Archive November 2017 XVIII, No. 11

Editor's Page: Those Who Are Bullied Bully Right Back

Now we know why the oppressed eat their young and each other.

Dan O

Dan O'Connor

BIO

primates CYCLE OF OPPRESSION When overpowered, primates will walk away and overpower an innocent bystander.

What does a primate do when he loses a fight? Inevitably he walks away and swats another primate who's innocently minding his own business. Those who are dominated and oppressed will look to overpower someone else — where have you seen that happen?

Yep, be it in the jungle or in the OR (which many liken to a jungle), those who are bullied will resort to aggression among themselves — usually a peer or someone lower down the hierarchy of power whom they perceive as having lesser status: a nursing student or a nursing assistant will do.

Psychologists call this phenomenon "submissive aggressive syndrome." You know it as bullying, horizontal violence or nurse-to-nurse hostility.

Some speculate that verbal abuse by physicians contributes significantly to nurse-to-nurse hostility because nurses pass their anger and frustration with physicians onto coworkers or subordinates. In one study, researchers who observed physicians verbally abusing more than 90% of nurses later witnessed 76% of those nurses exhibit nurse-to-nurse hostility, reports Kathleen Bartholomew, RN, MN, in her book, "Ending Nurse-to-Nurse Hostility."

So the bullied respond by bullying and the vicious cycle goes on and on, the oppression rolling downhill like, well, you know.

We hear so much about nurses dragging each other down, but you know who might get crapped on the most in hospitals and surgical centers? Sterile processing techs, viewed as the lowest of the low, the dishwashers hidden away in a cramped, damp basement room.

Weston "Hank" Balch, CRCST, CIS, CHL, the system director of sterile processing for University Health System in San Antonio, Texas, writes a terrific blog about sterile processing. In a recent post, "The Victims Downstairs: Surgeon Bullies and the Untold Sterile Processing Story," Mr. Balch writes that "surgical bullying of sterile processing professionals can go on for years unnoticed and ignored. This happens more often than folks outside the industry may understand, and more often than facility administrators may want to admit."

He's witnessed surgeons breaking scopes in half, cutting cords on $5,000 probes and throwing orthopedic drills on the floor.

And that's not the worst of it. Mr. Balch has also seen surgeons summon the central sterile supervisor to stand before them in the OR, just so they can dress him down in front of everybody — "orchestrated professional embarrassment," he calls it.

Pity the poor supervisor. But I'd really hate to be the tech who works for the supervisor. He doesn't know it yet, but he's about to get swatted. OSM

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