OR enviornment

CheesePotato, BSN, RN · May 28, 2012

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.

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.

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 orificenal 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.

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.

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.

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.

canesdukegirl, BSN, RN · May 28, 2012

CheesePotato:

I. Loved. Your. Post. :yeah:

TakeTwoAspirin, MSN, RN, APRN · May 28, 2012

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.

LovedRN, BSN, RN · May 28, 2012

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.

LovedRN, BSN, RN · May 28, 2012

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.

Argo · May 28, 2012

What state are you in? Most states have laws requiring one RN per patient in a surgical setting.....

LovedRN, BSN, RN · May 29, 2012

CA. I know right?

Well at least on papers there are RN names as circulators.

LovedRN, BSN, RN · May 29, 2012

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.

Argo · May 30, 2012

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.....

LovedRN, BSN, RN · May 30, 2012

I will think about it. Thanks.

CIRQL8 · May 30, 2012

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.

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