The 'Time-Honored Tradition' Of Blaming The Nurse : NPR June 27, 2011 NPR Shop | NPR Social Media | Login | Register Search is FIND A STATION SEARCH supported by: home news arts & life music programs listen News > Health > Health Care Twitter (12) Facebook (156) Share Comments (10) Recommend (10) The 'Time-Honored Tradition' Of Blaming The Nurse Pediatricians Recommend A Media Diet For Kids To Fight Obesity Your Health Podcast: Hammocks Rock For Sleep And Add to Playlist Two-Faced Nuts Listen to the Story Download Kids, Keep Your Tongue In Your Mouth (Where It Talk of the Nation [30 min 19 sec] Belongs) more June 6, 2011 text size A A A One of Theresa Brown's patients jokingly asked who he could blame after a long wait for test results. The doctor pointed at Brown, a nurse, and said, "Scream at her." Brown and Dr. Rahul Parikh, who writes the PopRx column for Salon, talk about the tensions between nurses and doctors. Copyright © 2011 National Public Radio®. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required. NEAL CONAN, host: NPR thanks our sponsors Become an NPR Sponsor This is TALK OF THE NATION. Im Neal Conan in Washington. A hospital patient jokingly asked who he could blame for delayed test results. The doctor pointed at most popular the nurse and said: If you want to scream at anyone, scream at her. Afterwards, in the hallway, the doctor shrugged the crack off as part of a time-honored tradition: Anything goes wrong, the nurse Viewed Recommended Commented always gets the blame. 1. Russian Women Prove It's Hip To Be A Babushka The nurse in question, Theresa Brown, attacked that tradition of bullying, condescension and insult in an op-ed piece in The New York Times titled "Physician, Heel Thyself," heel spelled H-E-E-L. 2. First Listen: Gillian Welch, 'The Harrow And The Harvest' Doctors, nurses, how does this tension play out where you work? Give us a call, 800-989-8255. Email us, [email protected]. You can also join the conversation at our website. That's at npr.org. Click 3. Among The Costs Of War: $20B In Air Conditioning on TALK OF THE NATION. 4. First Listen: Washed Out, 'Within And Without' But first - later in the program, comedian Aisha Tyler. But first, doctors and nurses, and we begin with Theresa Brown. She joins us from member station WQED in Pittsburgh, and it's nice to have you back on the program today. Ms. THERESA BROWN (Nurse; Author, "Physician, Heel Thyself"): Thank you very much. CONAN: And you write after being slapped-down in front of that patient, you'd think twice about speaking up around that offending doctor. Ms. BROWN: Yes, unfortunately, that's the case, and I don't think I'm alone in feeling that way. CONAN: Was he serious, do you think, or just joking? And I'm not saying it was an appropriate joke, but was he entirely serious? Web Resources Ms. BROWN: Well, that's - in the sort of blogosphere, people said this nurse needs to get a sense of humor. And what I would contend is that the only reason people would think that that's a joke is Read Theresa Brown's Piece For The New York http://www.npr.org/2011/06/06/137008080/the-time-honored-tradition-of-blaming-the-nurse[6/27/2011 11:45:39 AM] The 'Time-Honored Tradition' Of Blaming The Nurse : NPR because they think it's okay to make fun of nurses, and it's a joke to say that nurses aren't Times, "Physicican, Heel Thyself" competent, or they should be blamed for everything. Read Dr. Rahul Parikh's Rebuttal, "Do Doctors And Nurses Hate Each Other?" So he may have been intending to make a joke, but the joke itself is a symptom of the problem. CONAN: And the problem, you say, is - well, it goes back to - a very long way to doctors who persist in portraying nurses as little more than candy-stripers. Ms. BROWN: Yes, and I do want to be clear, though, and say it is a very small percentage of doctors who do have these negative attitudes towards nurses and act out negatively towards nurses. But with this small percentage, the behavior, the demeaning comments, the sarcastic remarks persist. CONAN: And is there a larger percentage that engages in what you call condescension or refusing to answer phone calls, that sort of thing? Ms. BROWN: I think again it's a small percentage of doctors. In my experience, most doctors work very well with nurses, and I enjoy working with doctors, and also the