NURSING HIERARCHY Kathleen Bartholomew, RN, MN, delivered a TED talk on the harmful effects of the nursing profession's hierarchical culture.

You can trace the hostility and incivility that mar the nursing profession and jeopardize patient safety to a most unlikely source: nursing's hierarchical culture that devalues and shames caregivers, and blocks communication, says Kathleen Bartholomew, RN, MN, in a recent TED Talk you can watch here.

"In order to keep our patients safe, we need to be able to communicate," says Ms. Bartholomew, author of the book "Ending Nurse-to-Nurse Hostility," which offered the first comprehensive and compassionate look at the etiology and impact of horizontal violence on both patients and nurses. "If you have a hierarchy, those communications lines are blocked."

Ms. Bartholomew's hope is that nurses one day dismantle the nursing hierarchy that separates them. How, she asks, can a profession with amazing potential for human connection fall short and fail to offer compassionate care? And why do nurses too often go in the other direction — and do harm?

Dan O'Connor