Verbal Abuse from surgeons in the OR

[spineCNOR]

Just curious...

How commonly do you OR nurses out there experience verbal abuse and/or disruptive behavior from surgeons?

How do you or your facility deal with this issue?

In the facility where I work such behavior from surgeons is common - ranging from demeaning, condescending comments to yelling and screaming. Dealing with this on a daily basis is demoralizing and (I believe) has a detrimental effect on nurse retention.

The surgical department where I work has no policy in place that addresses this issue. Most of my co-workers feel that there is nothing we can do about this issue because we do not have the support of our nursing managers or of hospital administration, as they are so anxious to keep their surgeons (AKA their cash cows) happy.

Do any of your workplaces have policies or procedures in place to deal with disruptive physician behavior???

[JenJen]

I had an experience with a fairly new general surgeon who was sweet as pie the first couple of years. Well, as he became more comfortable operating, he also became more verbally abusive. Imagine that! One evening he took it too far, threatening that if he had a gun and the opportunity, the first place he would begin was our OR, open fire on all of us! Hospital and Nursing Administration was immediately brought in. The doctor was put on probation, and ultimately he lost his priviledges at my hospital. It is nice not having to wonder if I will need to wear my Kevlar scrubs today.... Physician abuse of ANY kind is not tolerated here.

[ckalston]

I had one instance when doing sedation for a patient that the MD asked me to help the tech with something. Ordinarily I don't mind doing things like that, but at that moment I was pushing drugs, montioring respirations and documenting my vital signs. I told the MD I would in a minute and he hollered at me and said maybe you should grow a 3rd hand since you can't use the two you have. I told him if I grew a 3rd hand it would probably be to punch him out for talking to me like that.

Another nurse said a surgeon called her stupid during a case. She was the scrub nurse and when the surgeon asked for an instrument after calling her stupid she just stared at him. He asked why she wasn't giving him his instrument. She said, I don't know, I must be stupid.

[Chrislynn2003]

Recently, a surgeon verbally abused one of my coworkers and she just put in her resignation letter. The sad thing is is that she had only been there 3 months. The surgeon was reprimanded and the issue was taken to a higher level. However, it still continues. Where I work, we do a lot of ortho, and many of the surgeons in this service have a mean disposition; I do not know why, and I think it would be a much better working environment if we just got rid of some of this unecessary stress.

[DNRme]

a couple of ideas that have helped...of course there will always be a few beasts.

first, you may have to get the ball rolling. A catch phrase that administration never wants to hear "it is creating a hostile work enviornment." If the hosp. admin. is found to have ignored repeated documented abuse, you may have legal recourse.

second, document, document, document. Keep copies of everything and who you sent it to.

finally, the Board of Medical Examiners in your state can be a great help. We had one abuser (really horrible) who was reported by the staff at another facility he works at. IT WAS A MIRACLE. He is by no means a prince, but he no longer throws things etc.

Good Luck

[Peri-Op_Nurse]

The only places I worked where verbal abuse and sexual harassment was not accepted as normal behavior was in Australia.

I was utterly shocked when I came to the USA that doctors, who are the highly educated members of society, resorted to profanity and crude jokes in their everyday work.:imbar

I rarely if ever could recall a surgoen using the 'F' work in Australian ORs but in every hospital I've worked in, in the USA it's as common as can be.

I have worked in MA, RI, TX, FL and now TN and at each hospital surgoens were and are permitted to exhibit totally innapropriate verbally abusive behavior. There are no sanctions and a blind eye is turned by management.:zzzzz

A few years ago when I was working in Cardiac Surgery I had a surgeon almost kick me in the head in a fit of anger while I was positioning a step stool for an assistant. I was so shaken by the experience that I had to have somone else finsih my case. I reported the surgeon to the deparment manager but I have not to this day received an apology from the surgeon, nor was he ever reprimanded.

[Ferret]

G'day All,

Australian Surgeons can get nasty, but us convicts have some issues with authority... and "tall poppies". Even in the military ALL our soldiers are encouraged to think for themselves, and are less tolerant with authority than I've heard of any country in the world. (Considerably improving the effectiveness of our small unit tactics, biu that is another subject....)

