The standard we're all walking by

The Royal Australasian College of Surgeons recently released report by the External Advisory Group (EAG) was a damning look into the culture of bullying and harassment in surgery. In an unprecedented move, Professor David Watters, in his role as President of RACS, issued a public apology to those who have been bullied by surgeons. At the moment, we are awaiting the final EAG report where recommendations will be made into where to from here to stamp out bullying and harassment. I am impressed that RACS took this step in the first place. Surgery has a terrible reputation and the EAG report has unfortunately, upheld that. But where is the rest of the healthcare system? Where are the other specialty colleges, allied health, nursing, medical administration? RACS, if they continue on this pathway of addressing harassment, have an opportunity to be leaders. But it cannot be done alone.

Hospitals are a melting pot of different beliefs, ages, genders, races, backgrounds and experiences. It is natural that there would be interpersonal conflict. And there is. Whilst surgeons may well have learnt themselves a pretty bad rap, on a day to day basis, people from all walks of life are making someone else miserable. Since the report has been released, I have very rarely heard anyone else say that their specialty or profession or hospital are prone to bullying and harassment. I haven't seen (at least not well publicised) another speciality college saying that they will follow the lead of RACS and investigate bullying and harassment in their own specialty too. The hospitals have just carried on, business as usual.

Bullying happens everywhere in hospitals. I don't know what it is. The list of episodes of bullying and harassment is extraordinary. From the pay office who 'forget' to pay junior doctors to the senior nurse who likes to push around the interns. There was the time a senior physician commented about how women shouldn't be allowed to do surgery. There was the surgeon who liked to treat his theatre nurses so poorly, they had such a rapid turn over. A senior nurse was suspended for bullying her juniors, only to return to work. Some of these things, I've seen happen. Some have been stories from other colleagues at various times and at various hospitals. And quite often, the solution is to do nothing. Even those with some power do nothing; problems with staff members, especially if not your own, go in the too hard basket. And quite often, young doctors are told not to make a fuss, not to stand up for what is right because 'it may affect their career'. Even senior staff members within hospitals will freely admit that there is a problem, with an individual, a group or a culture then follow up by saying 'it's not worth the trouble'.

I agree, standing up for what is right may have negative consequences on the career  prospects of an individual. You are thought of as a trouble maker. And very often, as was identified with the RACS EAG report, a power differential exists. People have great ways of making your life miserable within the hospital environment. Despite this, one thing I am truly sure of. That is that the current standard of behaviour that we are accepting in our hospitals is definitely harming our staff members.

Again, I am going to refer back to doctors, but I would be quietly confident that this happens everywhere. Why would anyone subject themselves to constant stress? Good people leave. They leave that hospital, they leave the public health system, some leave healthcare all together. What's crazy about this is that the perpetrators, the system sees that as a win. But I can tell you it is an enormous loss. The people who care enough to say when something stinks can be our greatest assets, trying to change the status quo.

I worked with a colleague several years ago who was an extraordinary doctor. They came up against some difficulties with their training body and was not at all supported. This brilliant young doctor left the hospital system altogether. The people who made life difficult were pleased to have a problem out of their hair. The public should mourn this loss for we have lost a brilliant physician who was just beaten down by the constant fight just do a job.

So, now that the EAG report is out and RACS has been held responsible, I would like to see every area of healthcare take this lead. They may not need to commission an independent report, but I would like to see some of the recommendations made carry over to every other specialty college and healthcare profession. Surgery may have learnt it's stripes but let me assure you, that is not the bounds of the problem. It's time to stop walking by an unacceptable standard or pretending that your s*** doesn't stink. It's time for a multi-pronged approach to bullying and harassment in our hospitals. I hope that I can say in the future, that I am proud that RACS, my college, led the way on this and that we all rose to the occasion.