OR enviornment

  1. 0 I am a new grad RN and want to be in OR. I just have opportunities to observe in a small surgery center's OR. WOW what an experience!!! Here is my story:

    1. ****, ****, and other similar words are in every sentences here. PA had used **** word too but that because something was wrong with the instrument and the case took too long. I got that. But when they used it every time they talked, that's just too much.

    2. Dirty jokes. Hey I make them too and I know not to crossed the line. We were talking about the colors of USA and Thailand flags. (I came from Thailand by the way.) Our old flag had an elephant in the center. Elephants are highly respected animal in our country, enough to be on the flag if you can imagine. Then things got ugly. Anest said there should be a prositute on top of the elephant. Everyone laughted except surgeon, OR nurse (who is Thai), and me. Apparently, this anest took one of the surg techs for sex tour in Thailand and when they came back it took months for them to stop talking about it. It's non of my business what they did but that joke was not funny.

    3. This is where I learned what not to do. Fast is their priority. Good thing my second day was with an OR RN who used to work in the hospital. She spend all day pointed out what they did incorrectly. I got it. This is a small surgery center and not a hospital.

    4. If working in a small surgery center is like being with a family I hope I would never be with this family. 2 guys would ask anest, surgeon, RN, or other people who are not in their group for money. At first I thought they were joking but then they insisted on it, kept asking for several times. "I make your job easier. It's just $20." "Come on, you make too much money. Just give us $20." If you have to ask people for money because they make more than you do, I think you should go to medical or nursing school and earn it. One time one asked a nurse for a breakfast money, thinking he was collecting money to buy everyone in the surgery center food, she gave it. But when breakfast came, it was for their group. She talked to him and asked for her money back; he just ignored her. I was so embarrassed even though I got nothing to do with them.

    5. When I heard surg tech talked to surgeon about what should be done in the surgery, I thought "Wow he is smart." But when I saw he did the surgery by himself (it was on the pinky finger) I got this feeling of wanting to tell some one about it but of course everyone knows about it already.

    ..........

    Ohh my. I got more to say but I am just too tired. This is getting too long and those are just from my 2 days of observation. Sorry if there is any incorrect grammar or missed spelled words.

    My plan is to learn as much as possible and use it to get an OR job somewhere. They might not be what I thought they would be but I thank them for teaching me of what I had not known before. May be this is just a mini OR culture shock to me, I don't know.

    Other than venting, I want to know if there are any positive OR stories out there. I want to hear it please. One of my friends told me a story when she worked with a beloved surgeon and how everyone was treated as a family member. The surgeon would fly nurses to get their already-paid CEU out of state (paid vacation in a way.) Too bad he is retired.

    The good stories would keep me going. Thank You.
    Last edit by dianah on May 28, '12 : Reason: Terms of Service
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  3. Visit  LovedRN profile page

    About LovedRN

    From 'My house'; Joined Sep '11; Posts: 165; Likes: 79.

    13 Comments so far...

  4. Visit  CheesePotato profile page
    8
    Oh sugarbear, no....no no no no....just....just no. This is a very tainted picture of our world and I am so sorry that of all the hell-holes you stumbled across, this is one you ended up observing.

    To be fair, the OR is not perfect....no place is, but at the same time there is a limit.

    Quote from ScrubRNwannabe
    1. ****, ****, and other similar words are in every sentences here. PA had used **** word too but that because something was wrong with the instrument and the case took too long. I got that. But when they used it every time they talked, that's just too much.
    Yeah...okay, you got me there. My boys love to swear. They love to swear like the deserts need the rain and although it's not appropriate, I do my best to let it slide so long as: A) my patient is not awake, and B) It's not directed at me or any member of my crew (I will get my mama bear on....no one speaks like that to anyone in my room).

    Is it right? No. Is it the reality? Yes. Does every surgeon speak like a drunken sailor? Absolutely not. And as your rapport grows with the doctors, they will learn when to tone it down and talk like civilized individuals. Besides, there are some things in this life that nothing but a well placed F-bomb can make tolerable.

    However, keep in mind that, especially in the hospital setting, swearing and dark humor tend to run rampant as the stress level of the cases increase. For some it's a coping mechanism and one that is not about to change or disappear any time soon.

    Quote from ScrubRNwannabe
    2. Dirty jokes. Hey I make them too and I know not to crossed the line. We were talking about the colors of USA and Thailand flags. (I came from Thailand by the way.) Our old flag had an elephant in the center. Elephants are highly respected animal in our country, enough to be on the flag if you can imagine. Then things got ugly. Anest said there should be a prositute on top of the elephant. Everyone laughted except surgeon, OR nurse (who is Thai), and me. Apparently, this anest took one of the surg techs for sex tour in Thailand and when they came back it took months for them to stop talking about it. It's non of my business what they did but that joke was not funny.
    No, no that's not funny. I am sorry the anesthesiologist is an insensitive, chauvinistic ass.

