New OR Nurse and feeling overwhelmed...

  1. I am a nurse with 6 years of peds well baby experience and have recently been hired into the OR as a circulator. I have no hospital experience before this and have only worked in an office setting. I have good days and bad days in the past 4 weeks that I have been in the OR but I wanted to seek advice from other nurses or techs and ask them for their insight.

    Every Wednesday that I have been in my current position I am assigned (with my preceptor) to a certain cst and one dr. we follow this one particular doctor all day, mostly plastics cases. He will typically ask an array of questions and name very detailed anatomy of whatever he is working on. He will wait about 20-30 minutes and then ask me to repeat whatever we went over previously. If you do not get the answer correct you get 3 choices (phone a friend, 50/50, or poll the audience). Last week we went over the anatomy of the face/lips. He asked me a question I did not know so I phoned a friend and picked his rnfa. she said she didn't know the answer either. after about 40 seconds she finally said the answer but told me rudely I should write everything down. The same tech instigates his behavior. Everyone sings her praises and our charge nurse came in the room today and told her "you make the world go round, not sure what we would do with out you." She also asks for things in a very stern way and half the time she says stuff really quick almost on purpose so i have to ask her to repeat it to make sure I get the right item.

    every time i talk with her she is rude and harsh with me. my second week we were setting up a room and she started to put her gown on and i came up behind her and said can i help you with your gown, she replied its not going to tie itself is it? when i am learning how to properly prep the pt she is always standing there it seems like judging me. i understand it needs to be done correctly and i want to do a good job but it just seems like she is looking for a way to intimidate me. when i take a little longer she sighs a lot and it seems like there is always tension and awkwardness btwn us.

    The same doctor gave me a hard time about following my preceptor to lunch last week after our relief came for our break. he asked where i was going as i was following my preceptor and she said quietly to me "he wants you to ask him permission to leave with me". he let me go after i asked him. our relief said one time when she was new he made her call the holding room and ask if his next pt had a hcg done and she was over 90 yo. he also made me call our nurse liason and ask for an otis elevator. little did i know that that is a brand of elevator our facility uses. she laughed and came back to the room later and they all had a laugh on my behalf.

    most of the dr/nurses/techs have been good to work with. i am just having a hard time differentiating normal behavior on behalf of this particular tech or why she is having a problem with me. i am nice, come to work with a smile on my face everyday i have been there, avoiding being negative and have even tried to have conversation with her and she won't look at me or even reply to me half of the time i talk to her.

    to make a long story short i have left the past 2 wednesdays feeling extremely overwhelmed and uncertain that I want to carry on with my training. has anyone experienced a similar situation? i feel like my preceptor and her are always laughing and joking so not sure my preceptor is a great unbiased opinion. my charge nurse is the same way. i know the OR is a tough place and i need to find my way but how do i deal with a hostile co-worker? i can see in her eyes how much she despises me every time she looks at me. should i confront her before going to my manager? i am afraid that if i do so she will spread the word to the rest of the staff and make things worse for me. am i just being paranoid?
  2. Visit astrn profile page

    About astrn

    Joined: Dec '12; Posts: 13; Likes: 13


  3. by   Kooky Korky
    This is very common OR culture. Ignore it. You will do just fine if you laugh at yourself. Just let it all roll off.
    As for why the tech is nasty, it's probably jealousy. You're an RN, young, pretty, courteous, pleasant. You're an "OR virgin", though, and some experienced staff in OR love to razz those in your category.

    If anyone gets seriously rude, or sexually harrasses, or otherwise breaks the law, that would be different. What you're experiencing is, IMO, normal OR culture. I'm not saying it's good or right, but that's how it is in lots of OR's. (also in other settings where people work together often and develop relationships that are more than passing; In OR, teams must be able to trust each other in very critical situations, situations where feelings get shoved aside while you deal with "life or death" situations.)

    LOL, you'll eventually get confident enough that when the jerk tech tells you the gown won't tie itself, you'll quip back, "Well, duh", or something equally eloquent. She'll then get the message - you're no longer afraid of her. An experienced tech can save the butt of a new OR nurse, too. Just pay your dues.

