As I’ve written, I first saw how abusive hospitals could be — especially surgeons working in the operating room — when my collage Dan Denison spent a week observing a team of operating room nurses in the early 1980’s. The worst actions we were by a surgeon we dubbed Dr.Gooser. And I was writing The No Asshole Rule, and since I started writing this blog, I’ve encountered more and more research, and been told more and more stories, suggesting that nurses are among the consistently bullied workers, and doctors are often the culprits.
I just got a long, sad, and quite articulate email from a scrub nurse who feels trapped in one of these asshole infested places. I suggested that if she could possibly get out, that might be the best thing for her mental health, but it is unclear that she has this option. If not, as I’ve written in my tips for victims of assholes, this might be one of those cases were organized action could help, but she and others have tried that too. Despite my hesitation about recommending legal action, this just might be a case where that is the best option. Read it and tell me — and especially her — what you think is her best course of action. Here is the email with only the names removed to protect innocent and the guilty — she first presents what I found to be a very thoughtful contrast between Frankl’s classic and The No Asshole Rule, and then gets on to her difficult cas:
I read your book. You said that we could write to
you, so I am. Right after reading Viktor Frankl’s book "Man’s Search
For Meaning", I read your book. There are a lot of similarities
between the two books about how to get along in a bad work
environment, even though the content is different. Frankl survived
four Nazi prison camps and wrote about it. I read Frankl’s
book and then re-read it, typing important passages into my computer since it
was a library book. By the end, I realized that I should have just
bought the book. Anyway, if you do a quick read of the first half of his
book (before the section on Logotherapy), you will see that the similarities on
how to deal with the SS and how to deal with today’s work bullies are
similar.
I’ve read most of the how-to-deal-with-bullies-at-work books
and I think yours is the most pragmatic. You use multiple scientific
articles to back up your ideas. Furthermore, most of the other bullying
books only deal with what to do if you’re the CEO or middle management.
If there is a section on what to do if you’re a peon, they were obviously
written by non-peons and their suggestions were not practical (i.e. quit;
go to HR and complain <HR sides with the bully>; explain yourself to the
bully; work harder, maybe it IS you after all; support anti-bullying
legislation). Your book gets into the psyche of the asshole/bully and is
more helpful to the peons with better suggestions, even though you cover
the CEO’s, too.
Some of your suggestions overlapped Frankl’s solutions which
were: know what you’re getting into before you accept "the job"; let
fate take its course and learn to tolerate the abuse; appreciate the good
things that happen; escape if you can; avoid the assholes in life if
possible; keep your mouth shut and blend in; always let them see you working
hard; fantasize about other things; become apathetic to your abuse or other
people’s abuse; die with dignity by not succumbing to becoming an asshole
yourself. One thing he said that you didn’t that I thought might help in
another publication was that the prisoner/worker should develop
relationships with lateral next line up managers. In his situation, they
were called Capos–inmate prisoner first-line supervisors. In our day, it
would be considered shmoozing or networking with lateral managers (not
your own) so that some day, you may get to make a lateral move out from under
an abusive boss or maybe another lateral manager that you have befriended will
put in a good word for you. Frankl thought that contemplating winning the
war was pointless. I bet he’d think that anti-bullying legislation was a
pie in the sky idea and didn’t help the bullying victim in the ‘here and
now’.
I work with cardiac surgeons. They are all pretty much
cut from the same cloth. They’re all certified assholes, except for
one and I’ve worked with many over the years. I’ve been working with one
really mean surgeon on a daily basis for 20 years now. He throws things,
calls us names, charges at us like he’s going to punch us or shove us, he
screams incessantly, he makes jokes about whoever is or isn’t there for the
amusement of the team. The team has exhibited mobbing behavior and help
to laugh at or target whoever is the target of the day, then they go pat the
target on the back after the 8-10 hours of abuse as a parting gift for being
the abuse receptacle for the day.
Several years ago, the surgeon went absolutely nuts and pushed
a huge table full of heavy instruments. Someone caught it before it
slammed a nurse into the wall who had her back to the flying table.
