Career-Limiting Moves NOT to Make in a Hospital



As evidenced by the drunken (and completely unnecessary) rant against her boss (who just happened to be behind her in line for the corporate party video-postcard) “career-limiting-moves” – or CLMs, according to the Urban Dictionary folks – such as the above are a sure-fire way to get… well…fired.

Such moves in hospitals can be up there with extreme cases of malpractice and ridiculous mistakes in surgery (which we could fill 10 blog entries with.) But such things are statistical rarities…Here we’re talking about much more common ill-advised moves potentially detrimental to a much higher percentage of medical staff.

And while it’s a good idea to be aware of the attitudes and habits that can lead career damage from the ER to the OR, it’s an even better idea to look at specific examples of what not to do in the hospital or clinic you’d like to keep working in:

Long-term career-limiting-moves

While doing any of the below for a day won’t limit your career movement in a hospital or large clinic, making a habit out of any one of these will contribute to lynching you in the long term:

Chronic absence (or lateness)
We all have to work overtime and lots of days may be more draining than they should be, but if you’re late or taking too much time off, you could be labelled undependable. You may be in-demand to fill a specific medical position in your line of work, but chronic absence can keep you from making your way to the team or specialty of your dreams.

Refusing to admit you made a mistake
We’re supposed to learn from mistakes (or be doomed to repeat them.) But even worse than not learning from mistakes is refusing to admit to others and yourself that you made one. While most medical professionals fear making mistakes, everyone makes them. But not dealing with the aftermath of a mistake will catch up with you sooner or later.

Adopting a sense of entitlement
Doctors or nurses who think the hospital “owes” them for just showing up (setting aside whether or not they’re the next superstar when it comes to talent) may keep their job, but this is a recipe for alienating one’s self from friends and superiors alike.

Do anything to risk disciplinary action against yourself
While TV makes it look like every other physician is out there pulling a Meredith Grey or Alex Karev every day, the actual figure for doctors who are disciplined each year in the U.S. is 0.3%. However, “Actions taken by state medical boards may reflect only the most extreme forms of unprofessional behavior,” said the authors of an article that looked at this in the Dec 22, 2005 issue of the New England Journal of Medicine. If you are engaging in risky behavior, stop before it bites you in the posterior.

Short term career-limiting-moves

Every time you make one of these moves, you can be sure you’re running the risk of being asked to hang up your scrubs immediately. Best not to pull-off any of the following…evver…

Riding the [corporate] porcelain bus
Getting drunk at office-related get-togethers (or showing up tipsy or hung-over at work) and doing/saying anything even mildly inappropriate is not cool. Far more detrimental than the slightly-off-kilter comment made while you’re sobering-up or hung-over is the dangerous glimpse of a perceived “real” you that your superiors will see. Partying at the hospital Christmas party is fine, but it’s not a free pass to be a jerk. (Actual drinking on the job – it goes without saying – is on the farthest end of this particular CLM spectrum.)

Blogging/micro blogging about inappropriate things at or about work
This can be a long-term or short-term career-limiting-move; depending on when something unacceptable you’ve written publically catches the attention of HR or your superiors and what their tolerance level is for what you’ve decided to post. This is perhaps the most frequently-executed career-limiting move. Even in medical jobs where staff (theoretically) should usually be on their feet, away from computers, smartphone and tablet use by doctors and nurses on the job has made this CLM infinitely more possible.

Inappropriate relationships
This extends beyond sexual misconduct between co-workers or staff and patients, to ethical conflicts of an ongoing nature. Even the first instance in such a conflict is enough to end your career (unlike the seemingly-infinite get-out-of-jail-free passes TV medical professionals seem to get on this front.)

Bad-mouthing your superiors
This is the granddaddy of them all. It’s also the most-talked-about and least-done, for good reason. Rule of thumb: If you wouldn’t want it in the news, don’t say it on-ward or put it in a text or email. “In this era of dwindling face-time, your emails are increasingly a representation of your work ethic and professionalism” notes a post on on the pitfalls of sending the wrong email to the wrong person.

Drug abuse
Not just for you but for others: It goes without saying that dealing from the store room on your floor is a one-way ticket to having your accreditation revoked…Depending on the circumstances, this CLM can also be a one-way ticket to jail.

From inappropriate prescribing, to fraud, to failure to report adverse or unprofessional events or incidents or abuse, errors of omission can stall your career at-best, and end it at-worst.

Sketchy billing practices
If you or your colleagues/supervisors/subordinates are tasked with any aspect of billing and you are knowingly involved in cooking the books or defrauding patients or their insurance companies, you are starring down the barrel of a situation that will involve you seeing far more lawyers than doctors and nurses for the next while. Best to report any such abuses and prevent any situations in which you might be the one committing them.


Absolutely everything listed above is preventable for any medical professional.

Perhaps the key to a more cautious career starts in med school and nursing college: The New England Journal of Medicine authors concluded that professionalism “can and must be taught and modeled in medical schools” suggesting that modelling such things at this stage will set more doctors and nurses up for success. (Now why isn’t there a clever Urban Dictionary entry for that?)

Read More:

Further thoughts on the ills of blogging about work

Do’s and Don’ts to avoid the mindsets that lead to career-limiting-moves

8 reasons nurses get fired