We spend a lot of time talking to clients about culture. How can we create a:
I’ve worked in hospitals or with hospitals for the better part of almost thirty years now. I’ve worked with administrators, physicians, nurses, and front-line staff. Any one of these groups will tell you that the hospital work environment is unique on many levels. You have a workforce of intelligent, dedicated, people doing important work. In the best cases, every task and discussion is focused on the mission. There can be a strong sense of family and of dedication to the community. I recall driving my truck around town through a snow storm to get nurses to the hospital when all of the roads were closed – that’s what people in hospitals do for patients and for their colleagues.
At the same time, there are some negatives. While it’s improved greatly, some hospitals still don’t have a positive culture where people, especially women, feel safe and valued. It’s not a coincidence that many early soap operas and TV shows were about hospitals. The setting, the pressures, the close working relationships, and the unique hierarchical structure- all made for good drama. While these shows exaggerate, certainly, they were based on underlying realities. As a former employment attorney, most of the situations in TV hospital shows make me cringe!
A 2016 JAMA study found close to one-third of women in academic medical facilities reported having experienced sexual harassment in the workplace. They also experienced or perceived more gender bias than men. Yes, that number is not a typo – ONE THIRD. That means that anyone who’s worked in a hospital has likely seen various types of mis-treatment of colleagues and noticed that it seemed to be accepted as normal. It’s not normal. It’s not acceptable.
While the nation has been swept up in the #MeToo movement, has it started to make a change in how women are treated in hospitals? A recent NBC News story examined the problem:
The culture of medicine has been dominated by men. (Although 2017 marked the first time the majority of entering medical students were female, according to a report by the Association of American Medical Colleges.) This creates a historical power imbalance.
The hierarchical culture contributes to the problem. From the NBC News Story: “Part of it has to do with the culture of hospitals and the whole culture of health care in general, which is very hierarchical,” said Teresa Goodell, 58, a trauma clinical nurse specialist in the Portland, Oregon area. She has been a nurse for 35 years and says "she has endured multiple incidents of sexual harassment.”
“Physicians and top administrators are at the peak and feel free to mistreat nurses” and others they see as being underneath them, she added.
Harassment, sexual or otherwise, often becomes just a form of intimidation, a way to remind people where they are in the pecking order.
- A stressful work environment exacerbates the problem. Also, from the article, Paul Spector, a professor at the University of South Florida noted that the extreme stress of medicine contributes to the problem. “When people are under stress, they’re more likely to lash out at others, so this is more likely to result in mistreatment ... It could be sexual harassment, but often sexual harassment is just a piece of the bigger mistreatment pie."
- Sexual harassment from patients is also a problem – and not one people likely think about
To see the full article: #MeToo in medicine: Women, harassed in hospitals and operating rooms, await reckoning
David Ballard, Assistant Executive Director for Organizational Excellence at the American Psychological Association, summarized the situation for an article in Healthcare Dive: “Large bureaucracies dominated by men in decision-making – make healthcare particularly susceptible to sexual harassment.”
The Solution? The Courage to Change.
There are plenty of resources and articles on how to prevent and deal with sexual harassment. Obviously, solid policies and training are the foundation. What really matters, though is leadership courage - the courage to overcome a historical hierarchical way of thinking and culture that’s been willing to tolerate unacceptable behavior.