People, Why Are We Fighting?

By  |  December 2, 2014 | 

If my last post used the words of the brilliant Marvin Gay, today’s post reflects Mick Jagger’s  ultimately vain and ineffective plea for non-violence at Altamont in 1969, when a group of Hell’s Angels, acting as security, brutally murdered a concertgoer feet from where The Rolling Stones were performing.

A colleague of mine was telling me about a very ugly exchange on an anesthesiology message board between an anesthesiologist and a CRNA.  You can check it out here:

As I read it my first reaction was one of dismay, as well as disbelief.  The complete deriding of an entire class of professionals (CRNAs) by a physician colleague is wrong on so many levels.  It is never ok to decide that an entire class of anyone exemplifies a typical set of characteristics, not race, not religion, nor professional designation; it’s simply offensive and ignorant. Should I go online and flame all doctors after seeing one bad physician?  Should I pronounce that all doctors are money grubbing felons after reading an article about a physician indicted for Medicare fraud?  I wouldn’t do that for so many reasons. One is that it is simply bad manners.  The second is that I have respect for ALL my colleagues regardless of the initials they have behind their names, from physicians to custodial staff. I can only imagine the type of person who would lob this type of accusation in a public forum. A person perhaps who lacks a set of professional ethics that is required.

But as a member of such a professional group I feel I must call on all our members, be they PA or NP or Midwife or CRNA or CNS, to vigorously defend ourselves against baseless and inaccurate degradation like that seen on the above forum. How can we best do this?  Once more, a list:

1.  Please use spell check before posting anything.

2.  Please stick to facts that include, where possible, evidenced-based medicine.

3.  Please work hard to find ways to demonstrate the continued safety and efficacy of the care that we deliver.

4.  Please work with our graduate degree programs to ensure rigor and vigor of education in order to produce quality graduates.

5.  Please fight for and demand respectful communication between disciplines at work.  This exchange obviously reflects long simmering resentments at work.  From the top down and the bottom up, respectful communication is of utmost importance, regardless of the pretty initials behind your name.

6.  If  you are working at an institution that supports or even promotes this type of shallow, disrespectful and abusive communication, demand better for yourself. Do what you can to change what you can, but never accept this type of treatment as within normal limits. It isn’t. I have heard many, many stories of mistreatment of NP/PA colleagues. Do us all a favor; if you are putting up with this because that “is the way things are,” STOP.  Your unwillingness to demand to be treated in a professional and collegial manner hurts all of us.  It is NOT ok.

7.  Continue to support and be active in SHM, an organization that would never allow for such a vitriolic, immature and destructive display. More likely anyone that is a member wouldn’t want to act that way. Our members are pretty cool people,  people you might want to tip a fermented beverage with, or work with on a project, or get a great book recommendation from. We NPs/PAs have a role here.  We have a seat here at this table. We need to continue to grow our numbers, our activism, our experience and take part in the fastest growing medical specialty, one that actually does seem to understand who we are and what we can do, and respects us for it.

And as for the blowhards who are on the message boards, cowardly hiding behind their anonymity and weakness, I have a favorite proverb:

Let the dogs bark, the caravan moves on.

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About the Author:

Tracy Cardin
Tracy Cardin, ACNP-BC, SFHM is the Associate Director of Clinical Integration at Adfinitas Health and also serves on SHM’s Board of Directors. Prior to this, she was the Director of NP/PA Services for the University of Chicago and worked in private practice for a group of excellent pulmonologists/intensivists for over a decade. She has been a member of SHM for over ten years and has over twenty years of inpatient experience, which seems incredible as she cannot possibly be that old! Her interests include integration of NP/PA providers into hospital medicine groups and communication in difficult situations. In her free time, she likes to run and lift, read and write and hang out on the front porch of her semi-restored Victorian house with her dear family and friends while drinking a fine glass of red wine and listening to whatever music suits her whimsy.


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