While family physicians still delivered babies in those days, two obstetricians also practiced on that OBS Unit and cared for high risk pregnant women. They often relied on our nursing judgments to determine when they’d come to hospital to assess their patients. One such high risk patient had a sudden, devastating complication during her labour and died a few days later. Her case was the subject of a formal inquest. I had been on duty earlier on the day in question just as her symptoms became critical, so I was subpoenaed to testify in court. On the day of the inquest, several members of the medical staff were present to give expert testimony. The hospital CEO, Director of Nursing, and several Board members were in attendance, as were the Obstetrician and his lawyer. Since the inquest was a fact finding rather than criminal case, and I was merely a witness there to recount what had happened during my shift that day, I had not been advised to obtain legal representation. One of the hospital physicians who had been a “friend” when I worked in ICU/CCU took me aside and whispered that I should have a lawyer present. Puzzled, I asked him why. His response was “Barb, doctors have way more to lose than nurses do so they will always stick together. They will put the blame for this death on a nurse: you.”
Through the late 1980s, ’90s and until today, as fiscal restraints, staffing and bed reductions assaulted Ontario hospitals, I watched the workplace become increasingly toxic. It seemed to me that meanness permeated the hospital structure. Nurse researchers began to report an unsettling theme of lateral violence in hospital settings. They defined the term as meaning that nurses direct their dissatisfaction towards each other and toward those who have less power than they do. Associated behaviours include snide, rude, demeaning and condescending language; back stabbing and gossiping about others; and blatant disrespect for others in the hospital setting. Researchers further argue that nurses don’t even notice that their behaviour is inappropriate; it’s so deeply ingrained in nursing culture, it’s seen as normal.
Over the decades as I rose through the ranks of middle management, I felt a positive shift in my own power. I most often worked with a physician co-leader in mostly harmonious relationships but I observed other physicians disrespect and verbally abuse staff nurses. I always advocated for nurses but was most successful in effecting physicians’ behavioural changes when I persuaded my physician partner to speak to the offending doctor. Some of my physician co-leaders were more willing than others to “get involved” but a number of them were offended by physician abuse of power. When they did intervene, the offender’s behaviour immediately changed, at least temporarily.