Kathleen Bartholomew: Standing Up to Physician Bad Behavior

Rebecca Hendren, for HealthLeaders Media , December 2, 2010

This was not a road she expected to find herself traveling. The journey began in 1991, when she was out of a job, separated from her husband, and the mother of five children, all younger than 11. She was introduced to a lawyer who offered to handle her divorce for free—if she agreed to become a nurse. Never one to turn down a good deal, and recognizing her dire straits, Bartholomew accepted the deal.

She packed her five kids into the car and drove to North Carolina so family could watch the children while she attended school and studied. Eventually, her hard work paid off and she started her first position as a nurse. Almost immediately, she witnessed the perverse hierarchies involved when physicians and nurses talk to each other.

"Every time the nurse would call to report a temperature, the physician would slam the phone down, even though we had guidelines to call if the patient's temperature was above 102 degrees," says Bartholomew.

She knew that the belittling, demeaning, and hostile behavior she witnessed throughout healthcare was a serious problem.

"I realized it was something that carried over" and affected patient care, because a person cannot perform cognitive tasks when his or her emotional state is compromised, says Bartholomew. "No human being can think clearly when they are upset. When you create healthy relationships, you are providing a safety net. Our patients will never be safe until all caregivers feel safe enough to communicate—to challenge, question, advocate, and ask for clarification."

As Bartholomew progressed in her career, becoming manager of a 57-bed orthopedic unit in a downtown Seattle hospital, she worked on improving nurse-physician communication and she experienced amazing results.

She turned her attention outside her organization and began to talk about the issue to others. What she was saying struck a nerve. As she presented to hospitals and conferences, nurses would come up to her, weeping, and tell her their stories. She added the need to improve nurse-to-nurse horizontal hostility to her mission and became a celebrated author, speaker, and educator on the topic of bad behavior and the patient safety imperative for changing culture.

"It's just absurd that the two people who are providing the care are not required or expected to communicate on a daily basis," says Bartholomew, noting that poor communication "is the No. 1 cause of errors."

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5 comments on "Kathleen Bartholomew: Standing Up to Physician Bad Behavior"

Janet Eckhart, EdD, MSN, RN (11/13/2011 at 10:25 AM)
It is time that all of us acknowledge that whatever name we choose to give this ugly cancer on our profession (bullying, eating our young, lateral violence)is thriving in our academic center as well as the workplace. We ingrain this unspoken behavior in the earliest stages of developing our nursing: the educational programs. It starts with how faculty interact with each other and the students and spreads to how students interact with each other. We are what we teach. So is there any wonder when these young nurses enter the work force, they have novice experience with these undo forces and encounter the seasoned nurses who have refined the skills for bullying and "eating our young". We operate on the belief system of new graduates having to run the gauntlet, taking their beating/pay their dues before they can be assimilated into the sisterhood/brotherhood of nursing. The same holds true for any new member of the team. It is long overdue for those good nurses to take a stand for what is the ethical way to behave and conduct ourselves as professionals. Evil or bad practices are allowed to flourish because good people turn a blind eye and do nothing.

Shannon Buckingham (8/3/2011 at 12:37 AM)
Thank GOD! somebody put this issue on the map and gave it a name! I have been a victim as well. But it was always so hard to report since the behavior is/was so passive-aggressive. The complainer always had the complaint thrown back in her face as if she was the problem,I too, have tried to identify/stop this terrible behavior but as you can imagine, it's a very difficult task with no help o suppot.At least now we have a starting point. I used to tell my husband, "You'd be surpeised at how Vicious!! nurses can be to one another when the general public thinks we are just sweet little angels of mercy" when in reality, we can be absolute DEVILS!! to each other

Ava Madison (12/20/2010 at 9:25 AM)
Dear Ms. Bartholomew, Our family just recently experienced a nightmarish experience at a leading Hospital, that resulted in the senseless death of a baby. I turned this in to management before the baby was cold. They accept no fault. I have turned it into every entity ( The Joint Commission, All State entities ect.) that I thought could do something about this to make sure no other family experiences this tragedy and no other baby senselessly losses it's life. everyone that we have told what happened looks at us in horror. It is about the most egregious sitution I have ever heard about. I would like to talk to you about it. Thank you and Merry Christmas.




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