The power imbalance at hospitals between doctors and nurses has a negative effect on safety in medical workplaces, according to a jury investigating the murder of a nurse by a doctor at a Windsor, Ont., hospital.
The jury was part of a coroner’s inquest into the 2005 murder of Lori Dupont, a registered nurse a Windsor’s Hotel-Dieu Grace Hospital. She was killed by her former boyfriend, who was an anesthesiologist at the same hospital.
The two had shared a home but Dupont ended the relationship in February 2005. Shortly thereafter, the doctor tried to commit suicide. When he returned to work a few months later, he was monitored but the inquest discovered many of his colleagues at the hospital felt threatened by his behaviour. On Nov. 12, 2005, he stabbed Dupont in the hospital’s recovery room, then injected himself with a fatal dose of anesthetic.
The inquest, which began Sept. 24, 2007, and finished on Dec. 11, discovered several managers at the hospital were aware of the doctor’s behaviour towards Dupont as well as other staff. There had been complaints about misconduct including aggressive behaviour, sexual harassment of nurses, breaking operating room equipment and inappropriate conduct in front of patients. The complaints went back as far as 2000 but, the jury found, “there seemed to be much confusion and indecision as to how to deal with this physician.”
At the conclusion of its investigation, the jury released a list of recommendations for the health-care system to address the problems which can contribute to an abusive environment at hospitals and tragedies like Dupont’s.
The jury recommended:
• putting patient and staff safety first in public hospitals;
• ensuring hospital by-laws put patient and staff safety ahead of doctors’ rights to practice;
• hospitals implement a formal procedure to deal with doctors who show disruptive behaviour;
• ensuring workplaces implement a domestic violence policy;
• hospitals have someone to specifically deal with abuse and harassment complaints; and
• proper investigation into the theft or abuse of drugs in hospitals.
Both the Registered Nurses’ Association of Ontario (RNAO) and Ontario Nurses’ Association (ONA) welcomed the outcome of the inquest and said they would work with everyone involved to implement the recommendations, but both emphasized the importance of addressing the power imbalance between doctors and other health-care professionals.
“Until systemic hierarchies embedded in our health-care system are addressed, physicians will continue to wield a disproportionate amount of power over other health-care professionals,” the RNAO said in a statement.
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