Nurses, abuse and the myth of the "good woman"

Patriarchy promises protection to women who conform to the "good woman" myth. Once again, it lies.

I had lunch with a friend last week. She’s a nurse in a big urban public hospital and always arrives with a quiverful of believably unbelievable stories. One of them, with her permission, I’m sharing with you here. It was about one of her student nurses who was working in palliative care (where people who are dying go so they don’t have to die in a noisy hospital ward). The student’s name is not Lucy so that’s what I’m going to call her. Lucy is 22 years old and in her second year studying nursing. She’s working in the palliative care unit to get some experience, earn some much needed income and help people who she believes are most in need of kindness and care.

A couple of weeks ago a man in his late sixties came into the unit. He had end stage cancer and wasn’t expected to live long. After he’d been admitted and settled into his room, the senior nurse asked Lucy to help him have a shower and get changed into clean pyjamas. She helped him walk to the bathroom, undress and sit in a chair under the shower. Then, despite her rubber-soled shoes, Lucy slipped on the wet floor and fell to the ground in front of the patient. He grinned, leaned over and kicked her in the stomach, then laughed gleefully as she stared at him in shock. Lucy told my friend afterwards that he hadn’t really hurt her, he was too weak to do much physical damage, but the humiliation - and his obvious delight at being able to hurt her, even a little bit - did far more harm than the kick itself. She had to finish showering him as he continued to snicker to himself, then she helped him settle comfortably in his bed and left him to rest.

He died three days later.

Abuse and power

Violence and sexual harassment are usually about power. Men who are patients in hospitals, feeling sick and vulnerable, too often choose to alleviate those feelings by abusing the nurses who are looking after them – they’re using the power given to them by the hospital as well as the myths that even nurses believe – abuse by patients is just part of the job.

Hospital policy requires that patients cannot be restrained (by pharmaceutical or physical means) regardless of how threatening or aggressive they’ve been, until they’ve actually committed physical violence against someone in the hospital. So, as my nurse friend told me, she can (and has) spent an entire shift caring for a man who calls her a bitch and a cunt and a whore, threatens to beat her and kill her, and refuses to let her treat his illness while also demanding she attend his every call. She cannot leave. She cannot choose to not respond when he rings the bell, she cannot get angry at him or yell back at him. The most power she has is that she can say “I’m not going to stay here if you keep talking to me like that” and leave. But the next time he rings the bell, she must go back to his bedside and ask what he needs.

Another story my friend told me: she recently had to call one of the ward doctors to ask for assistance with a patient who was unmanageably aggressive and threatening. The doctor strolled into the ward a couple of hours later and said, “Are you sure? He seemed fine when I talked to him.”

I’ve told several people this story and it reduces women to screaming rage and leaves men bewildered. “How is he supposed to know if the guy was ok with him?”

He’s supposed to know because his colleague, an experienced and trained professional, told him about the patient’s condition. He’s supposed to know that an abusive man does not speak to another man in a position of power the same way he speaks to a woman when he believes he has power over her. He’s supposed to take a woman seriously when she says a man has treated her badly. He’s supposed to do his job.

He failed on all counts. The patient continued to swear at, threaten and intimidate all the nurses and female doctors on the ward. He magically turned into a calm and reasonable man when male doctors appeared, and this dynamic didn’t change during his entire three week stay in hospital.

Nurses and the myth of the “good” woman

Nurses, in popular imagination, embody the “good woman” myth, selflessly dedicating themselves to caring for others in their time of need. They are ministering angels who look after the sick, tend to the dying, help bring babies into the world, clean up mess and hide the yukkiness of ill health away so the rest of us don’t have to see it. They give empathetic kindness as care, doing nothing more demanding than providing soft cloths and a glass of orange juice while (male) doctors supply all the skill and knowledge.

On the flip side (because anything female dominated can’t exist without being objectified) the revoltingly pervasive naughty nurse myth punished women in nursing for their professional independence by sexualising them, erasing their expertise by dressing it up in a tight, white uniform and a flirty giggle.

Neither of these myths recognise the reality of nursing. The expertise, the professionalism, the ongoing study and training, the hard physical labour, the demanding standards and the sometimes harsh practicality that will inflict pain to promote healing.

The ministering angels, however, don’t get the protection that patriarchy promises to “good women”.

A study of Queensland nurses in 2010 found that 54% of nurses in public hospitals in Queensland have experienced workplace violence. The person most likely to attack them is their patient. Most of them don’t report the violence and the main reason is that violence and sexual harassment is seen as “normal in their nursing work.”

Another study in 2009 found that 60% of female nurses (and 34% of male nurses) reported being sexually harassed in the previous two years. Again, patients were the most likely perpetrators, with doctors mentioned as other common offenders. Additionally, while most of the nurses in the study expected (male) patients to make sexual comments or even attempt to grope and grab them, the general attitude was summed in a couple of quotes from nurses in the study:

“It comes with the territory”

“If you take offence for every lewd comment made by a patient, you shouldn’t be in this job.”

Nurses tend, by necessity, to be resilient and cheerful people, but there are good reasons Australia is expected to face a shortfall of around 70,000 in the next ten years. Too many experienced nurses leaving due to exhaustion and burnout, combined with high barriers to entry for new nurses (unsustainable conditions for student nurses, not enough graduate positions and no positions for new nurses who didn’t get graduate jobs).

It’s difficult to believe that the constant drain of lewd comments, groping, grabbing, swearing, abusing and belittling doesn’t contribute in some way to all those nurses streaming out the doors of public hospitals, determined to never return. The evidence says it contributes to workplace stress and that hospital leadership can make a considerable difference but is often lacking.

Men abusing their nurses is not inevitable – I’m not going to do a NotAllMalePatients here but the men who don’t behave like assholes are proof that assholery is not an inherent characteristic of manhood. We need nurses. We need more nurses – lots more. And if we’re going to ask (mostly) women to do this difficult and demanding job, they deserve better support from their hospitals, better conditions, more money and at the very minimum, that we believe them when they say a man is being a jerk.

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AI declaration: I do not use AI in any of my work. Not for writing, structure or research (although I do use it occasionally to find research papers - the academic databases search engines are rubbish). Mostly I stay away because the few times I tried it the results were so incomplete and unreliable that it ended up being faster and better to do it myself. I’m told AI has improved significantly since then, but I’ve chosen to not explore this because I don’t want to be tempted away from the complex imperfection of my own thoughts, voice and analysis.

I have sometimes used AI to create images, and they are all labelled as such. Graphs and data are all my own work from spreadsheets I create myself and data I download from reliable sources such as the ABS.

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