Would you report this?

[canesdukegirl, BSN, RN]

I was circulating a case in the OR when I was told by the surgeon that the next patient was a VIP. I was setting the room up after I had interviewed this patient (young athlete, never had surgery before and is TERRIFIED) and told my scrub tech to be "on point" because this pt was special to the surgeon. This scrub tech has only worked in the OR for about a year, is completely unprofessional, and I have had multiple issues with her. I have reported these issues when they come up, but nothing has been done about it. This tech has a very hard time seeing beyond herself and her own needs, and often will ask the docs (while in the middle of surgery) if she can drop scrub to go "take care of business". She is pregnant, so they feel bad if they tell her that she can't go. Because of this pregnancy, she is even MORE self centered and cannot stop talking ad nauseum about her pregnancy. If someone makes a comment, she immediately turns the focus to herself-example: "We need to set this room up quickly because this patient is bleeding out." Her response: "I can't move quickly anymore and I am getting ready to wet my pants!" or "Have you pulled all of the supplies that you need for this case?" Her response: "I don't think so, I don't know. I have placenta brain. If I forgot something, I will just ask you for it."

So this young patient just rolled into the OR. He is so nervous that he has required 4mg of Versed. I am trying to do the "Time Out" before induction of anesthesia. The CRNA asks him, "Are you ok now? Are you still nervous?" Before the pt can respond, the scrub tech turns to him and says, "YOU are nervous??? Dude, I am nervous! I am very nervous!" The poor pt turns white, looks up at the CRNA and says, "Oh man, that isn't good." I am trying to do damage control and telling him that she was just kidding, but I am totally seething mad. I told my manager about this, but he brushed it off, saying "Well that's just how she is."

I am really angry about this, but my manager seems to think that I should just forget about it and move on. I thought that we were in the industry of taking care of PATIENTS and I feel strongly that this scenario was plain wrong. Should I go over my manager's head about it or should I just let it go?

[pinkpig]

I think delegating task is one of the hardest things in nursing.... I like to write e-mails to my manager when I have issues b/c I like to have everything in writing and a response or a lack of one in writing too. It's tough when the person you're having problems with is also pregnant, I can empathize-looking for an answer myself on that one...

[OttawaRPN]

What about telling her up front, "This young man is nervous enough as it is without you worrying him even further, let's all be a little bit more professional to ease his anxiety, shall we?"

And each time she stoops to that level, call her on it in a similar stern but non-threatening manner.

.....Or you could always just b!tchslap her but I'm guessing that's not allowed in the OR.....

[canesdukegirl, BSN, RN]

Thanks pinkpig. I also am of the belief that putting things in writing is always the right thing to do. However, I have very little faith that my manager will do something about this. I think the reason I am so angry is because the tech was not focused on the PATIENT, even though I gave her a heads up to do so.

First of all, I shouldn't even have to verbalize to her that her focus should be on the patient. Secondly, although I make every effort to be cognizant of her pregnancy and the issues that she faces as a result, I feel that if she is making excuses, she should just sign up for FMLA and stay at home. It sounds cold, and I don't mean for it to, but I have worked with a number of pregnant nurses and NONE of them acted like this. I am at my wits end with this one. She sits on a stool during cases that are "standing" cases and directs the other nurses and even the surgeons in the room as to how they can do their job better. I have also told my manager about this (research shows that contamination is highly likely when a sterile scrubbed person sits, and is therefore not recommended by AORN standards), and my manager tells me that I need to ask this tech to stand. So I do. And she gives me a sob story every single time about how I have no idea what it feels like to be pregnant and have to stand all day (she does not know, and does not need to know that I WAS pregnant when I was working, but lost the baby at 34 weeks). It is difficult for me to have sympathy for her and I want to make sure that my perspective is not skewed, which is why I am posting here. I am totally focused on my patients, and I have a very low tolerance for staff members who forget this. Is that harsh? Do I need to be more understanding?

