Ensure that staff have access to resources and information on how to handle and report incidents of abuse.
- Offer training that covers communication skills, conflict-resolution techniques, and the impact of verbal abuse on patient care (Averbuch & Avni, 2021).
Promote a culture of zero tolerance for verbal abuse:
- Set up ways to report abuse. Make them safe for nurses. They should not fear reprisals (Kahya & Oral, 2020).
- Communicate that there is zero tolerance for verbal abuse.
- Encourage healthcare professionals to report incidents of verbal abuse they witness or experience.
- Reinforce a respectful and professional work environment.
Lead by example:
- Make sure that hospital management and leadership show respectful communication and behavior toward all staff members.
- Oppose verbal abuse and other forms of mistreatment.
- Communication promotes a safe and respectful work environment for all healthcare professionals.
By implementing these strategies, hospitals can create a healthier work environment that supports well-being and improves patient care. Hospital management must oppose verbal abuse and ensure that healthcare professionals are accountable for their conduct toward others.
In Conclusion
We must address verbal abuse and strengthen the nurse-doctor relationship. The well-being of healthcare providers is crucial, and it is also vital for patient care quality. Promoting respect and clear communication is important as we can create a place where nurses and doctors thrive as a team and achieve the best outcomes. Take a stand today and work to build healthy nurse-doctor relationships, as these relationships will revolutionize healthcare. Under-reporting and a need for more accountability exist. Staff may fear retaliation or harm to their careers if they speak up against abuse, and hospitals may hesitate to discipline staff who misbehave. Silence in healthcare and normalizing abuse make the problem at hand worse.
References
Alshehry, A. S., Alquwez, N., Almazan, J. U., Alotaibi, K. A., Alajilan, A. S., & Alharbi, A. M. (2019). Workplace mistreatment and burnout among Saudi nurses: The moderating role of cultural values of collectivism and power distance. Journal of Transcultural Nursing, 30(6), 560567
Bostridge, M. (2008). Florence Nightingale: The woman and her legend. Penguin UK.
Dingwall, R., Rafferty, A. M., & Webster, C. (1988). An ethnography of knowledge in medical practice. Sociology of Health & Illness, 10(2), 134156.
Kahya, E., & Oral, N. (2020). Verbal abuse and its effects on nurses: A qualitative study. Journal of Nursing Management, 28(4), 947-954.
McDonald, L. (2001). Florence Nightingale and the early origins of evidence-based nursing. Evidence-Based Nursing, 4(3), 6869.
Nightingale, F. (1860). Notes on nursing: what it is and what it is not. Harrison.
Selanders, L. C. (2010). The power of environmental adaptation: Florence Nightingale's original theory for nursing practice. Journal of Holistic Nursing, 28(1), 8188.
Averbuch, E., & Avni, S. (2021). Nurses perceptions of verbal abuse and its impact on their work environment: A qualitative study. Journal of Clinical Nursing, 30(34), 417427.
About the Author:
Glenel Loring is a dedicated nurse transitioning into freelance health writing. With 20 years of bedside nursing experience, Glenel deeply understands healthcare. She is now looking to apply her medical expertise to craft engaging, informative content for diverse audiences. Glenel's writing highlights her ability to make complex health topics accessible and relatable. Her interest in herbal supplements as alternative health solutions showcases her dedication to lifelong learning. As a mother of two and avid gardener, Glenel brings a personal touch to her work. With her strong nursing background and emerging writing skills, Glenel seeks opportunities to help brands and publications educate and empower readers to take control of their well-being.
Glenel is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfasts Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