    As for her being indispensable, well, that's today.

    I'd ignore her, too, just as she ignores you. She's a miserably, crabby wretch. I've known so many in my life. They're everywhere, but OR's seem to have more than other settings.

    Good luck, get tough. And if it doesn't work out but you still want to do OR, find a different OR. The culture could be different.
  4. by   Krystle022
    Very sad but it is what it is, just get one year under your belt and you can go somewhere else. Which state do you live in?
  5. by   Krystle022
    Well said!
  6. by   astrn
    thanks for your feedback! i really appreciate you taking the time to respond to my post!
  7. by   astrn
    dear cheese potato,
    I tried to reply to you but for some reason my response keeps getting rejected. Something about having 15 post before you can use the pm. I wanted you to know I appreciate all of your input! It meant a lot to me after a rough week! Thanks again!!
  8. by   kguill975
    As an adult learner, I've been "new" at something many times as I went from CST to RN to NP/RNFA. I have never encountered this type of behavior in a place of employment. It angers me to think that these so called "professionals" would treat a part of their "team" that way. The ribbing and the joking is to be expected, but not to the extent that it's affecting you negatively. I think the conspirators feel that as long as you are the target, they're safe. I blame everyone there for being enablers. Life is too short, find an institution that focuses on teaching and patient care, and not petty antics. If you can find a university based level one trauma hospital, there's no better learning experience. Good Luck to you!
  9. by   Ruby Vee
    Do you want to work in the OR or not? That seems to be the basic question. If you don't really want to work in the OR after having some exposure to the job, then you have your answer. If you DO really want to work in the OR, you're going to have to ride out some hazing. Try to ride it out with good grace and a sense of humor.

    If most everyone you've encountered has been good to work with, concentrate on those people and not the ones who aren't so good to work with. Don't let a few people with less than stellar interpersonal skills deflect you from a goal you've set for yourself and that you still find yourself wanting to attain.

    It sounds as if people are trying to educate you -- albeit not in the best manner. Or not in the best manner for you. Believe it or not, you don't have to like people to learn from them, and they don't have to like you for you to be able to learn from them. They don't have to be good teachers. If you really want to learn this, learn it. I see an awful lot of assumptions on your part, assigning motives to others and interpreting "looks" and "tone of voice" to mean that people don't like you or are trying to trip you up. You can "see in her eyes" how much she "despises" you. Really? A "stern voice" may mean that the person takes their job very seriously -- or it may mean that you're overreacting because rainbows aren't flying out of their orifices every time they speak to you. It may also mean they they don't like you, but what of it? Not everyone is going to like you.

    Your co-worker may or may not be hostile, and she may or may not like you. There's not much to be gained by confronting her, except that if she didn't already despise you, you may tip the scales in that direction. Why not try a calm, honest conversation with her? Don't make any assumptions about what she's thinking or feeling . . . after all, she's the only one who knows for sure. Maybe she'll tell you that she's never precepted before and she's scared to death. Or maybe she'll tell you that she thinks you're too slow or too sensitive or not studying enough on your own. Confronting her may just make her angry. As far as spreading the word . . . your co-workers have known her longer than you have. If she's the type who takes against every newbie, they'll know that. But on the other hand, if you really are screwing up, they'll figure that out sooner or later with or without her input.
  10. by   Poochiewoochie
    What's really sad is these people are supposed to be professionals. They went to college to attain a degree and somewhat look their noses down on others who didn't. Such shameful behavior.
  11. by   canesdukegirl
    OP...hang in there. A bit of hazing should be expected in the OR. The Otis elevator joke has been long running. They wouldn't kid around with you if they thought you were a total idiot. They want to see how you react.

    As far as the RNFA goes, her behavior seems "territorial" to me. She is also testing you. You wrote:

    "She also asks for things in a very stern way and half the time she says stuff really quick almost on purpose so i have to ask her to repeat it to make sure I get the right item."

    She is likely wanting to see if you are paying attention to the field. This is an assumption, but I have seen residents and attendings do this.

    If, when you ask her to repeat the requested item, and she is downright nasty/condescending to you, simply reply that you don't have a comprehension problem, you just didn't hear what she said. The onus then lies with her to repeat what she needs in a more respectful way.

