How to treat nurses correctly

**canoehead, BSN, RN** · Apr 21, 2005

If you go in with a spirit of respect you can't go wrong. Mostly its common courtesy, which you already have plenty of.

Thanks for your consideration-it's very much appreciated.

sharann, BSN, RN · Apr 21, 2005

The expression you can catch more flies with honey than vinegar is very true. We have to treat eachother well. That's it. Good for you exploring yourself early.

grimmy, RN · Apr 21, 2005

i appreciate the residents that i work with that are:

a) willing to help...in any way. there are a group of residents in one of our services that have a reputation for being top-notch. this is mostly because the chief of the dept requires certain behavior, the responsibilities of the junior residents are clearly spelled out, etc. there is typically a junior resident at each case. he/she has all pathology forms filled out (correctly), answers senior residents' pagers, and will help set up equipment. needless to say, these folks are dearly loved and appreciated. contrast that to another service where the residents don't show up unless they are paged, usually forget consents, whine about updating h&ps, and drop towels on the floor. :stone

b) patient. whiney, adolescent residents are fodder for nurses' ire. this is truly tested when i have a surgical tech student scrubbed in for a case, and they stamp their feet, 'tsk' when the student takes their time loading a suture, or won't teach a student when given the opportunity.

c) willing to learn. that's is what residents are there to do, but the cocky ones (and there's never a year that goes by without seeing at least one) will always wind up in trouble. be able to laugh at yourself. :rotfl: be sensitive to what is happening around you. you will be talking into a hole, sticking your hand out, waiting for the right tool to drop into it. speak up, without screaming, name the tool you want, and if you forget the name of it (we all do from time to time) look up at the mayo stand and point. nurses and sts are there to help you...we are a team. the minute things are not running smoothly, the team ceases to function efficiently. find out how you can help. good luck in your internship! :)

stevierae · Apr 24, 2005

Hi there,
This site, and some discussions/horror stories about verbal abuse to surgical nurses by doctors came up with some Google search I did. This has been a concern of mine for awhile, and I'd like to ask if anyone can provide any advice to someone who will be going into a surgical residency soon about treating nurses and other staff in the operating room like human beings, while still being able to get the job done.
I know for a fact surgeons have a stereotype of being cocky and condescending, especially to nurses, but I REALLY don't want to exhibit that. I can name many RN's who have really made a difference in my life, and I need advice (or just some things to remember) on how I can show the respect I have for nurses when I'm in such a position.
Thanks!

Wow, I can already tell you'd be a great person to work with. You have an awesome attitude.

Here are my thoughts; just a couple----get and open your own gloves (or, alternatively, ask the circulator if she minds if you get and open your own gloves--some very anal circulators (I'm not one, LOL--I'm all about delegating--less for ME to do!) want to control everything in the room or what's added to the field (they also may have to keep track, for billing purposes) OR, often unfairly, they don't trust the first year resident's (intern's) sterile technique. Once they work with you a few times, they'll relax and lighten up.

Don't try to stand up at the head of the table to assist the anesthesiologist with induction. That's the circulator's job. We are all very good at airway support--many of us were doing it before the resident was born. You can, however, ask the circulator if there's anything you can get or do while she's up there. If not, and your attending has nothing he wants you to do (such as assist with positioning) go ahead and scrub.

Generally, circulators have a certain routine. I, personally, usually put my Foley in during my prep on a lady partsl case (or any case that requires a lady partsl prep.) Sometimes residents want to rush to put the Foley in, and that delays us prepping, and requires unnecessary steps. You can ask the circulator if she minds if you put in the Foley; if she says she prefers to put in her own, respect that. You'll have plenty of other opportunities.

Same goes with TEDS and SCDs. Some residents tend to put them on sort of carelessly, with lots of wrinkles, etc. that could cause problems for the patient--skin tears, pressure. The circulator ends up having to adjust them correctly--redoing what the resident has done. Let the circulator do it, or ASK if she'd like help with the opposite leg. Watch how she puts hers on, and do yours likewise.

Don't put the Bovie pad on. Again, even some 4th and 5th years put it on on the wrong place, or leave gaps that could cause shock or even a burn. Let the circulator do it.

