they want, and surgical residents seem to learn this behavior by observation.”
If medical school helps to ignite what the ISMP calls a “culture of disrespect among healthcare providers,” then some hospitals and health officials help to perpetuate that hierarchy. In October 2014, when Texas Health Presbyterian Hospital nurse Nina Pham contracted Ebola from a patient, Dr. Thomas Frieden, the head of the Centers for Disease Control and Prevention, seemed quick to appear to blame the victim. “Clearly there was a breach in protocol,” Frieden told
Face the Nation
. “Infections only occur when there’s a breach in protocol.”
But Pham’s colleagues said that was not the case. National Nurses United, the country’s largest nurses’ union, spoke to the nurses and issued a statement asserting that the hospital neither trained the nurses nor established protocols to begin with. Supervisors told nurses that certain protective masks were unnecessary, hospital authorities resisted a nurse supervisor who demanded that the patient be moved from a non-quarantined zone to an isolation unit, and the nurses’ protective gear left their necks exposed, according to the NNU.
While, amid an uproar from nursing communities, Frieden later said his remarks were misconstrued. “There’s a lot of outrage about Frieden’s comments,” American Academy of Nursing president Diana Mason told NPR. “It’s blame the nurses again.”
Some health organizations place nurses on the front lines, and then fail to protect them, let alone treat them like the heroes they truly are. On a lesser scale, many hospitals develop policies that blatantly set nurses apart from other staff members. WSMV-TV Nashville reported that at Vanderbilt Medical Center in 2013, administrators cut costs and risked cross-contamination by forcing nurses to perform housekeeping duties, including emptying garbage cans, changing linens, sweeping, and mopping patient rooms and bathrooms. At other hospitals, nurses were the only employees who were charged for parking. A lighter but still legitimately irritating example occurred at a northern California hospital, where administrators announced that they would no longer provide half-and-half for nurses and other staff, but would continue to have it available for doctors and administrators. The staff responded by planting a “Will Work for Half-and-Half” jar in a break room, in which coworkers deposited donations of half-and-half containers.
These administrators’ message is clear: They value doctors more than they value nurses and treat them accordingly. They might also prioritize some doctors over others. In one study, nearly 40 percent of doctors said that administrators are more lenient with the physicians who generate large amounts of money for their organization. Hierarchies like these do not promote patient care; rather, they enmesh doctors and nurses in territorial fights that can make them lose sight of what matters.
The controversy over the doctorate of nursing practice degree (DNP) is emblematic of the professions’ crossed signals. As of 2015, nurses wishing to become nurse practitioners—who are able to diagnose and treat patients in ways similar to a general practitioner—must go beyond master’s level training to earn a doctorate, and can therefore add “doctor” to their title. Nurse leaders say the additional education is important to expand nurses’ expertise, enhance their qualifications for hospital administrative jobs, and gain more respect in the medical field.
But physicians have turned the debate into a turf battle over the “doctor” title that some NPs, as they are known, would use, claiming that the degree threatens the medical doctors’ position as healthcare leaders. They argued that nurses calling themselves “doctor” will confuse patients and is an attempt to equate their status with physicians, who have thousands more hours of medical training. The American Medical
Maggie Brendan
Barbara O'Connor
Jan Washburn
Terri Blackstock
Norah Simone
Barry Kemp
G.P. Taylor
Alan Cumyn
Linda Barnes
Lisa Jackson