Hospital Culture

The High Stakes For Healthcare Workers

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Working in healthcare is challenging. Being a good doctor is difficult. Being a perfect doctor is impossible.

The stakes are high. Healthcare workers are often stressed. I have never seen a hospital without some amount of intrapersonal conflict and drama. Some all-time favorite classics on an internal medicine service you may recognize:

    • “Ugh, can you believe they admitted this to me? They didn’t even do X, Y, or Z . . .”
    • “Can you believe so-and-so won’t just do this procedure?”
    • “She should definitely not be on my service, why won’t general surgery just take her?”

Making disparaging comments about another doctor, nurse, or other healthcare worker has no place in the hospital. Don't engage in trash-talking. Ever.

General Advice for Working in a Hospital

  • Everyone is working hard to do what they believe is the best thing for the patient.

    If you really think someone is being negligent or does not know how to provide appropriate care, feel free to express your concern and ask directly how certain decisions are being made—or if needed, escalate it to administration through the appropriate channels.

  • If someone makes a mistake, give them the benefit of the doubt.

    When you make a mistake, it won't be because you are a moron—it will be because of a difficult situation or circumstances.

  • Ask clarifying questions.

    When you take an admission from the emergency department, and you feel that something else should be done for the patient or diagnostic uncertainty remains, feel free to ask clarifying questions. However, you are now part of this patient's care team, so pick up the case and keep going with it, as opposed to criticizing the emergency department. You were called to continue evaluation and management. If you need help caring for the patient, ask for it by calling a consultant.

  • Brag to your family about having good clinical judgment, and move on.

    Sometimes you will be right about something when everyone else was wrong. "I knew this was going to be cancer, not a bacterial infection!" "I knew that the patient would do poorly without surgery!" "I knew the patient needed that diagnostic test!"

  • If you need to talk to someone, reach out. If someone reaches out to you, make time to listen.

    Suicide and burnout in healthcare is a serious problem. I have personally known people who committed suicide in part due to what was going on with their work and medical career.

Image credit: Eric Tanenbaum. 

Page Last Updated: July 19, 2022

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Headshot of Eric Tanenbaum, MD · Assistant Professor, WSU College of Medicine; Nocturnist, Swedish Hospital Medicine
Eric Tanenbaum
MD · Assistant Professor, WSU College of Medicine; Nocturnist, Swedish Hospital Medicine
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