Upend the Hospital Hierarchy

The current clinical hierarchy, a top-down structure where power starts with physicians and flows down to nurses, is flawed. Is this really the best way to care for patients?

5 comments on "Upend the Hospital Hierarchy"
Deborah Andrews (4/26/2013 at 2:45 PM)

It really is high time that nurses are viewed as the eyes and ears of the physician when they are not available versus as enemies. Nurses, especially seasoned nurses, have brains and are able to think critically. It's time that nurses receive the respect they deserve from the administration, patients, families, and physicians.
Jim (3/25/2013 at 11:34 AM)

why are there no jobs for RN's with no nursing experience?
Bruce Moskow (3/21/2013 at 3:50 PM)

Really? The US government with full on gridlock as a model for patient care? Was this intended as satire? Dr: Please hand me a 5-0 nylon suture so I can sew up this laceration. Nurse: I think the other Drs use a 4-0 prolene suture for this type of injury. Dr: Lets call a committee meeting and have hearings before a judge to decide this. Or perhaps the clerk at the front desk can be the tie-breaker.
June Levine (3/20/2013 at 3:14 PM)

I applaud the articulate way that you identified an issue that has plagued the professions of nursing and medicine. I found your analogy not only interesting but very perceptive. Individuals entering both professions are sometimes educated in a way that facilitates this hierarchy. Physicians are not informed about the the nurse practice act that actually requires nurses to not implement any "orders" that the nurse believes to not be in the patient's best interest. Nurses are not always educated about their legal and ethical responsibilities in a way that should give them the voice to protect their patients. Organizations do not always clarify up front to new nursing and medical staff the expectation of collaboration and the roles each must play to assure patient safety and quality of care. There are many examples of meaningful and exemplary collaboration between nurses and doctors. However, It is always the examples outlined in your story that continually remind us, this critical issue still has a long way to go. June Levine RN MSN
martin paul (3/19/2013 at 3:14 PM)

The clinical hierarchy,of physicians to have dominant power it is not a best way of providing care to our patient.The nursing professional has for long been looked down despite their contribution in caring of patients and wellbeing of the society.I think the hierarchy should respect both group and promote mutual respect to both group.The hierarchy should not imply control,any more that it implies bullying or intimidating nurses by physicians.


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