When you get to be a 4th or 5th year, don't get arrogant and act as if you are already a board certified surgeon. To the nurses, you are still a resident, even if, at the med school and to the junior residents you are a pretty important guy already . Treat your interns and second years as you wish YOU had been treated when you were an intern or second year. I dislike nothing more than 4th and 5th years who try to make their junior residents look bad or stupid in front of the attending---the attending, also, can pick up on people who try to make others look bad in the belief that it will make themselves look GOOD. It doesn't.

Before you scrub, delegate care of your patients on the floors to another resident (possibly even a med student) who isn't scrubbed that day. Turn your beeper OFF, or leave it at the desk. Don't come in and expect that the circulator will answer all those calls regarding patients whose care should have been delegated to someone who can actually round on them and make interventions. Understand that, as the patient advocate, your circulator is responsible for the patient ON THE TABLE AT THAT TIME. It would be grossly unfair--and dangerous--for her to compromise that patient's care while constantly taking and relaying messages back and forth for all the residents and med students in the room. If you notice, your attending NEVER has a beeeper going off.

Say to the crew (both scrub and circulator) once in a while, "It was fun (or a pleasure) working with you. Shake their hands. Treat them like fellow professionals. Remember your names, and they will remember yours.

Don't run off to scrub in on another case before your patient is even transported to PACU or ICU. This patient is still your patient---transport them, or at least accompany the people who transport them, to PACU or ICU. Feel free to report anything significant to the RN taking over care of your patient, when the anesthesiologist gives report. You can sit in PACU and write orders, etc. while you are talking, if you'd like, and kill two birds with one stone.

I have worked with some awesome, awesome residents in my day; all of them I recall fondly by name, and many of them, I have since heard, are outstanding and wel-respected surgeons now--but they treat their crew, including their residents, extremely well. I am not surprised--they were a pleasure to work with.

Then again, I've worked with some foreign residents who, in their countries, were royalty---literally--and were used to ordering servants around---many also were taught, in their culture--that women are second class citizens. That won't fly here. Nurses can make your life REALLY hard. Sadly, some of those guys are now attendings, and they still act like jerks--and their residents imitate this behavior, thinking that it's acceptable. It's not, and it's not necessary. Bottom line is, residents are soon gone, and their names forgotten when a new group comes in (until they come back as 4th or 5th years--) but, generally, the attending will support the circulator---not residents with attitudes like this. He has known her much longer, trusts her, and considers her a critical part of his team.

All that said, don't put up with RNs who treat you like scum simply because you are a resident, and they dislike residents, and have "always done it this way--it's tradition." I hate seeing that happen, and it's not true. The nurses who do that have really severe attitude problems and control issues, and it makes them feel important--many of them don't have lives outside that operating room---the operating room IS their life. Take them aside quietly, not publicly, and tell them that you respect that they are in charge of the room, but that you expect to be spoken to like a team member--with respect. You have a right to that.

Makle this your mantra: I resolve NOT to be a prima donna.

Don't wear loupes unnecessarily (say, on a herniorrhaphy) just because you have recently purchased them and you think it makes you look cool or important, (it doesn't) or aspire to be the next Michael DeBakey or Denton Cooley. It looks stupid. Wait until you are actually scrubbed on a vascular case to put them on.

You'll do great. I think it's really cool that you asked our advice. I hope I get to work with you someday! :)

rnpilot · Apr 25, 2005

Very simple- treat others the way you would want to be treated. We all have our moments. Saying you're sorry goes a very long way, and will garner you even more respect. Notice everyone you work with and treat them with respect, starting with housekeeping who takes out the (your) garbage. Remember that without support form the lowest people on the "totem pole," you wouldn't be doing surgery, and you will be loved and respected. Show appreciation for the people you work with. If you're with certain nurses frequently, remember them on holidays and periodically do something nice for them. Big difference between the nurse who got a spa day for Christmas from the surgeon she worked with daily and the nurse who worked with a different surgeon and got nothing. Which working environment was better, esp. considering the surgeons were living well and the nurses were barely getting by? Try to think what it would be like to 'walk a mile in the moccosins' of the people you work with each day. Make a friend, you have an ally. Make an enemy of a nurse...don't even want to go there! ( I always like to have a bag of mini candy bars in my locker, too.) Surgery can be terribly stressful, and words said without thinking, but if you're honest, treat people with respect, appologize when needed, get ego out of the way, and show appreciation, you'll be the surgeon everyone wants to work with. Alpha dog (power trip) = Alienation. "He who is greatest shall be least among you."

