Physician and Nurse Burn-Out. Part VI Pulling rank

-“Doctor…I can’t stand when they interrupt me—just ‘cause they’re my superior.”

One of the sourer complaints that nurses (usually female) voice to us physicians (usually male) is that they literally despise when we pull rank to interrupt or silence them. In a respectful professional environment, the significant discussions should be carried out at a congenial peer-level, with methodical respect to other people’s opinions. Sadly, a few “dinosaurs” (not necessarily related to their age) are stubbornly “reminding” their subordinates that somehow their opinions should carry more weight per se. Paradoxically, most nurses know much more clinical and sociological details about our patients than we do as they are in closer daily contact with them. The irony of it.

Considering that in certain toxic environments, worsened by the terrible strains of this prolonged pandemic that is taxing the human resources in all health care settings, this flaw is still festering and affecting the attainment of good health outcomes, we believe that it constitutes a major cause of professional disenchantment of nurses. In these  times, we cannot afford to lose a single nurse. In our upcoming book Emotional frustration – the hushed plague we thoroughly discuss the reality and implications of carelessly interrupting women’s talk. Here is a book’s excerpt.

-“Doctor…Don’t want me to speak out —always f******interrupting me.”

Carla X. is young middle-level executive in a big American corporation that due to her great expertise in targeting the most dynamic segments of the markets is destined to climb much higher in the corporate ladder. However, she resents the not too subtle attempts by her less endowed male colleagues to sideline her in meetings. She argued that, in the latter, men use an antediluvian tool to bring her to keel and sabotage her impact on the discussion: the interruption of women’s talk.

The power dynamics in her job mimic the one prevailing in our society.          

Christopher Karpovitz et al. studied data from several groups to find out if there really was gender inequality in the deliberation process and if improving the feminine participation would eventually raise their authority within those groups. They found a significant gender gap in voice and authority that nonetheless could be erased if there was unanimous rule and a fewer number of women in meetings; likewise, it could be counterbalanced if women were present in higher numbers.[i]   Lynn Smith-Lovin and Charles Brody studied the speaker transitions in task-oriented groups to determine if men do interrupt women often. They said that: “Gender inequality in these task-oriented discussions is created by a mixture of attempts to use power and of differential success…Men discriminate by sex in attempts and in yielding to interruptions by others. Women interrupt and yield the floor to males and females equally.” [ii] Does their composition have an impact?

The same authors found that in all-male groups, individuals often interrupted each other; but when more women joined them, the number of interruptions fell. [iii] Another  requisite for advancement is to get proper credit for our words and deeds in order to rank appropriately in the institution’s formal evaluation for promotions.

Sean R. Martin et al. studied if there were gender differences in speaking up with data from cadets of the US Military Academy [iv]. The first mailed survey collected basic biographical information; the second one was delivered prior to a crucial two-day competition of war games, at the end of their training period. In the latter they asked to rate each member’s performance and standing to calculate individual scores. In the third survey, they measured the leader emergence score as members had to rank them as leaders. They found that: “men who spoke up with ideas were seen as having higher status and were more likely to emerge as leaders. Women did not receive any benefits in status or leader emergence from speaking up, regardless of whether they did so promotively or prohibitively.” [v]

-“Doctor…When I lead the way, men resent it—only because I’m a gal.”

Marjorie X. is a very proficient management expert that works in a medical supplies company; whenever she opens her mouth to pinpoint a defective process or an outlier member, men often disparage her with gross epithets behind her back. Paradoxically a few women also join in the fray…Talk about a brave new world. Diary USS Awareness – Is the silence of the seas teaching you the art of listening?

Ealy and Karay discussed a role congruity of prejudice toward all those women that dared to assume the pivotal leadership roles in our modern society. [vi]  These authors distinguished two major aspects in this generalized bad attitude:

  1. Perceiving women less favorably than men if they are viewed as potential occupants of leadership roles.
  2. Evaluating behavior that fulfills the needed attributes of a leader role less favorably when it is carried out by a woman.

Consequently, women are perceived less favorably in leadership roles, which can significantly gnaw at their real authority in times of crises of modern institutions. If women-leaders  should become mentors for other women that are trying to emulate them, the camouflaged opinion of their co-workers will certainly have an impact. In every organization there is a parallel structure of power that must be reckoned.”

Note– The feature image was taken from Wikimedia Commons.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.



[i] Christopher F. Karpowitz, Tali Mendelberg, Lee Shaker, “Gender Inequality in Deliberative Participation”,  American Political Science Review, Volume 106, Issue 3, August 2012, pp. 533-547, published online August 9, 2012.

[ii] Lynn Smith-Lovin and Charles Brody, “Interruptions in group discussions; the effects of Gender and Z

Group composition”, American Sociological Review, Vol. 54, No.3 (June 1989) pp.424-435.

[iii] Ibidem as above.


[v] Sean R. Martin, “Research: Men get credit for voicing Ideas, but not Problems. Women don’t get credit for either” Harvard Business Review, November 2017.

[vi] Eagly AH, Karau SJ, “Role congruity theory of prejudice toward female leaders”, Psychology Review, 20012, July; 109 (3); 73-98.