Kathleen Bartholomew: Standing Up to Physician Bad Behavior

Rebecca Hendren, for HealthLeaders Media , December 2, 2010

When she started talking about this dirty little secret, no one else was acknowledging that healthcare culture could and should change. And yet the Institute for Healthcare Improvement clearly stated that the greatest barrier to patient safety is culture.

"At the time, there were only a few articles on this topic," she says. "It was not at all a priority anywhere. No one saw the impact and no one had demonstrated the impact."

Bartholomew focuses on the critical importance for healthcare to learn how to create collegial teams, just as has been done in other professions, such as aviation and nuclear power.

"Until we get there, patients will never be safe," says Bartholomew. "Allowing one person to behave badly undermines trust. You can't have collegial teams without trust and everyone on board. An institution cannot have integrity when there are different rules for different roles."

"We will look back in 20 years and wonder how we possibly thought we could deliver care when the physician doesn't think it's necessary to read the nurse's notes or even speak to the nurse," she says. "It's absurd that two people delivering care are not required to communicate."

Bartholomew now works on delivering her message to all levels across healthcare, from staff nurses to boards of directors.

"Right now, I'm thrilled to be able to have an impact on a much larger scale," she says. "I speak to boards of directors at hospitals and get to spend a whole day explaining culture and the impact of that culture on quality and safety. I teach them about nurse-to-nurse and physician-to-nurse communication and it's been profound. Boards are now adopting behavior rules. Now senior nurses are being given the clout they need from the boards of directors. They are saying, 'It doesn't matter how much money that physician brings in, he screamed at and demeaned the nurse!'"

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits www.StrategiesForNurseManagers.com and manages The Leaders' Lounge blog for nurse managers. Email her at rhendren@hcpro.com.
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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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