Dealing with Circulators as a New Student.

[gymnut]

Oh no another post about grouchy people in the OR! This is very long and if the journals were up it would actually have gone in there. I just need to vent or I'll explode!!

So once again I'm turning to AN to help me out with my clinical portion of my schooling. This forum has helped me with going from a complete career change to becoming a wonderful PCA on my unit and also helped me conquer my fainting problem in the early days of my OR clinical. So I'm sure you can see why I keep coming here for advice.

My program is run through my local hospital and we rotate out to their other sites for clinical but the bulk of it is done at the main campus and that's where all of this is occurring. The surgeons are wonderful and love to teach students but as far as the circulators go a majority of them are very demeaning and rude to myself and fellow students. One of my classmates actually filed a complaint against one RN after being bullied by her all day. Nothing happened because a few days later another student was with her and the bullying just continued.

One thing bothers me the most is counting items. Some RNs will like to count everything when the skin is being closed and others like to only count small items. When there is a laparoscopic surgery again some will count everything in case we open and others will only count small items because we're not opening and if they do they'll count them then. I was already yelled at because I didn't keep counting sponges when the RN stepped away and answered the phone. She didn't tell me to keep going so apparently I was suppose to mind read. Finally you have some who just glance at the table and do a "Yeah you have everything" and fill out their paper. So I never have any idea when I should count what with who and if I ask they look at me like I'm a schmuck.

One RN was nasty to me because I don't know the doctors glove size right off the top of my head. The doctor and patient weren't even in the room yet and I did have his gloves I was just sorting through the pile of them on my back table because a lot of residents and students were going to be scrubbing in. This same nurse later on said she was going to give me NSS and I marked a small round basin and put the basin on the edge of the table so she wouldn't have to reach. She then came over and proceeded to dump the entire contents of the bottle in the small kidney basin and wouldn't stop even as it was pouring over the sides, flooding my back table and spilling onto the floor. When I told her about it she blamed me and said it was because I left the bulb syringe in the basin.

As I said other students have all had issues with the RNs I mentioned above as well as others and we approached our instructor about who told us that if we felt we were being bullied we should come to her and file a complaint but, everything just stays the same. It's to the point most of us have such bad anxiety before hand and we don't even want to be there.

I understand the OR is a rough and tumble environment and you need to have a thick skin. I do have a good one developed after years of customer service and dealing with patients and their families. If I was actually employed and getting a paycheck they could all just take their attitudes and stick'em where the sun don't shine but when I'm shelling out almost 10 grand in money I don't have and all the nasty and belittling behavior is becoming a detriment to my learning we have a problem.

So I'm not sure what I should do at this point. It's Friday night and I'm already sick to my stomach thinking about Monday clinicals. I just feel so incompetent, slow, stupid and that I made the wrong career choice. The only advice I've gotten from the nice RNs and techs is to just smile, nod and agree no matter what, don't let anyone ruin your day and to shake it off and make tomorrow better.

Oh and before a tired old argument is brought up I'm not one of those techs who think they are superior above circulators and could run the OR without them. To be honest you guys work ridiculously hard and it makes my head spin!

[SandraCVRN]

Why do OR nurses continue to give the suck it up advice???

This student is being bullied. This get a thick skin attitude has to change. It's why went back to the floor. I still help out in the OR since they are short staffed but about an hour into the stift I can feel the toxic forces overflowing.

To the OP, document what is happenening. These toxic people are allowed to stay because to get someone to change there has to be documention. Surgeons stopped thowing stuff after it started to be documented....No one is ever fired or repremanded if there are only "stories" going around.

So yes, maybe toughen up, but toughen up where you stand up for yourself!!

Good luck with the rest of your program then look for warmer waters.....

[bsktballmom]

Well said, I couldn't agree more. We are all professional adults, we should act like it.

[canesdukegirl, BSN, RN]

Great advice, Sandra. The only way we can change the culture of a toxic environment is if we take that first brave (and sometimes scary) step by refusing to be bullied. It sounds so much easier than it really is...but documenting inappropriate behavior by filling out incident reports is the best way to combat this ugly issue. We may never see the end result-but that doesn't necessarily mean that nothing is happening.

Gym-unfortunately there are nasty people everywhere. It is much more challenging to learn when you are having to deal with unpleasant attitudes. Take from it what you can-in this case, you will know NEVER to treat your future students the way you are being treated now. That's a pretty valuable lesson, yes?

Stick by your knowledge and insist on doing things the correct way. You were absolutely dead-on when you stopped counting while the circulator was answering the phone. In my opinion, counts aren't taken as seriously as they should be. If the circulator is only marginally paying attention to the count, then what is the stinking point of doing a count? Like others have mentioned, I have witnessed a far too lackadaisical attitude by both scrubs and circs when counting. It truly frightens me. AND-you are correct regarding laparoscopic counts. Instruments should be counted at the beginning of the case.

All the best to you!

[Winx51]

Get out of the OR.

[ninja-nurse, BSN]

Not trying to be rude, Winx51, but could you explain why the OP needs to leave OR? Granted, I'm not an OR nurse, but it seems to me that s/he raised good points about the counting issues and overall rudeness if that's what's going on. So please clarify?

[Sevenly]

OR, Floor, PACU, SDS, Oncology... There is not one specific type of nurse that eats their young! As an OR nurse, Endoscopy and Clinical Coordinator in an outpatient setting, I've seen this everywhere.

Nurses in general are skeptical but that does not excuse horizontal violence or bullying. In the OR get your case sheet, study your supplies, ask this nurse how you can help. Also, use your ST preceptor as a guide to circulators personalities. Do your best to stay polite and professional at all times (of course). When you are always doing what you are supposed to do, the people around who are not being polite, professionals and not following protocol will stick out like sore thumbs.

IT IS NEVER OKAY TO BE MISTREATED!! Be sure to tell your supervisor any event where this occurs.

Always count in a case where the surgeon could potentially open and always with an RN who is paying attention! Demand the attention, especially if they are blaming you for mishaps.

Remember this is only temporary and take these experiences with you. That way when you are training a new student you will remember how it feels. It will get better!!!!