    When it comes to dirty humor, the most powerful weapon in my arsenal is complete silence, prolonged eye contact and an arched eyebrow. If I need to go in for the kill, I allow the silence to settle a beat before striking with a well placed, "Really?". Master that, and you can have even the most pompous, boisterous fool squirming in flustered awkwardness. Body language is power. Let yours do the talking.

    Quote from ScrubRNwannabe
    3. This is where I learned what not to do. Fast is their priority. Good thing my second day was with an OR RN who used to work in the hospital. She spend all day pointed out what they did incorrectly. I got it. This is a small surgery center and not a hospital.
    Okay, I get the fact that this RN pointed out things that they were doing wrong to you, but what was she doing to fix it? Do you see where I'm headed with this? Pointing out that the IV is infiltrated doesn't stop extravasation, just as yelling, "look out" doesn't stop a child from wandering into the street. Only actions can save us. What I wish for you take away from being with this nurse is not that she knew what she was talking about, but her lack of action. In your career, do not be a squeaky wheel. Be the one that brings the WD40.

    Digress.

    This is the point where I could climb onto my rickety soap box about sterile technique, etc etc etc. But I won't. What I want you to remember is that speed is not the enemy. Speed can save lives. But there is a time and a place for fast and furious and as you go along in your career, you will see what I mean.

    Quote from ScrubRNwannabe
    4. If working in a small surgery center is like being with a family I hope I would never be with this family. 2 guys would ask anest, surgeon, RN, or other people who are not in their group for money. At first I thought they were joking but then they insisted on it, kept asking for several times. "I make your job easier. It's just $20." "Come on, you make too much money. Just give us $20." If you have to ask people for money because they make more than you do, I think you should go to medical or nursing school and earn it. One time one asked a nurse for a breakfast money, thinking he was collecting money to buy everyone in the surgery center food, she gave it. But when breakfast came, it was for their group. She talked to him and asked for her money back; he just ignored her. I was so embarrassed even though I got nothing to do with them.
    Run fast. Run far. Don't look back.

    Quote from ScrubRNwannabe
    5. When I heard surg tech talked to surgeon about what should be done in the surgery, I thought "Wow he is smart." But when I saw he did the surgery by himself (it was on the pinky finger) I got this feeling of wanting to tell some one about it but of course everyone knows about it already.
    See comments for #4. Lather, rinse, repeat and add some profanity and a whole mess of !!!!!!!.

    There are tons of lovely stories of the OR and there are even more "war stories" and I, as well as any of the fine OR nurses around here, could smother you with plenty of each.

    I could tell you tales of babies born in our trauma room and the sight of every person in the hall freezing in perfect synchronized form the minute that little bubbling cry echoed from behind the doors. I could babble endlessly about hands held, tears wiped, and patients waking to tell me about Sponge Bob Squarepants dancing naked on the kitchen counter. I could go on and on about moments when surgeons actually danced with joy, anesthesiologists rocking it out on air guitar solos, and the absolute heart rending silence when the code is called.

    But what I think you need more than my rambling, is to talk it out and know that, like so many things in this world, yes, there is good in it but sometimes you have to squint to see it.

    So as long as you wish to vent, we will listen. Chin up.
    Last edit by dianah on May 28, '12
  5. Visit  canesdukegirl profile page
    0
    CheesePotato:

    I. Loved. Your. Post.
  6. Visit  TakeTwoAspirin profile page
    0
    I am really not sure what you are going to learn at this place that would be useful any place else. It sounds like a disaster waiting to happen. I back what the poster said above, don't hang around here. Run fast, run far.
  7. Visit  LovedRN profile page
    0
    Thank you for your long comment. "Sugarbear" is so cute. Never heard that one before.

    1. F word: I have talked to many nurses about this. They all said to ignore it. On the second day was much better not that they had stopped using it but I just learned to ignore it.

    2. Dirty jokes: That too I was told to ignore it. Specially that I am new and just an observer. I will use your tactic when I secured a job somewhere.

    3. OR RN: No, she didn't do anything to correct them. She said this is how is done here for long long time. And she only works here 1 day a week. She said this is a small surgery center and their concern is to save time. (Yes, sometime is a good thing. Cutting corner is not.) STs usually run the OR during the week. Only on Saturday that they would have OR RNs work here. There are RNs in the center but they only work in pre- and post-op even though their names were listed as circulator. She would try to do the best she can without crashing into STs norms.