It could have killed her. He physically backed up one of the scrub techs
against the wall and shook his fists at her, his face beet red and his whole
body shaking with anger. This type of behavior went on for hours as the
case dragged on. He threw things, he screamed and called people
names. In his eyes, everyone was incompetent! He was hoarse from
all of the screaming. The anesthesiologist (a doctor) who witnessed the
whole thing said that the target should have called a lawyer. Did he go
to bat for her to administration? No. Did he try to stop the
surgeon from ranting? No. After the ordeal, one of the other scrub
techs wrote a synopsis of what happened and reported the doctor to Human
Resources for what he did. Doctors at our hospital are
self-employed. They are not employees of the hospital. Furthermore,
they bring in a lot of business. They are in the asset column, we are in
the debit column. We are there to serve the physicians. A case was
built against the girl who filed the complaint. They looked into her EAP
(work sponsored counseling) files to find out if she had gone for counseling
(against the law). They looked into her medical claims to see if she had
any counseling and found that she had gone to counseling (also against the
law), and she had, for marital counseling. They called her into the head
physician’s office and asked her if she was making this claim against the
physician because she was unhappy about the outcome of a surgery that the
physician in question had performed on her nephew (how did they know that?),
but she wasn’t unhappy with the way the surgery went on her nephew. He wanted
to know why she was getting counseling. She just reported what happened,
that’s all.
The head of HR had a meeting with the scrub tech that the
surgeon directed his anger at, and three other members of the team. Other
members of the staff who were helping out that day and not members of the
regular cardiac team, including the anesthesiologist, were not asked to attend
the meeting. The scrub tech who made the claim was not asked to
attend. The HR Director leaned over, pointed at the intended recipient of
the question and got in everyone’s face, and asked them one at a
time, "A___ (the scrub tech who reported the incident) writes here
that she thought that Dr. Y. was about to physically attack B___. Did YOU
think that Dr. Y. was going to physically attack B___?"
"Yes." "Did YOU think that Dr. Y was going to physcially
attack B____?" "Yes." Did YOU think that Dr. Y. was
going to physically attack B____?" "Yes." "B____,
you did not report this incident. Why didn’t you report this
incident?" B____ said, "I need this job." She did
not explain that she just bought a house and she found out she is pregnant and
her husband had just been laid off from his job. He leaned forward and
asked B____, "B_____, did YOU believe that Dr. Y. was going to physically
attack you?" "Yes." "Then why didn’t you report
it?" he asked. She said, "I need this job.".
He fell back against the back of his seat and grimaced as if to say,
"I don’t believe it. Who would put up with that?" And
then she leaned forward, and again repeated the words with conviction, "I
NEED this job." She got paid a little over $10/hour. All
this for $10/hour. The outcome was that Dr. Y was sent to ONE anger
management session.
Fastforward about 7 years. This type of thing
continued to go on, but we learned that we were expendable so no
one complained any more. We learned that it didn’t help.
Occasionally when Dr. Y misbehaved because he couldn’t get what he wanted
because of a Department of Health policy and the nurse in the room was
trying to uphold the state policies (the RN gets fired when the doctor breaks
the State Health Department rules), he would call the head physician of the
hospital who would tell the nurses that he has permission to break the rule,
just this once, again. One day recently, Dr. Y. went nuts on another
unit, not in the OR. A group of nurses wrote him up,
again, not knowing that it doesn’t matter. After that, he was told
that he has to attend another (as in one) anger management class and has been
put on probation. Probation? That means that we’re supposed to
watch him for poor behavior and report it, right? Except that they never
told US in the OR that he’s on probation or that he was sent to anger
management. They are only telling nursing floors that do not interact
with him that he is to be watched. Therefore, those of us who COULD
report about him were kept in the dark. Not that it matters, of
course. They wouldn’t do anything about it. That same week,
an anesthesiologist punched a new nurse in the arm and then shoved her
into a wall. There were four witnesses. A non-witness was asked to
write up the incident to report it to the head physician. The punched
nurse had a big bruise on her arm the next day. The abusive anesthesiologist was
sent to the head physician’s office of the hospital by the acting OR nurse
manager. He was told by the head physician of the hospital that "he
would be watched". Watched for what? And by whom?
The partner of Dr. Y, (Dr. X) heard about this and smiled and said aloud,
"Oh boy! It’s open season on nurses!" Dr. X is currently
being investigated by Child Protective Services for beating his own son
repeatedly. As for the temporary head nurse of the OR, she is replacing a
nurse with backbone who told the doctors that their abuse couldn’t go on.
