I have had an okay year so far as a junior doctor. It is better than my intern year. My past term in the emergency department was overall quite positive. It felt like one of the safest terms I’ve been involved in for patients, with so many seniors available and less patients under one doctor’s care.

However, there was a strong culture of bullying against junior doctors from the ED nursing staff. I especially found the nurses targeted young female doctors. I don’t know where this toxic environment stems from, but young female doctors get treated in a very different way to male seniors.

You can find yourself at the end of hostility and passive aggression, with no obvious triggering factor.

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Examples

I asked a nurse looking after one of my patients to please do an ECG. The response was, “for fucks sake”.

Certain nurses would spend most of their shift speaking negatively about me or other doctors within ear shot.

They often made passive aggressive remarks about any decision making.

The refusal of help on a number of occasions.

Questioning my decisions in front of patients and their families in a loud way. Which is terrible for patient trust and very unprofessional. The decisions I made were never on my own, as a junior we always discuss every case with the senior doctor in charge.

Pointing out which doctor was working which day on the roster and saying things like ‘oh thank GOD they’re working’ or ‘oh my god not them’. In front of staff.

Acting hostile and angry at any sort of interaction or request.

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What I ended up doing

In the end I was scared or anxious to even approach certain staff members who were particularly mean. They often banded together and as a duo or trio treated you in a nasty way.

I would give patients medications and pain relief, I’d do ECGs, urinalysis, and multiple other jobs myself to avoid further annoyances. I’d try extra hard to avoid the wrath of certain nursing staff, but nothing was ever enough and I’d always seem to anger them.

Or give them an excuse to loudly complain about me to staff, in front of me and patients.

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Why it’s so wrong

Bullying is never okay. It is especially bad in an already stressful work environment. The emergency department is fast paced and team work is essential. Having people make staff feel unsafe, stressed or unsupported is dangerous.

It also affects the trust patients have for their health care professionals.

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Not uncommon

Unfortunately, it is all too common. With many female doctors reaching out to me with similar problems.

Someone anonymously posted on a Facebook group for doctors:

I am sick and tired of the sexism and racism in medicine, and having to essentially suck up to all medical and nursing staff in every new job, because I am not a white male.

Anonymous doctor

Many people liked the post, and few commented that they feel the same.

I always strive to be polite and professional, and have never encountered such hostile treatment before this term. It is a shame that this behaviour is so normalised however.

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The bullying epidemic in medicine

There should be a zero tolerance policy of this type of behaviour. It is an epidemic, and should be named.

The nurse bullying phenomenon is well-documented in the clinical and leadership literature. It starts early and is present from the classroom to the bedside to the boardroom. One study showed that over a 6-month period, 78% of students experienced bullying in nursing school

Edmonson, Cole; Zelonka, Caroline, OUR OWN WORST ENEMIES THE NURSE BULLYING EPIDEMIC

Bullying is not only pervasive and systematic in nursing culture, but amongst fellow doctors as well.

Over half the junior doctors in the present study experienced bullying and nearly one-fifth experienced sexual harassment. Junior doctors are reluctant to speak out, not only for fear of reprisal, but also because they do not believe it is worth doing so.

Bullying and sexual harassment of junior doctors in New South Wales, Australia: rate and reporting outcomes

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Change is needed

Let’s speak up about it. Name it. Raise awareness, and break this cycle of bullying. Just because you had to endure being ‘taught by humiliation’ does not mean you should subject juniors to it.

The more we speak against it, and support each other, the less commonplace bullying will be.

Don’t be afraid to speak up. I was too scared to post about this before, out of fear someone will find out who I am and not want to hire me. But if speaking out against bullying is seen as a bad thing, I don’t want to be a part of that work place.

The first step to changing this work culture is changing yourself and how you interact with your colleagues.

Feature photo by Jonathan Borba on Unsplash