    4+5. I will after I get a job. At least I will learn something from here.

    Not that everything is bad here. One anest encouraged me to learn from OR nurse and had me do the pre-op assessment in front of him and an OR RN. He was soft spoken too. He is so nice and so are other surgeons. Here is my first time seeing PA covered with tattoo and rode a motocycle. I didn't know how to take it at first since I used to a clean, elegant, soft spoken MDs. I was just standing there tried to read his tattoo. There were so many of them.

    Thank You.
  8. Visit  LovedRN profile page
    0
    Thanks for all comments.

    I understand what you are saying. But between sitting at home and read Alex all day, and come here to see how things go, I choose the later. I just have to keep in mind what is the right/wrong way to do it.

    Thank You.
  9. Visit  Argo profile page
    0
    What state are you in? Most states have laws requiring one RN per patient in a surgical setting.....
  10. Visit  LovedRN profile page
    0
    CA. I know right?

    Well at least on papers there are RN names as circulators.
  11. Visit  LovedRN profile page
    0
    Ohh and today an old surgeon somehow felt like jumping up and down, and it turned out he didn't have anything under his pant. Good thing I only saw his back side, or I might make up my mind not to come back here. Ha Ha Ha.
  12. Visit  Argo profile page
    0
    I would get what experience I need and call the state anonymously to have this place shut down. And straightened out. Surprise visit from th state board for surgery center certification..... Or just do it now and watch the fun when they show up.....
  13. Visit  LovedRN profile page
    0
    I will think about it. Thanks.
  14. Visit  CIRQL8 profile page
    0
    Wow, CheesePotato. Great post. Couldn't have said it better. If I understand correctly, the tech did the surgery and not the surgeon? That would be complete and utter malpractice on the surgeons part and practicing beyond the scope on the part of tech. If that is so, I think you have an obligation to report it. Do it anonymously if you feel that you must.

    I wonder if you can get time somewhere else to observe surgery. Wherever it is that you were at sounds atrocious.

    Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com
  15. Visit  Lorodz profile page
    0
    OMG ScrubRNwannabe! Your story is really, really depressing. It really paints a horrible portrait in the operating room.

    Let me tell you my story.

    I’m a registered nurse from a different country and migrated to the down under. Prior going to Australia, people were warning me that this is a racist country, that racism here is rampant. I was even more scared because I will be working in the theatre. The operating room is very different from other departments. It is a very close knit, fast paced environment.

    When I arrived here and started working in big and busy Hospital, I was greeted and treated well with management (orientation day). When I started working inside the theatre, my clinical educator was very nice and accommodating. The people inside my theatre are not only exceptional in their skills, updated with their knowledge, well versed in the anatomy and physiology of each case but also very, very nice. Each of the preceptors that I work with everyday introduced me to the surgeon and the rest of the team. The surgeons would flash their big warm smile and would welcome me like a long lost family member. They would ask me questions on where I come from and my practice (I have theatre experience in my previous country). During the surgery, they (doctors or RN’s) would ask me to take a peek at the surgical site (without breaking sterility) to see the site they are working on (peek on the microscope for an ENT case, hover near the operative site during an open heart, etc). Some doctors would even discuss each step their doing to me.
    There are some doctors who would bring food for the team to eat during breaks. And it’s for free! After the FREE treats, we help the doctor wash the plates and tidy the table.
    My fellow RN’s also are nothing short of amazing. They are like brothers and sisters to me. They always look after me, making sure that I take my tea breaks and lunch breaks. Whenever there is a busy, busy day and the surgery is non-stop, there would be other staff walking in from time to time to relive you so that you can have your morning/afternoon/lunch break. My fellow RN’s would also ask me what I know about the procedure (to gauge on what I know and fill in the gaps) and would happily discuss with me the case and what instruments to give to the surgeon. (learning is facilitated here because it is not by rote memorization but rather by understanding)
    I have only noticed that teamwork not only exists inside the theatre, but also the surgeons and fellow nurses treat even the orderlies and janitors as part of the team. They talk to them ask them how they are and even sometimes (if the nurses have time) would help them do their work (like mopping the floor for them or wiping the tables after procedures)
    In our theatre it is a team. It is a great working environment. It is a big and busy hospital but you never notice the time, you never notice how tired you are because working in my theatre is very light because everyone is so nice. We are a family in there helping patients get the best care they deserve. Getting up every day and going to the hospital is not a chore, for me it is changing the world one patient at a time.
    The theatre is a lovely place to be. From your story, it is a nightmare! I suggest you try working somewhere else. You might get employment and some skills if you get hired there. But it would only eat you. You might develop some trauma in the theatre and swear not to join this lovely field of nursing.


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