[himilayaneyes]

Sorry for your loss OP. Being pregnant isn't an excuse to be self-centered when you're working with patients. We're dealing with lives here. I would do what one of the pp suggested by sending all of my complaints in email or writing so that if you need to go to HR there will be a record. You could also try telling her in a professional manner what you think about this situation. If her pregnancy is that bad...then perhaps she should take leave early..as far as her wetting her pants...perhaps you guys should insert a foley into her on her workdays...or perhaps she should be before you take a case.

[LaurenMarie]

Im only a nursing student, but I feel like you are giving the tech as many opportunities as possible. I, too, have an issue when people make excuses for lack of performance. Why even get into this profession, you know? Bottom line is that I wouldn't want my patient getting an infection because she was too tired to stand up and practice sterile technique. If you tried to correct her actions and she's STILL acting this way, I'd be telling someone. You should always do what YOUR GUT thinks is the right thing to do.

[saltwaterstat]

If after a few repeated trys w/ this tech, and she obviously refuses to get the message, and your own manager brushes it off, yes, I would report it. this is not an office setting. It certainly is not in the patients best interest to be treated this way. you have your own job to do w/o having to constantly police a tech's (or another nurse or a surgeon or whomever) actions. And your own manager needs to rethink the reason she/he is in nursing. :argue::smackingf

[Amagoo]

I think you should report her. Maybe talk to a nurse educator, or do an incident report form and let the risk management handle her.

I am a surgical tech in the operating room, I don't get to interact with the patients as much as the nurse does, but our only chance is when they come in the room and are going off to sleep. For her to tell the patient that she is nervous is not professional. It makes all of us in the operating room look bad.

Can you ask not to work with her?

I have worked with many pregnant women and none have acted like her. So she needs to shape up or get out of the OR.

[laughing weasel]

If she was sick she would stay home right? If she can not physically preform her job then she needs to transfer or take the time off. There are no do overs in nursing and no oops I am so sorry either. Every one handles pregnancy different but if she can't enabling her until something very bad happens just exposes every one to undue risk.

[wee_oneRN]

Wow, sounds like this tech needs more guidance with learning her boundaries. Because you have more experience it puts you in the position of being able to guide and teach this tech (even though you may not want that task). Try the manager 101 tools: don't forget to praise this tech when they do something correct and redirect their behaviors in a non-threatening and positive way. "You handled that patient in a very professional way when you said, blah blah blah" "If you aren't sure if your tools are ready I'll give you a little extra time to reorganize, I know you are excellent at thinking ahead".

I wish I could think of some better phrases for you, but you would be the best at that. It sounds like you already know her weaknesses. Try to sit and think about some therapeutic phrases you can have ready ahead of time. I know it sounds silly. But, this stuff really works. Think about her strengths, too.

Let me know what you come up with!

[DayDreamin ER CRNP]

"Have you pulled all of the supplies that you need for this case?" Her response: "I don't think so, I don't know. I have placenta brain. If I forgot something, I will just ask you for it."

I am trying to do damage control and telling him that she was just kidding, but I am totally seething mad. I told my manager about this, but he brushed it off, saying "Well that's just how she is."

First of all, I cannot stand the "that's just how she is" excuse for bad behavior or laziness. I had a little run in with a nurse a few weeks ago and that's the same response I got from the charge nurse. I was trying very hard to not to lose my composure when I asked the charge nurse if would be ok if I started to act that way and we could start using that excuse for MY behavior too.

Secondly, her lack of planning or laziness is not your burden to bear. Ultimately it IS because you are responsible for the patient's care but if she cannot perform her duties at work she needs to go ahead and take her maternity leave. It is not your responsibility to pick up her slack when you have bigger fish to fry.

If you have gone up the proper chain of command and she is still allowed to behave this way, maybe it is time to take it to the next level of management.

On the other hand, y'all may be teaching her how to treat you. If she isn't getting XYZ ready and you do it for her, she will continue to be lazy and allow you to pick up her slack. Can you write her up? In our hospital, a nurse can write up a tech (or vice versa really) for not doing his/her job as it is outlined in the job description.

I hate being the work police but enough is enough & sometimes you just have to do it.

good luck!

m

[Mulan]

Write it up every time. As well as giving your manager a copy, give a copy to her boss, and to risk management.

Some hospitals have a 3 write up and you're gone policy. Does yours?