Monday, December 18, 2017

Violence Against Nurses -- Our Own #MeToo Moment

It's well-known that nurses are often the subjects of bullying by other nurses, a phenomenon often referred to as either "lateral violence" or "horizontal violence". But what happens when the perpetrator of violence against nurses is a doctor or surgeon, especially in this era of the #MeToo movement?

The bullied nurse

Cedars-Sinai Surgeon Attacks Nurse

During the week of December 14th, 2017, it was brought to light that a former charge nurse from Cedars-Sinai Hospital in Los Angeles is suing surgeon Kerry Kourosh Assil, the doctor who apparently attacked her at work and told her that he did it because she "liked the abuse". The incident was caught on security camera footage that was released to the press.

Nurse Paula Rickey is asking for an apology from the surgeon, as well as assurances that this type of behavior will not be tolerated by the facility in the future.

Unfortunately, Rickey feels that she was actually punished for reporting the attack to Human Resources. She was moved to a different unit so that she would not have to work directly with Assil, but he appeared to have received nothing more than a slap on the wrist. Her work hours were also reduced while his did not change. While Cedars-Sinai issued a statement that the surgeon was indeed disciplined, they have so far declined to describe the consequences faced by the doctor.

A Clear Power Differential

Doctors -- and especially surgeons -- are generators of the lion's share of income earned by medical facilities, and we can rest assured that Dr. Assil is no exception. Nurses' work, on the other hand, is largely unbillable (with the exception of APRNs, of course). These facts alone belie an underlying power differential that goes far beyond levels of education and responsibility.

Surgeons bring in a lot of income, thus it is no surprise that Dr. Assil apparently suffered few or no real consequences for his egregious actions that can be clearly seen in the video referenced above.

In the cases of Harvey Weinstein, Roy Moore, Senator Al Franken, and other powerful men whose careers have been brought to an unceremonious end by allegations of sexual assault or misconduct, power eventually could not protect them against such reprehensible behavior. Perhaps because these men are public figures, it is actually easier to exact justice against them due to their celebrity status.

On the contrary, for surgeons (who are not exactly household names), there is less pressure to resign or lose an elevated professional position since it may be easier to keep such accusations under wraps.

However, in this case, the nurse in question has taken the courageous stance of speaking out and standing up for justice, and we can only hope that her lawsuit will have a chilling effect on hospitals and medical centers that feel they can overlook physicians' aberrant behavior with impunity while blaming the victim and shirking their responsibility as employers.

Nurses Standing Up

Nurses often feel disempowered in a healthcare system where doctors and surgeons are perceived as gods, while nurses are seen as their subservient handmaidens. In a professional setting where nurses are still approximately 90% female, the potential for abuse along gender lines is high. For nurses like Ms. Rickey, the consequences of speaking out and standing up for what's right are often a frightening and disconcerting unknown.

In the spirit of the #MeToo movement, it's time for nurses to stand up to physicians' abuses of power, such as that displayed by Dr. Assil. There is deservedly plenty of literature about horizontal violence between nurses, yet we need to also see an equally significant body of literature regarding "vertical violence" perpetrated by doctors against nurses.

Power differentials generally spell trouble in most workplaces. Unless healthcare institutions are themselves willing to do the hard work of training staff and holding perpetrators accountable for their unacceptable behavior, it is going to be up to nurses to have the courage and fortitude to stand up and speak their minds when they are on the receiving end of violence, abuse, intimidation, harassment, or bullying -- no matter the rank, position, or earning power of the perpetrator.

Nurses' #MeToo Moment

The moment for nurses to say "me too" has come. Abuse and violence in the workplace do not need to be sexual in nature to be worthy of our attention.

The sexual exploitation and abuse of women by men is generally viewed as a consequence of the aforementioned power differential and an overwhelmingly patriarchal system. Any form of violence -- verbal, emotional, psychological, sexual, or physical -- is unacceptable in every situation or environment.

Nurses, our "#MeToo" moment is here. It's time for those who transgress against us to be held accountable for their actions, be they other nurses, surgeons, or doctors. In the words of Bob Marley, "get up, stand up -- stand up for your rights." The time is now.

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Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of RNFMRadio.com, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. Keith has written for Nurse.com, Nurse.org, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, NursingCE.com, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality and social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and intelligent cat, George.
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