Dealing with Circulators as a New Student.

[gymnut]

Oh no another post about grouchy people in the OR! This is very long and if the journals were up it would actually have gone in there. I just need to vent or I'll explode!!

So once again I'm turning to AN to help me out with my clinical portion of my schooling. This forum has helped me with going from a complete career change to becoming a wonderful PCA on my unit and also helped me conquer my fainting problem in the early days of my OR clinical. So I'm sure you can see why I keep coming here for advice.

My program is run through my local hospital and we rotate out to their other sites for clinical but the bulk of it is done at the main campus and that's where all of this is occurring. The surgeons are wonderful and love to teach students but as far as the circulators go a majority of them are very demeaning and rude to myself and fellow students. One of my classmates actually filed a complaint against one RN after being bullied by her all day. Nothing happened because a few days later another student was with her and the bullying just continued.

One thing bothers me the most is counting items. Some RNs will like to count everything when the skin is being closed and others like to only count small items. When there is a laparoscopic surgery again some will count everything in case we open and others will only count small items because we're not opening and if they do they'll count them then. I was already yelled at because I didn't keep counting sponges when the RN stepped away and answered the phone. She didn't tell me to keep going so apparently I was suppose to mind read. Finally you have some who just glance at the table and do a "Yeah you have everything" and fill out their paper. So I never have any idea when I should count what with who and if I ask they look at me like I'm a schmuck.

One RN was nasty to me because I don't know the doctors glove size right off the top of my head. The doctor and patient weren't even in the room yet and I did have his gloves I was just sorting through the pile of them on my back table because a lot of residents and students were going to be scrubbing in. This same nurse later on said she was going to give me NSS and I marked a small round basin and put the basin on the edge of the table so she wouldn't have to reach. She then came over and proceeded to dump the entire contents of the bottle in the small kidney basin and wouldn't stop even as it was pouring over the sides, flooding my back table and spilling onto the floor. When I told her about it she blamed me and said it was because I left the bulb syringe in the basin.

As I said other students have all had issues with the RNs I mentioned above as well as others and we approached our instructor about who told us that if we felt we were being bullied we should come to her and file a complaint but, everything just stays the same. It's to the point most of us have such bad anxiety before hand and we don't even want to be there.

I understand the OR is a rough and tumble environment and you need to have a thick skin. I do have a good one developed after years of customer service and dealing with patients and their families. If I was actually employed and getting a paycheck they could all just take their attitudes and stick'em where the sun don't shine but when I'm shelling out almost 10 grand in money I don't have and all the nasty and belittling behavior is becoming a detriment to my learning we have a problem.

So I'm not sure what I should do at this point. It's Friday night and I'm already sick to my stomach thinking about Monday clinicals. I just feel so incompetent, slow, stupid and that I made the wrong career choice. The only advice I've gotten from the nice RNs and techs is to just smile, nod and agree no matter what, don't let anyone ruin your day and to shake it off and make tomorrow better.

Oh and before a tired old argument is brought up I'm not one of those techs who think they are superior above circulators and could run the OR without them. To be honest you guys work ridiculously hard and it makes my head spin!

[PureLifeRN]

Sounds like you need to grow some thick skin.

As a student, you are not a necessity to a room....in fact you are an obstacle to the RN. Just as long as you remember that.

Some days I could scream when a nursing student is assigned to me. Nothing against students, but its extremely difficult to circulate AND teach at the same time. You think you have it bad because you are "shelling out almost 10 grand in money," well just think of the RN who has to teach you for NO extra pay. How bout that for ya?!?

[bsktballmom]

WOW...Gymnut first of all I'm sorry for your continued bad experience in the OR, trust me it's normally not like that. As for the rude response, sorry about that too. If I remember correctly we were all students at one time, I always remember that little fact when I have a student.

Now as for the $10,000 you shelled out, that was your choice, it doesn't mean it will affect how your treated.

There are a lot of grouchy people in every department. You just happen to come across several in the OR, which sucks.

Stay strong and don't back down. Hang in there!

[Rose_Queen, BSN, MSN, RN]

Folks in the OR tend to have strong personalities. Think about- most people go into health care to help people. Yes, we do that in the OR, but think about how we do it. We literally tear their bodies apart, be it removing part of the colon, or intentionally dislocating a hip to replace it. Not everyone can handle it, and some people cope with it in not so good ways. It's true that you (general you, not necessarily you specifically) really do need to grow thicker skin to deal with that and the strong personalities. However, it sounds like you are in a bit more of a toxic environment than most.

In regards to the counts, what is the facility policy? Our policy is that everything must be counted at the beginning of the case if there is a potential that we could open a body cavity (lap chole that could go open, VATS that could turn into a thoracotomy, etc); however, at the end if we didn't open we only need to count sponges, sharps, and any other little thing that had the potential to get left behind. Students also aren't allowed to count; only an RN may count with the scrub person (or if the scrub person is an RN, she/he may count with an ST, just so long as one of the people counting is an RN).

