Responding to Words That Hurt

“Sticks and stones may break my bones, but words will never hurt me.” My mom taught me that saying when I was a kid, but I realize that words can and do hurt sometimes. Yes, sticks and stones, and now guns and bombs, can do a lot of damage, but so can words and attitudes if we are not careful with them. Over the years, the NP profession has faced many critical and negative words, often from other healthcare professionals (HCPs), about our capability of delivering competent care, about our training, and about our role in the healthcare system. We need to know how to respond to these charges in a professional and appropriate way.

These thoughts came to the forefront recently, when I was made aware of a post on Fox News’ health blog by Dr Keith Ablow, a psychiatrist and Fox News correspondent, entitled Nurses Masquerading as Doctors. Dr Ablow was bluntly critical of nurse practitioners and our inadequate education, making comments such as, “The average doctor has more training, relevant experience, and raw intellect than the average nurse—period.” When I first read the blog post, I felt angry and made judgments about the writer. I was considering writing a scathing response to his post. In fact, many people did so; within 3 weeks, the post garnered more than 300 responses. Many responses from the general public and from HCPs supported Dr Ablow’s position, stating that if nurses wanted to be doctors, they should go to medical school. Sad to say, many nurses and NPs posted angry, belligerent, and negative comments about physicians.

I thought about Dr Ablow’s post, and realized that my response needed to go beyond the blogosphere. There was much that I could say to rebut his position and to defend and support NPs’ training, competence, and quality of care. I could also relate my experiences with doctors who, despite their training and “raw intellect,” have lacked basic skills. I could tell him about the patient who left me flowers, thanking me for making the diagnosis and devising her treatment plan, the very day after I read the blog, or I could mention the many patients who choose to see me rather than a physician. I think that we’ve all shared these types of experiences. But, based on the tone of Dr Ablow’s post, I feel that no response short of agreeing with him would make any difference for him.

As I reflected further, I realized that the real response needed to be to the general public and to our colleagues, especially physicians. As Gandhi says, “Become the change you want to see in the world.” Rather than criticize and defend, could I be the change I want to see? I want to see a healthcare team that works together, grateful for each team member and the role each one plays. I want to see people affirming the positive qualities in each other, be it in our NP, PA, or physician colleagues and other team members. I want to see people collaborating for the sake of our patients and the community, not cutting down, criticizing, or judging each other. I want to see people who will help me grow from my weaknesses and mistakes, not broadcast them as my incompetence. The challenge is to be that change, to respond in these ways to our colleagues. It is a challenge in that it’s not how we might respond from our gut (yet), but it is also an opportunity to grow as individuals and as a profession.

So, how do we respond to negative words about NPs? First, we must refrain from criticizing back. We must continue to provide competent, compassionate care in our day-to-day practice. Despite the pressures of the healthcare system, we must not lose sight of quality care. If we are giving excellent care that patients appreciate, the truth will speak for itself. Second, we must speak positively about our colleagues—be they physicians, PAs, or other NPs—and about all the good things they do. It’s easy to find things wrong and place blame, but it doesn’t accomplish anything. Blaming doesn’t solve problems, as Antonio Banderas states in the movie Take the Lead. “Assigning blame is okay for the moment, but it doesn’t make the problems go away.” So many good things are happening all around us that we need not broadcast the negative, the mistakes, or the blame. Instead, we can look at the many NPs and physicians who work well together and respect each other. In fact, one of the “gifts” of Dr Ablow’s blog was the discovery of strong support of NPs on the part of some physicians. For example, one physician wrote, “NPs are no less intelligent [than physicians], and the vast majority of patients are well cared for by a practitioner in the nursing profession. I have seen many [NPs] over my years as a surgeon and witnessed first-hand the genuine benefit their patients receive.”

Finally, consider sharing the positive things about what we NPs do by publicizing the NP profession. You can write a column or a letter to the editor in your local newspaper, discuss our profession at a school career day, deliver a talk on a health problem in a public forum, or testify in front of your state legislators about a policy issue that you care about. Many people are unaware of what NPs are and what we do. I believe that many people, Dr. Ablow included, don’t understand the difference between a nurse and an NP, be it our training or our role. We need to create opportunities to share who we are and what we do. I noticed that Fox News has regular contributors, including a gynecologist, an allergist, a dentist, a psychologist, a dietician, a breast surgeon, an internist, a natural medicine physician, and a urologist…but not a nurse or an NP. Rather than contacting Fox News to complain about the blog, maybe we should encourage the network to consider adding an NP as a regular contributor.

Words can hurt. The lesson I learned from all of this is to do everything I can to be sure my words don’t hurt others, no matter what their profession. More important, I can use words in a positive way to promote healing, harmony, and good health. Our physician colleagues are part of the same team. Let’s be sure never to use the critical words used about NPs when we talk about our physician colleagues. Negativity says a lot more about the speaker than the object of his or her speech. Our positive words about others will promote our profession as well. Let’s become the change that we want to see in the world.

Tom Bartol can be reached at .(JavaScript must be enabled to view this email address)