Etiquette in the OR? - page 4

Hey nurses! I was wondering...I had the opportunity to go down the OR with my pt last week (I'm a NS). This pt was very sweet and easy preop, the surgeon, anesthesiologist, CRNA and... Read More

  1. by   Anxious Patient
    Quote from FurBabyMom
    We generally don't have those conversations until the patient has been put under anesthesia and intubated. Of course there is a potential for awareness...
    I'm curious. Isn't one of the reasons Versed is used so that the patient can't remember anything later?
  2. by   FurBabyMom
    Quote from Anxious Patient
    I'm curious. Isn't one of the reasons Versed is used so that the patient can't remember anything later?
    Yes. But anesthesia is individual for each person. Not everyone can have the same drugs (allergies, contraindications, family history of/risk factors for MH), some procedures require specific types of anesthetic agents, etc. Agents are administered and titrated differently (inhalation vs IV and even among that different IV agents are given/titrated differently). What it might take to anesthetize you is probably not what it would take for me. And just because you give versed on call to the OR? Some people it doesn't have an effect on, and it may or may not last long enough. If your patient's procedure lasts hours? That pre-op versed isn't going to "cover" the entire OR time (considering versed peaks in 5-7 minutes with a duration of something like 20-30 minutes when given IV). Hopefully the anesthesia team maintains the patient "deep" enough that they have no remembrance of anything. But awareness under anesthesia happens.
  3. by   cmj806
    I work in the OR as a surgical technologist, and I am currently a nursing student. The stress of working in an OR, and because the crew is tight knit does not make it ok to make fun of patients! You as an OR nurse and me as the surgical technologist, it is our job to be an advocate for the patient. I speak up when I hear it happening in the rooms I am assigned to. Anyone that makes fun of a patient while they are laying on an OR table, naked and vulnerable with a tube down their throats is not only unprofessional but overall not a nice human being. My sister is overweight and she was made fun of on while she was walking dow the hall to the OR to get her C section by 4 of the members of her OR team. She heard them, and not only did they ruin was supposed to an amazing day, they made her distrust her surgical team and she became fearful of them. I was with her and she begged me make sure they didn't touch her. You can bet I started yelling for a charge nurse and her team was changed, I got a surgical technologist, a nurse, a CRNA and a resident reprimanded. It is not right to make fun of a patient PERIOD!
  4. by   sop832
    Every time I have a heavy/ obese patient, and someone has a snotty comment about the patient's weight, I always ask if they would say the same thing about me. There is no correct answer to that question. If the answer is no, then they can't talk about the patient that way. If the answer is yes, then "Go **** yourselves"
    Last edit by dianah on Feb 18, '15 : Reason: Terms of Service
  5. by   Anxious Patient
    As a patient, I found this article surprising, actually it's an editorial. Has anyone here experienced this kind of conduct in the operating room?

    Editor's Page: Sexual Predators in the OR > Outpatient Surgery Magazine > February, 2015
  6. by   middleager
    I find the comment "If you don't like it don't work here, but don't judge us" to be a bit self serving or perhaps dismissive. People are judged every day. We all judge people and their actions daily. When you sit down at a table for dinner at a nice restaurant, you don't judge just the quality of the food, you judge how the people involved did their job and not just the mechanics of getting it to the table. Did they acknowledge you quickly, did they smile, were they friendly, courteous. You don't bother finding out did they have a bad day, is there stress in the home, did 2 people call off and they are short handed, is their boss a jerk, are they missing their kids birthday party to be judge them on their actions and how they present themselves. That goes from the finest restaurant to the kid making min. wage at McD's. Ever get a kid behind the counter that acted like he didn't care if you were there or not, that talked to his/her friends while waiting on you? Did you ever judge them, their behavior? That goes in nearly every occupation, every job, if you took your car for an oil change and heard the mechanics laughing at some "fat ass woman" pumping gas would you think that was OK as long as she couldn't hear them? No where are people required to put more trust than in health care providers...shouldn't you hold yourself to a higher standard than the teen age kid at McD's...he has stress to.
  7. by   GadgetRN71
    Quote from Guttercat
    There's a reason many OR peeps choose OR. IME, they're more fascinated with the science of poking around on a slab of meat than they are comfortable with the relational and human-side of the equation.

    Once the patient is out, the humanity ceases and they might as well be digging around in a car's engine compartment performing a head gasket replacement.

    There are fine, compassionate surgeons out there. IMHO, the surgeon sets the tone, and there are plenty of OR theaters where no one in attendance dare make disparaging and inhumane comments about the unconscious person on the table.
    I am going to respectlfully say that I think this is a generalization. I have been fortunate to work with nurses, techs and anesthesia providers who truly care about their patients. On the rare occasion where someone made an inappropriate, mean spirited comment, they were disciplined for doing so.

    My humanity doesn't cease once that patient is asleep. if anything, it increases, because the patient is helpless. And, I've noticed far more nurses outside of the OR being insensitive to patients. We had a transgender patient a few years ago and the non-OR nurses( pre-op, Pacu, and the floor nurse who gave report) refused to call the patient by their chosen gender, engaged in eye rolling in front of the patient, and made comments about the situation in a snarky tone. Contrast that with the OR, who made it a point to call the patient by their chosen gender identity, even while the patient was asleep. Or, who made it a point to protect the patient's privacy and modesty by covering the windows(pt request).

    The example in the original post is the exception, not the rule.
  8. by   GadgetRN71
    Quote from Anxious Patient
    As a patient, I found this article surprising, actually it's an editorial. Has anyone here experienced this kind of conduct in the operating room?

    Editor's Page: Sexual Predators in the OR > Outpatient Surgery Magazine > February, 2015
    No, thank God. I suppose the one that may come closest is the one about the surgeon wanting the breasts exposed without need or reason. But, even in that case, the circulator and other staff shut that nonsense down quickly and reported it later.
    The surgical tech with the cell phone needs a slap in the head and to be fired immediately.
  9. by   Chicano nurse
    For thirty years I have been told I would become like many before me...cold, uncaring, negative and callous. I won't lie to you many critical situations and deaths have made me a bit less buoyant in my cup half full outlook. But you were offended and it is appropriate and correct to take your concerns to the OR Manager. Some people talk about anything when the patients are under anesthesia.
  10. by   MaudKennedy
    If it's just humor,why not share it with the patient?
  11. by   subee
    Patient awareness should be assumed, especially these days when patients are being kept so light. This kind of talk is usually out of frustration, but the people who are doing it have to be held to higher standards than people on the street. We have no excuse to be so ignorant. Anesthesia should be admonishing staff to cut it out.
  12. by   MaudKennedy
    I agree. I woke up during my surgery and I remember perfectly what was said at the time. It happened to be nothing deragotory but I'd have heard exactly the same it had been insulting. I honestly don't understand why people who work in the OR feel so free to talk trash about someone they don't know just because said someone is supposed to not be able to hear them.
  13. by   TheMoonisMyLantern
    Dignity and humanity aside, no one forced us into nursing. Taking care of those that are ill and sometimes fail to care for themselves os part of the job. A job that we're paid well for. If you can't behave in front of a patient for their dignity at least behave out of the fact that without that big fat person you're lifting on you wouldn't be cashing a paycheck.