How to handle an abusive surgeon?

[aquarius1]

I'm presently working as an Operating Room Nurse ( scrub/ circulator ) in one of the best hospital in the country when it comes to heart and lung surgeries ( incl. transplants ). I can say that I am enjoying my work, and learning so much from it...to be honest i've got no background in this type of specialty coz i've been used to do General, Ob-Gyn, ENT, Ortho, just to name a few.

It's been over a year now since I started. I'm now more settled assisting/ working with most of the surgeons except for one.

Eversince I started, I haven't had a day with him that he hasn't shouted at me/ degrade me becoz of little things such as he has to wait for a minute or even just for seconds for a needle to be loaded to another needle holder, in cases like CABG where the smallest needle would be an 8/0 prolene; or like when his castro needle holder isn't holding properly, etc....

I'm now really ****** off with his attitude towards me, he doesn't show the same reaction whenever " white " people are scrubbed with him and getting delayed as same manner as i do....

Help !!! what am i suppose to do? My manager won't talk to him coz they also have a conflict.

Should i answer back? what? pls help. Thank you

Aquarius1

[Great_time]

I am a new nurse - straight out of school and work in OR. What I noticed about this hospital is surgeons get away with pretty much everything (I talked to some nurses, and they sadly confirm this). I've never heard of reporting abusive ones to management, and it seems our leaders are not willing to do anything about. Other nurses say there are very few leaders that would defend us. Surgeons bring their cases to us, and we should be gratefull that we have jobs and the hospital makes money.I can hardly imagine myself talking privately to a surgeon about him yelling at me earlier. Yes, I make minor mistakes and sometimes I sound naive. But I am a bright person - I am still learning and I do my best; and btw I still love OR!

I heard that one new girl had been fired a while ago, and it happened during her probationary period. She tried to resolve her issues with a surgeon, and I guess she was not very polite either. So I am quiet... Sometimes I get upset; I know I do not derserve to be treated like that. But I also know that I need experience, and then we will see...

[orkwb]

I understand your position, especially as a new graduate. Sometimes silence is the very best response. That being said please keep in mind that a hostile work environment is not only morally wrong it is illegal. Next time you need to speak with supervisors about abuse in the OR trying to work in the phrase "hostile work environment". Also make mention of this same phrase to Human Resources. This is technical speak to HR types, more like legal-speak, which will get attention. Alternatively, working hard to gain the respect and good-will of the surgeons over time will go a long way to overcoming this problem.

[singingtothewheat]

I absolutely would say something. As for the surgeon who specifically made reference to race or inferences about race. Someone needs to stand up to him and if your manager won't, then go to your chief nursing officer. It's 2010 and that sort of behavior is TOTALLY UNACCEPTABLE! I am surprised that none of the other staff already went to the cno. I would sooner loose my job than put up with that sort of nonsense

[jacrabbitrn]

Wow, I want to work with OBMDPHD, Just got yelled at by a surgeon who felt that new grads cannot work with his patients who are difficult. Then yelled at us for advising her to call at 11pm when there was an unfamiliar change in his surgical patient. Several nurses agreed that the surgeon should be called after discussing the finding. After he yelled at us he ordered a battery of tests and told us to call back if there were any other problems.

[singingtothewheat]

At my hospital we have a special form to report Dr.'s who act like a horses behind. I have not ever personally used it. I would if I needed to then. I strive for total respectful of the physicians but sometimes that is not easy. We have one surgeon who seems to have some gripe every time you see him. It gets sooooooooooooooooooooooooooooooooooooo flippin old.

[jessrene, LPN]

As anyone can see, this is a hot topic for OR nurses, especially if you have experienced this 'hostile work' environment personally. I myself have decided to file a formal complaint after I got no satisfaction from the nurse manager. (she is about to retire early and I think part of the reason is this one surgeon) In addition to the formal complaint, every single other person in the surgery department signed a statement of dissatisfaction with the work environment and individually met with the HR rep to discuss the issue. We all voiced the same issues with this doc and made sure that our experience of 'harrassment' was well documented. The 'hostile work environment' phrase and 'harrassment' carry special weight with administrators do to the burden of liability if anything is litigated. They sit up and take notice when you write things down, get witnesses, and use words that make them liable to initiate a change or risk legal consequences. Myself I am waiting to see what shakes out, but at least it can only get better:nurse:

[canesdukegirl, BSN, RN]

We had a particularly abusive surgeon that treated non-white scrubs/circs the same way. I personally institute a zero tolerance policy for this behavior and did not even approach my manager about it. I knew what my workplace rights were and I was advocating for the ones that were scared to speak up for themselves. I just wrote an incident report every single time he pulled this crap. I stuck to the facts, and those reports went straight to legal. He is now on probation.

