For Nurses, the "Patient’s Always Right" Attitude Opens the Door for Abuse
Mary*, 37, a nurse practitioner, shares her experience anonymously to Time's Up Healthcare founding member Dr. Jessi Gold.
There is a culture in healthcare, especially in nursing, that no other field would tolerate. It is a mindset that says caregivers are supposed to take absolutely everything they are given from patients, because patients are vulnerable. In other words, patients can scream and call me names, they can grab me inappropriately, they can tell me they want to “f— the scrubs off of" me, and all I can do is remain professional, report it to the charge nurse, and let it go.
I was once punched in the face by a patient, and the doctor told me not to do anything about it because we are in healthcare, and that just happens. And this wasn't a case of psychological distress or drug abuse — this patient was being treated for cold symptoms, and hitting me was clearly assault. I think a lot of us in healthcare, especially nurses, just become accustomed to thinking, “I signed up for the job and the patient is always right. This is just how it is sometimes.”
It is part of our jobs to care for people who are mentally ill or incapacitated in any number of ways; those who sometimes aren't aware of their actions or their consequences. That's not who I'm talking about. I am talking about the younger male with abdominal pain who spends the whole night commenting on my body. Or, the drunk guy who comes into the ER nightly and asks me (in more vulgar terms) if I am “good in bed.” These are the patients who know what they are doing and saying. This is everyday in the workplace of healthcare. This is abuse.
I can’t even count the number of times a male patient said sexual comments to me when it was time to bathe them, or one would graze my breast when I bent over and tried to take his vital signs. In the ER where I spent 10 years, especially with younger men, it is incredibly common for someone to reference the sexy nurse trope, or nurse porn, and say something like, “Why don’t you wear that? You would be so hot in that.” After a while, you learn to expect these things, but it is the repeated abuse that burns you out. You get so used to it that it becomes normal. The constant message of, “the patient comes first,” I think, contributes to how we respond, or don’t respond in these situations. The patient comes first.
I try to put myself in patients’ shoes before I get mad or upset, but, people do not consistently treat us like professionals, or even humans. If I was walking down the street and someone said half of what was said to me in my prior job in the ER as a nurse, I could say “fuck off,” aggressively stand up for myself, walk away, or I could fight back. But, if I said that at work, I would be called into the office, my side of the story would be aired, the charge nurse would speak to the patient, and in the end I might even be written up if my response was deemed unprofessional.
I’ve never seen anyone stand up for themselves with any success. Maybe a charge nurse will go talk to the patient or the nursing administrator, but that is where it stops. It is also the exception, and not the rule. Often, it is the opposite, and if a patient complains, patient services will come and cater to the patient and try to make them happy. In these situations, the hospital is worried that the patient will file a complaint, or the extreme, sue the hospital, or it will affect patient satisfaction scores. That is really the bottom line. At the end of the day, I still have to take care of him or her. That is my job, apparently at any cost.
I always knew that nursing was not all balloons and babies, but does duty and caregiving mean we have to tolerate inappropriate verbal and physical interactions? Do they have to go hand in hand?
In my almost 15 years in this field, I wonder why we make exceptions for patients. This work environment would never fly anywhere else. It's time that it stops flying here.
This essay is a part of our exclusive coverage of Time's Up Healthcare, which launches March 1. Read more, here.