It's also true that having a student isn't easy. There is no compensation for doing so in most places, and it does, contrary to many students' beliefs, cause more work for the nurse because they are still responsible for the patient. Many places don't ask the nurses if they want a student- they just come to work and find out they have one. Some nurses may get students so frequently because they're good at precepting that they burn out from it. Some nurses may still be so new to the environment that they may not be ready or able to have students. Then there are just crappy people who should be kept far far away from students. The same thing will be found in all walks of life, not just nursing. It's all part of the cycle of life really not being fair to everyone.

[ORoxyO]

I can't believe they let you count. Our students pretty much stand in the corner.

[Rose_Queen, BSN, MSN, RN]

I can't believe they let you count. Our students pretty much stand in the corner.

That's something I was wondering- OP, are you a nursing student or a surgical tech student? You mention having something on your back table, which makes me think ST since most places don't have RNs scrub, let alone student nurses.

[kids]

If I was actually employed and getting a paycheck they could all just take their attitudes and stick'em where the sun don't shine but when I'm shelling out almost 10 grand in money I don't have and all the nasty and belittling behavior is becoming a detriment to my learning we have a problem.

It's not the hospital staff's problem you're spending money you don't have.

The staff isn't seeing a dime of that money and they really don't owe you diddly. You're giving money to the school and the real issue is with the clinical site the school has chosen, the school is who you need to deal with and your instructor has given you advice on how to deal with it: report it to the instructor so a complaint can be made. Complaints probably aren't going to have an impact on the treatment/behavior you recieve but may factor when the school is choosing clinical sites.

[GadgetRN71, ASN, RN]

The OR is a tough environment. There's a certain amount of sucking it up that comes with being a student, unfortunately. When you are out in the workplace, you have a little more leeway to complain, but not much, especially when you are new. Try to put a positive spin on it..like what doesn't kill you will make you stronger. As far as you paying the money for your program, they won't care about that and nor should they. It's not about you- it's about the patient.

[gymnut]

I guess I should explain a couple of things about the tuition statement. I meant "money I don't have" in a more genral sense. If I had the money I wouldn't need to take out a loan. I didn't mean to come across as saying since I paid 10 grand I demand to be treated with respect and I'm sorry if I conveyed that. I just feel that no matter what you are going to school for if your not learning or being productive then your money is being wasted. Whether it's your own fault for not caring or your preceptors/instructors fault for not teaching. To me it's the same if you're in nursing school and get a crappy preceptor for the day who teaches you nothing your time and money were just wasted for that day.

We are a large teaching hospital that has one of the oldest nursing programs in the nation, the surgical tech program is 15 years old itself and we are currently partnered with Temple to build a medical school. There is a constant stream of students throughout the whole hospital. All of our clinicals are done through our hospital and its other campus sites. The other campus sites are great and they love students and no one has issues there. As one poster above mentioned I'm in a more toxic environment. It's why a lot of students of all types divert to the other campuses or just other hosptials in general after they graduate. There is just such a high turnover rate.

Yes, as a student I am allowed to do everything I would when I pass the boards and actually become a CST. I open, set up, pass instruments, count, keep tract of medications on the back table, staple, cut sutures, hold retractors and pretty much whatever the surgeon needs me to do. The only thing is I must have a CST scrubbed in with me at all times. Most of the circulators don't scrub in although at the other campuses it's mostly RNs. I've heard of several tech schools that only let their students observe and I think that's sad. It's such a hands on position and I don't understand how anyone can learn that way.

[GadgetRN71, ASN, RN]

I know how it feels to be in a toxic environment. It does sound like you are in one. Keep your chin up and focus on getting through it so you can find a less toxic place to work. All ORs have their tough people but some places encourage them.How much longer do you have for school?

[ruralgirl08]

Where is your preceptor in all of this? Have they "debriefed" with you after your shift? Like what you could do to improve, or what you are doing well, what you need to work on? They must notice this behavior, because it does sound like you are in a toxic environment. Like the above posters said, part of the challenge in the OR is learning to work with all different types of personalities. Remember to be respectful, regardless of how other people come off while you are learning, and follow the proper procedure/policy. You may need to re-approach how you communicate to others, how you ask for things, who you word your questions and responses, (here is where you need to draw from your customer service experience.) I hope that the person scrubbed in with you, has your back a bit more while you learn. Think "raincoat" and let the negativity roll off your back, you can get through this.:)

[ORoxyO]

I didn't realize you were a tech student so that changes things. First of all, I've seen many sponges inside patients during a scope...they must be counted! I don't understand that one. Also, you were right not to continue to count when the RN was not paying attention as they must participate in the count. There is a reason two people count together, and you are a student so technically it should be 3 people.

As far as the personalities go, you're going to have to suck it up and deal with it. People can be nasty. They can be cruel and rude and there's nothing you can do about it. But there are also wonderful fantastic people out there. Preceptors are the same. I've had some horrid experiences with people who were supposed to be helping and training me. I wanted to cry. But I didn't. I took it and use it as a guide to treat my students. I'm sorry you are having this bad experience, we love our students in my OR. It will be over soon. Just do your work and do it well, and be polite. If you do that, you'll be better for the experience.