You can be the most brilliant, most recognized and valued surgeon, but if you treat the people in your room like total crap, you are really nothing more than a cowardly wimp who needs to grow a pair.

Zero tolerance. Write. Him. Up. Management can do nothing without documentation. Make your documentation factual. This is the only thing that risk management and legal can rely on.

[canesdukegirl, BSN, RN]

You can say something directly to him, but it's important to be professional(no swearing, crying or yelling). If the surgery is a touchy one with an unstable patient, you may want to wait until after the surgery to confront him. I've found through my own experience that many of these "bully surgeons" back down once they see you don't tolerate their garbage.

I worked with a surgeon who used to throw things and then drop scrub. I had heard about his behavior, but never experienced it until one day he pulled this with me. After the case, I said, "Dr. So and So, I realize that what you do is difficult. I am trying to help you, but it is extremely hard for me to do my job well if I am constantly running interference between you, the techs, anesthesia and myself. This is a PATIENT on the table. How would you feel if your MOTHER was the patient and you saw her surgeon acting like you do?"

He immediately backed down, got red from embarrassment and bought me coffee everyday that I worked with him!

[singingtothewheat]

Good for you canesdukegirl. This sort of behavior should NEVER EVER be allowed to occur. If a surgeon chooses to behave in this manner he's going to have a darn hard time keeping a job. Maybe if he's asked to leave by enough hospitals he'll learn to keep his trap shut. At least then no one will be forced to hear what a complete idiot he is.

I do have to say, ignorantly perhaps, I am utterly amazed that anyone with that amount of education can be so incredibly stupid. I guess that sort of crap no's no real bounds but for heaven sakes how does someone like that actually make it through residency?

We had a particularly abusive surgeon that treated non-white scrubs/circs the same way. I personally institute a zero tolerance policy for this behavior and did not even approach my manager about it. I knew what my workplace rights were and I was advocating for the ones that were scared to speak up for themselves. I just wrote an incident report every single time he pulled this crap. I stuck to the facts, and those reports went straight to legal. He is now on probation.

You can be the most brilliant, most recognized and valued surgeon, but if you treat the people in your room like total crap, you are really nothing more than a cowardly wimp who needs to grow a pair.

Zero tolerance. Write. Him. Up. Management can do nothing without documentation. Make your documentation factual. This is the only thing that risk management and legal can rely on.

[canesdukegirl, BSN, RN]

After reading through all of these posts, it is clear to me that the overwhelming majority of nurses do not get support from their managers regarding abusive behavior from surgeons.

You simply do not have to include them, or even alert them. Write an incident report. You may not have a policy in place for "abusive surgeons" because then whatever overseeing branch you have in the UK will immediately see that as a weak point in the system, (In the US, the governing body is the Joint Commission on Accreditation of Healthcare Organizations, or just JCAHO) that will make the hospital vulnerable to lawsuits. My dad is an attorney, and he taught me that for every law there is a loophole. The loophole here is that there IS a policy for "disruptive behavior" and the difference is that it includes EVERY employee, not just surgeons. Do you see what I mean?

Your manager does not have to know. You don't even have to sign your name to the report-it can be anonymous. If there are several reports written for this one particular surgeon, legal and risk management will have no other alternative than to explore further.

Management typically does not want to get into a p***ing contest with the surgeon. Part of their evaluations come from the surgeons. (This is the case in my hospital...I don't know about others.) So no wonder they don't want to back the lowly employees like us. Go around. Use the loophole. You won't be sorry. I did it (granted, I signed my name because I was not in fear of losing my job, and if I HAD lost my job, there would be one heck of a lawsuit!) and it made a difference.

Remember that the KEY is to be factual. No emotion or supposition must be documented. As we say in the US, "Just the facts, Ma'am!"

Keep us posted.

[ctvsurgrn]

What the surgeons need to realize is that we are educated individuals just as they are and there is no job when it comes to patient care that is more important than another. That being said, I made it a habit to be on a first name basis with all of my surgeons. It made for a more comfortable work environment and there it made for a healthy relationship, seeing as we worked together every day. I decided early on that they were not going to treat me as inferior. I discussed it with my manager, and was told that as long as I remained professional (within reason) that they would back me. The surgeons must be reminded that the OR room is YOUR HOUSE for the day, not theirs. They are guests in YOUR HOUSE and need to behave themselves. I have thrown several surgeons out of the room during non-critical moments in the case if their behavior has gotten out of hand. One started throwing a fit on a tech student and I suggested that he step out for a moment. Once he refused, I gave him the ultimatum that either he step out on his own or I would have security escort him from the room. He looked at me like I was stupid, but then changed his tune when he saw 2 security guards standing outside the room. But that is just my 2 cents. At every hospital that I have worked, I go into the interview process and let them know how I handle abusive surgeons and they all have been very supportive.