The former head nurse of the OR had been told by senior management that senior
management supported her efforts to curb the physician abuse
problem. Then they demoted her.
The irony of all of this is that our marketing campaign for
our hospital is "Great Place To Work, Great Place to Recieve Care and a
Great Place to Practice Medicine". Yeah. There are other
stories I could tell you, like the one about an RN with Lou Gehrig’s
disease not moving fast enough for a surgeon so he threw three big, long,
bloody laparscopes at her one at a time, each time hitting her. She
couldn’t dodge quite fast enough. It was reported. Nothing
came of it. That same surgeon shoved a male scrub tech off of his stool a
total of three times, too. Apparently, if you can go three rounds
with this surgeon, you’ve survived that episode. The male scrub tech
did not report his incident with this physician because he didn’t want to
look like a whimp. When physician abuse events are reported,
they are reported to the head physician of the hospital. We think that
the CEO has an active "kill the messenger" program so nobody gives
him bad news, including the head physician. I am cutting the CEO slack in
my mind because I can’t believe that he would do absolutely nothing about
all of this abuse if he just KNEW about it. He must be kept in the
dark on these issues. I thought for sure, that after Dr. Y’s table
throwing incident and threatening to hurt B____, that it finally would be dealt
with. It was just too big to ignore. But no, nothing happened,
except for the anger management class. Oh wait a minute. I just
remembered. One of Dr. Y’s ex-partner physicians became an
administrator. He and another administrator presented a business
case (financials) against Dr. Y to senior management showing how Dr. Y isn’t
just an asshole, he’s a screw-up and his screw-ups are costing the hospital x
number of dollars. Yes, the CEO finally took action. He fired the
two administrators for plotting against Dr. Y. You see, Dr. Y is in
a protected class. Dr. Y brought in a lawyer to the meeting saying he was
being "harassed". Case closed.
Honestly, they tell us to "document, document,
document" when it comes to abuse. But when it IS documented,
the doctor gets a slap on the wrist (anger management times two–oh yes, and he
had to apologize this time) and there is fallout on whoever reported it.
A manager actually told us that senior management considers the nurses dealing
with Dr. Y as "bunch of whiners". Without documentation,
there’s no case. With it, there’s retribution. What does the CEO
really want?
For myself, the biggest sense of disappointment in this
whole issue isn’t that I’m bullied by assholes. It is the fact that the
CEO sits on his lilly white ass and turns his back to it. My anger
for the bullies in my life is dwarfed by how angry I am at
the administration and the CEO who allows it to continue, gives
doublespeak about how it won’t be tolerated here (great place to work and all
that bullshit)—and then tolerates it, offering any one of us up for a
human sacrifice on a silver platter at the request of the biggest bully
monster physicians. That’s what makes me so fucking angry, disappointed,
and disillusioned with the spineless, eunuch "leaders" where I
work. They couldn’t last one day in my job with the abuse that is hurled
at me. These nutjob doctors always look psychotic, like they are one
hair’s breadth away from pounding the shit out of me or my co-workers and from
what we have seen in the last month, it isn’t just possible or probable, it’s
real.
After the "table throwing incident" I made
an appointment with a psychiatrist because I was so disillusioned and depressed
with how the administration handled that situation. I really felt that I
was being fed to the lions and nobody could or would help me. I
would go to work and just shake. I’d be on the verge of tears all
day. The psychiatrist started me on anti-depressants to get through the
day. There aren’t enough anti-depressants in the world to fix this.
My psychiatrist told me, "I want you to know that I’m putting the wrong
person on anti-depressants. You’re not the only patient I see because of
Dr. Y." She eventually diagnosed me with PTSD. She said that
she treats cops, too, who have PTSD and she said our problems are
identical. At least the cops are the ones who are supposed to be "in
charge" and they can defend themselves with a gun, if necessary. She
said she could put me on disability for six weeks, but I refused. How
would that look? Who would hire me after that? I have begged my
spouse to let me quit this job, but my salary pays the mortgage and as I
said, with the type of work I do, the type of people I work
with are the same everywhere you go. (I know because I’ve been around.)
I went back to college part time to learn a new skill. After
graduating, I couldn’t get a job in that skill without moving out of the
area and my family won’t move. So I’m stuck. Until I finally
have a stroke or heart attack of my own and then I’ll be free. What a
price to pay.
P.S. Dr. Gooser was also a cardiac surgeon.
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