flipside is true. There are nurses who can be very difficult for doctors when they're in training, and again I would say it's a small percentage of nurses. But for these few MDs, the behavior persists, and then unfortunately for nurses, we never know - well, now could this doctor, who's usually been nice, could he suddenly be like this? CONAN: Oh, I see. Ms. BROWN: Or if I ask a question, is this person going to jump on me? So it makes all of us nervous, and we can't protect our patients and stick up for them the way we need to. CONAN: And according to your piece, anyway, it sort of infects the work atmosphere at the hospital, and it perpetuates the old traditions of where the doctors tend to dominate the nurses and sometimes, as you say, older nurses, more experienced nurses, might tend to bully a younger doctor sometimes. Ms. BROWN: Yes, and I think it's a perpetuation of any sort of negative cycle. You can see a cycle of child abuse in families. So nurses see: Wow, these important doctors get away with this behavior, and then when they have the opportunity because they're angry, they can take that out on doctors, and everyone starts to see this really negative and destructive behavior is accepted, even though it's by a small percentage of actors. And I've been having a lot of conversations lately with people who say this level of incivility that's tolerated in health care, you just, you don't see it in a lot of other professions and that it's quite remarkable that, in a sense, we haven't cleaned up our act. CONAN: What's been the reaction to your story? Ms. BROWN: A lot - there were a lot of angry doctors who said it's not doctors who are bullies, it's nurses who are bullies. And it's true there are nurses who are bullies. The piece I took out of those comments that made me sad was that medical students seem to feel like they are treated like the absolute worst thing on Earth by a lot of doctors and even some of the people in medicine who are training them. And so then of course you feel like, well, that's why this problem just keeps perpetuating itself. So there was this initial negative response but also supportive comments. And in the end, the head of New York Presbyterian wrote to me and said: I really support what you said. And he had a letter in The New York Times saying he supported what I said. The head of Kaiser Permanente wrote to me and said: I really support what you said. So I felt like there was a flurry of negative reaction but also an acknowledgement, sometimes reluctantly, sometimes not, that yeah, this is a problem, and we need to do something about it. CONAN: Well, also with us today is Dr. Rahul Parikh, a pediatrician who joins us from the studios at the University of California Berkeley. He wrote a piece called "Do Doctors And Nurses Hate Each Other?" for salon.com, where he writes the PopRx column. And Dr. Parikh, thanks very much for being with us today. http://www.npr.org/2011/06/06/137008080/the-time-honored-tradition-of-blaming-the-nurse[6/27/2011 11:45:39 AM] The 'Time-Honored Tradition' Of Blaming The Nurse : NPR Dr. RAHUL PARIKH (Author, "Do Doctors And Nurses Hate Each Other?"): Yeah, thanks for having me back, Neal. CONAN: And Dr. Parikh, your piece was very specifically a response to Theresa Brown's story. Dr. PARIKH: Yes, it was, and I was not one of her detractors or critics. I thought she did a fine job of taking a personal experience and magnifying that to address an issue about how to better take care of patients. And ultimately, that's what we're there for every day is to take care of patients. So in taking her story and how it made her feel and then talking about how it could potentially negatively impact patient care and the workplace, she did the right thing. CONAN: On the other hand, you wrote, I've been driven nuts by nurses who consistently botch a patient's care plan, misinform patients about their child's health or simply refuse to do what's needed of them. Dr. PARIKH: Yes, that's true. And I think that I've probably been driven nuts by doctors who have done the same. I think the point is that how we communicate with each other as professionals, be it nurse to nurse, doctor to doctor, student to teacher in hospitals and teaching settings and training settings, really has an important impact on how we take care of patients.