    I'll share a story with you:

    When I first started in the OR, I was humble, vigilant, always positive and very eager to learn. I smiled all the time, and thought that my outgoing attitude would be embraced. I knew that the OR was a tightly knit group, and was prepared to "take my lumps". I got the same 'Otis elevator' joke, got sent on wild goose chases for a 'henway', etc. Staff snickered behind my back, and made bets on how long it would take for me to lose my sunny disposition. I also felt that I was being scrutinized.

    I WAS being scrutinized. The team wanted to make sure that I understood the rationale behind my implementations (i.e., sterile prep), if I could think on my feet, and if I had not only a sense of humor, but also a thick skin.

    I learned the hard way that being "nice" isn't necessarily an asset that is valuable in the OR. Some people equate nice with weak. Not saying that's right, but sometimes, that's the perception. The surgeons don't care if you are nice; they are only concerned that you know what you're doing.

    Without going into a long drawn out explanation of the definition of nice, let's suffice it to say that you should conduct yourself in a professional way, with a sort of "neutrality" in the beginning. Don't be overly nice, don't try to strike up conversations during a procedure, and don't knock yourself out trying to appease every single person in the OR. Be inquisitive at the appropriate times, and do your homework. Prepare by looking at the cases that you will be doing the next day, and research the procedures.

    Snarky remarks from the RNFA ("it isn't going to tie itself") should be met with a neutral tone, tinged with JUST the right amount of backbone. I am having a hard time giving an example of how you should do this, because I am a very sarcastic person by nature. I would have said something like "Oh yeah. I remember reading that in a textbook somewhere." When you stand up for yourself while alluding to the ridiculousness of these kinds of comments, the staff will likely think, "hmmmm....she's gonna fit in nicely!"

    Bottom line: be prepared, don't take anything personally, when you get pushed, push back (gently and tactfully with the right amount of wit). The staff and surgeons will respect you if they know that you can hold your own.
  12. by   carolurbe
    I have experienced the same as well but now I can say that I have gained confidence in all that I do...just like what they have said be prepared when going to work and concentrate on people who are nice to you. ..
  13. by   wartthree
    When you tie her up, if your gowns has velcro near the neck, take a lil bit of her hair net and stick it to the velcro. I had a tech that was always making me run for stuff than giggle about it. Her hat got stuck to her velcro and when that happens you can't move your head very well, so she asked me to fix it for her..."oh so you need me to do something for you huh, you gonna keep being a twerp?" And now it's a joke between us and I tell her that if she doesnt settle down I'm gonna stick her hat to her velcro.

    Unfortunately as many others have said the OR is a very difficult place to work and also to get into the group. But once you do, it all is ok. The doc just has to feel like he is God, just play his game, study up on the cases you'll be doing with him, and maybe even ask him questions, even if you know the answers. It makes them feel good. You may find 9 months down the road when you've settled in that tech may tell you she never had a problem with you and thought very highly of you.

    I would however address that behavior of hazing to your manager or an educator (not preceptor). It is something many managers are aware of and most facilities are trying to tackle, but it is a huge problem.

    Good Luck, it's a great career if you've got the skin for it.
  14. by   meriposa
    I started in OR boot camp back in Feb 2012 but came as a seasoned nurse with a background in L+D, medsurg and homecare. Everyone warned me that you had to have thick skin for the OR and treat the surgeons like they walk on water. I figured I would just get accustomed to the culture and with 10 years of exp under my belt I had high hopes for myself. Let's just say I cry at least 2-3 times per week (after work of course) and have to give myself a pep talk most days before I will even get out of the car. Each day I try to find witty comebacks, stand up for myself, try to remain non-emotional, get things done as fast and efficiently as possible and am prepared to be thrown under the bus by any team member I am working with. This is the norm and each day is like entering the battleground anew. I find it so unfortunate that this is my focus rather than giving excellent patient care and becoming an expert in my new setting.

    I hope things improve for you. After going on a year in the OR, I have accepted that my environment will likely not change. I am stuck in a contract but will likely move on after I fulfill my time.