sunnyjohn · Apr 25, 2005

Wow, I can already tell you'd be a great person to work with. You have an awesome attitude.
Here are my thoughts; just a couple----get and open your own gloves (or, alternatively, ask the circulator if she minds if you get and open your own gloves--some very anal circulators (I'm not one, LOL--I'm all about delegating--less for ME to do!) want to control everything in the room or what's added to the field (they also may have to keep track, for billing purposes) OR, often unfairly, they don't trust the first year resident's (intern's) sterile technique. Once they work with you a few times, they'll relax and lighten up.
Don't try to stand up at the head of the table to assist the anesthesiologist with induction. That's the circulator's job. We are all very good at airway support--many of us were doing it before the resident was born. You can, however, ask the circulator if there's anything you can get or do while she's up there. If not, and your attending has nothing he wants you to do (such as assist with positioning) go ahead and scrub.
Generally, circulators have a certain routine. I, personally, usually put my Foley in during my prep on a lady partsl case (or any case that requires a lady partsl prep.) Sometimes residents want to rush to put the Foley in, and that delays us prepping, and requires unnecessary steps. You can ask the circulator if she minds if you put in the Foley; if she says she prefers to put in her own, respect that. You'll have plenty of other opportunities.
Same goes with TEDS and SCDs. Some residents tend to put them on sort of carelessly, with lots of wrinkles, etc. that could cause problems for the patient--skin tears, pressure. The circulator ends up having to adjust them correctly--redoing what the resident has done. Let the circulator do it, or ASK if she'd like help with the opposite leg. Watch how she puts hers on, and do yours likewise.
Don't put the Bovie pad on. Again, even some 4th and 5th years put it on on the wrong place, or leave gaps that could cause shock or even a burn. Let the circulator do it.
When you get to be a 4th or 5th year, don't get arrogant and act as if you are already a board certified surgeon. To the nurses, you are still a resident, even if, at the med school and to the junior residents you are a pretty important guy already . Treat your interns and second years as you wish YOU had been treated when you were an intern or second year. I dislike nothing more than 4th and 5th years who try to make their junior residents look bad or stupid in front of the attending---the attending, also, can pick up on people who try to make others look bad in the belief that it will make themselves look GOOD. It doesn't.
Before you scrub, delegate care of your patients on the floors to another resident (possibly even a med student) who isn't scrubbed that day. Turn your beeper OFF, or leave it at the desk. Don't come in and expect that the circulator will answer all those calls regarding patients whose care should have been delegated to someone who can actually round on them and make interventions. Understand that, as the patient advocate, your circulator is responsible for the patient ON THE TABLE AT THAT TIME. It would be grossly unfair--and dangerous--for her to compromise that patient's care while constantly taking and relaying messages back and forth for all the residents and med students in the room. If you notice, your attending NEVER has a beeeper going off.
Say to the crew (both scrub and circulator) once in a while, "It was fun (or a pleasure) working with you. Shake their hands. Treat them like fellow professionals. Remember your names, and they will remember yours.
Don't run off to scrub in on another case before your patient is even transported to PACU or ICU. This patient is still your patient---transport them, or at least accompany the people who transport them, to PACU or ICU. Feel free to report anything significant to the RN taking over care of your patient, when the anesthesiologist gives report. You can sit in PACU and write orders, etc. while you are talking, if you'd like, and kill two birds with one stone.
I have worked with some awesome, awesome residents in my day; all of them I recall fondly by name, and many of them, I have since heard, are outstanding and wel-respected surgeons now--but they treat their crew, including their residents, extremely well. I am not surprised--they were a pleasure to work with.
Then again, I've worked with some foreign residents who, in their countries, were royalty---literally--and were used to ordering servants around---many also were taught, in their culture--that women are second class citizens. That won't fly here. Nurses can make your life REALLY hard. Sadly, some of those guys are now attendings, and they still act like jerks--and their residents imitate this behavior, thinking that it's acceptable. It's not, and it's not necessary. Bottom line is, residents are soon gone, and their names forgotten when a new group comes in (until they come back as 4th or 5th years--) but, generally, the attending will support the circulator---not residents with attitudes like this. He has known her much longer, trusts her, and considers her a critical part of his team.
All that said, don't put up with RNs who treat you like scum simply because you are a resident, and they dislike residents, and have "always done it this way--it's tradition." I hate seeing that happen, and it's not true. The nurses who do that have really severe attitude problems and control issues, and it makes them feel important--many of them don't have lives outside that operating room---the operating room IS their life. Take them aside quietly, not publicly, and tell them that you respect that they are in charge of the room, but that you expect to be spoken to like a team member--with respect. You have a right to that.
Makle this your mantra: I resolve NOT to be a prima donna.
Don't wear loupes unnecessarily (say, on a herniorrhaphy) just because you have recently purchased them and you think it makes you look cool or important, (it doesn't) or aspire to be the next Michael DeBakey or Denton Cooley. It looks stupid. Wait until you are actually scrubbed on a vascular case to put them on.
You'll do great. I think it's really cool that you asked our advice. I hope I get to work with you someday! :)