Our nurses have a tendency to give as good as they get, or walk out, even if scrubbed for a neuro case at the time. (As appropriate, with consideration to patient safety, of course). I've seen quite a few nurses refuse to scrub for a particular surgeon, and as here the scrub is in charge of the theatre, surgery can really be held up by something like that. Talk about hitting the hospital in the hip pocket!

Management HAS to listen, New South Wales is the second most letigious state in the world, after California, a statistic that considerably startled us recently. We thought the legal system over there was universally rediculous, and worried that we were getting as bad... now we know we are 8^)

Abuse of any kind cannot be tolerated in the workforce, and Surgeons MUST be accountable for their actions. If your management does not do anything about it, take it higher. And, as everyone else has said, cover your backside and DOCUMENT EVERYTHING!

[orrnlori, RN]

Most of my docs are great, I love em. But there is this one ENT (we call them bugger-pickers) doc that thinks he's a neurosurgeon, very self important, somewhat bi-polar. One of the nurses I work with says that working with him is like being a hunted rabbit in the brush, you never know when you're going to get it.

One day he was being a total a**, barking and carrying on but not at me at first, when he did finally scream at me, I put my hand to my forehead and stated that I felt strange, that I felt something coming on, what was it, oh, I know, it's mental anguish, perhaps litigeous mental anguish, the kind one gets when faced with harrassment that could cause the filing of a harrassment report with HR and the Director of Surgery.

The surgeon didn't speak to me the rest of the case, actually he didn't speak to me for about 6 months.

[efy2178]

Was the ENT surgeon not speaking to you a bad thing? I also worked with a real a** aelf important ENT surgeon, before that it was a even worse gastroenterologist whose claim to fame was that he at one time had made every nurse cry. Not me, I just got madder than a hornet. I finally took the advise of my dear old Dad and refused to speak to him or acknowledge him for about a year. I never looked him in the eye, laughed at his jokes or even acknowledged a "hello' or 'thank you'. The only time I spoke with him was when I needed to Administration would do nothing about him. (In my town, both hospitals adopt the attitude that 'we can't change them so we need to figure out how to live with them' while nurse after nurse is abused) Finally after all those months I told him I would talk with him if he would treat me with respect and the other nurses I worked with. Interestingly, other nurses would work with him only if they were in the room with me. This is called Personal Power. You teach others how to treat you. Don't allow abuse.

[Ferret]

G'day All,

I tell my friends that it is when I'm quiet that I most pissed off. I don't talk to anyone, do my job and what I'm told, and that is it. I think it is almost a white mutiny.

Sometimes it it the best thing to do until you calm down and work out a better path of action

Have fun! Jason 8^)

[PrincessORNurse]

I don't take the surgeons talking down to me. I feel that there is a way to take care of the patient competently, without being talked to like a servant. I don't get into arguments with them, but I stand my ground. I became like that, because I realize that if we were outside of the hospital, they wouldn't dare say the things that they say in the OR, so, I don't take that downtalking. They bite, I bite back. Now, if we're doing a trauma, or, code, or some critical situation, I let tings slide, because everyone gets worked up (even me). To me, the OR is a dog eat dog world, and it's not for the timid. Sometimes you have to be a adamant about your point of view to be a effective patient advocate.

[odatrn]

I am amazed at the differences in opinions on this issue. Obviously there are are some institutions that support their staff, and some that do not. I work for one that does not support the staff against verbal abuse by the MDs in the OR.

We are a smaller OR, with 7 rooms and an endo lab, with another hospital with the same amount of rooms in the same community. All meetings center around turn over time, the ability to keep the surgeons content, etc. I understand that all from the business end, and for Heavens sake, I want to go home sooner than later, also.

I have read this forum from afar for a while now, to get a feel if this is the real thing: do people come on here to vent and complain, or are there real issues that are dealt with in a professional way? I think this is a place for professionals to discuss things intelligently, and will continue to monitor it. Grateful to have found this sight.........

[bbear]

Removed because it just didn't sound very nice.