Good post! You should turn this into a pamphlet or poster, " A New Resident's Guide to Getting Along in the O.R."

UM Review RN, ASN, RN · Apr 25, 2005

Even though I'm a nurse, there are some doctors--one is a surgeon--whom I will refuse, under ANY circumstances, to let treat me or my family. Not because of his skill, but because of how he treated me while working with him.

So you might want to think about that too. I'm a nurse, yes, but nurses, their friends, their families are also potential patients. It doesn't go a long way to inspire confidence in all these folks to hear about temper tantrums.

:stone

JaneRNBSN · Nov 10, 2005

I disagree with the nurse who instructed the resident to help with TEDS, etc. As a circulator, I am already rushing to get things done and any help from a doc is regarded as rushing me further. I've worked with some real pills who scream, throw tantrums, throw instruments, berate the staff and walk out after the procedure with at BEST a cursory "Thanks, guys." By all means, treat the staff with common courtesy, but don't let them walk all over you....and they will if you are TOO NICE. Make it clear in a RESPECTFUL manner that you expect efficiency and competence and you will get it. We are all there for the patient and work as a team. THERE IS NO I IN TEAM.

Ferret · Dec 2, 2005

Good humour and chocolate....

I remeber a particular list years ago that was busy, hectic, but the Surgeons and always kept in good humour and took it in turns to bring a couple of bars of chocolate along. Yeah, I know that having chocolate in the theatre is against regs, and so did the managers... but they were always bribable with a bit of .... Chocolate! That was years ago, but still I remember that weekly list with a smile :biggringi

Ferret :devil:

SFCardiacRN · Dec 2, 2005

Thank us at the end of the case. Tell us when we do a good job. Explain rationales to us when we err. Include us in the decision making process. Apologize when you lose your temper (and you will!) Bring donuts or bagels occasionally. Good luck...I like your attitude already.

singe · Dec 7, 2005

If you are as sincere in your concern for the proper treatment of the people-not just the nurses-working in the OR w/ you 10 years from now, you will be in the minority. I wish I could say the surgeons I've worked w/ in the past 20 yrs. have helped me to maintain my respect for THEM. I don't know if it's part of a change in this generation over the last, but the doctor was THE WORD when I started nursing, and no one and nothing else really mattered except from the standpoint of-will they call me in the middle of the night w/ a stupid effing question. I don't want to be your friend, I'm way over that. I just want to be able to do my job to the best of my ability, and don't YOU be the impediment in that process.

I'm sorry to say I wouldn't bet your attitude will stay as generous as it is now. Your peers will not support it. Maybe you can start a new trend? Treat the nurses w/ the same respect you do your parents-the way patients are treated is sometimes just as bad. I wish I had a quarter for every doc I know who sucks when it comes to the way they treat patient and staff alike. I give up. Is it a complete lack of social skills that makes you docs in the first place? If it weren't for the patients, I wouldn't do it.

It makes me sad to admit that.