In The Right?

[SweetSouthernLove, ASN, BSN]

Good Morning All,

As of late I have returned to allnurses to find solace in my specialty of nursing. Currently, I have been trying to adjust to a new job in a new hospital with new coworkers as well as new surgeons. Everything has been going well except for one particular surgeon who seems to always place his misdirected anger at me. I have worked with many surgeons during my time as an OR nurse, but this past week an instance occurred that really changed the way I feel when I walk into work.

It was a pretty standard but quick case. At the field she made requests for the following regarding the tissue she had extracted from the site: 1 frozen specimen, 1 permanent specimen, and 1 culture with the following tests: Aerobic/Anaerobic, Fungal, and Viral. I put both specimen orders in and had a runner take the frozen, which the results were relayed from Micro to him in a timely fashion.

The culture order is where all hell broke loose. I am still within my 90 days at this new facility and so I was with a preceptor. I wanted to make sure the culture order was entered correctly because we had a different process where I came from. She said she was unsure and asked me to call Micro and so I did. I got information from Micro to relay to the surgeon about that there needed to be specificity regarding the type of viral culture that he wanted as they do not offer a virology culture panel for tissue. When I explained this to the surgeon and asked what viruses he would like to test for he simply shouted "ALL VIRUSES." I again relayed the information to Micro thinking there must be some order that he wanted for this and that they would know what it was as I am new and my preceptor was also unsure. They again told me that there is no such type of order for this. So again, wanting to do right by my specimens/cultures AND patient I tried to clarify with him and he screamed in an irate manner in front of my preceptor and my coworkers that "we have discussed this twice, I want all viruses - how can I know what virus to test for if I don't know what the tissue could have?" and so I began my physical walk to Micro, and again, they said maybe there is an Add On order that he wants and to clarify, and that there is no way they can test for ALL viruses because it is simply not reasonable or practical. If she had an idea of what viruses he wanted then they could tell me what order to put in for the patient.

At this point after exhausting all of my own options as a new nurse I finally went to my manager. She spent 10 minutes on the phone calling half a dozen employees trying to investigate the order that he might be talking about and again to no avail. Finally, he comes around the corner and she asks her to come into her office, where we are trying to get to the bottom of this and when questioned calmly by my manager he proceeds to scream "we have discussed this three times just cancel the order!" and he proceeds to talk about me down the hallway to anyone who will listen. My manager's door was ajar and I am sure if there were patients in holding, they heard the whole ordeal.

This of course is not the first time this surgeon has snapped on me and proceeded to talk within hearing distance about me to other coworkers. I feel that this surgeon is undermining my ability to be a decent nurse and communicate properly regarding the needs of my patient. The patient had some questionable history and I felt it necessary to get to the bottom of it if an order like that existed so that all appropriate testing could be done, especially when the surgeon themselves have given a verbal order for this. I felt the surgeon was just extremely pissed off in general regarding my presence and the communication regarding the culture order was poor at best on his part. At no point did he tell me to cancel this order in the OR and that was only finally revealed in my bosses office after all the leg work I had done to investigate the matter, and then I felt the blame for being an inconvenience. I dread this particular surgeon because of her treatment towards me and I know that is a part of a job, but I really felt like I was verbally abused in that moment and I am worried that it will only get worse.

I expressed my feelings to both my preceptor as well as my manager and my preceptor apologized for putting me in an awkward position for not handling the order as she has been there much longer and could have assisted me with the navigation but she was also unsure and agreed that how we handled it was best because now we know better. My manager expressed that this particular surgeon is "that way" with everyone, but I am with him 8-10 hours per day and I directly observe his behavior with others and then with me. I know I am new and I am trying my best, but I feel like I am being treated as incompetent and even blamed for just trying to do the correct thing and be an advocate for my patient. Is there anything I can do differently? I don't want to shy away from the surgeon or the cases as I am one of the primary nurses for this area and will most definitely have to work with her at some point in the future. I am just not sure how I will be able to communicate properly if this is how it will constantly play out.

I am not off of my probationary period yet, but I just felt defeated and incompetent and it really has changed the way I feel.

[beachgirl17]

I just want to say that you should hold your head high knowing you acted professionally and in the best interest of the patient. Like most OR nurses, I too have worked with difficult surgeons and it really can affect many things. It sounds like management is aware of surgeon's difficult behavior because they said she is just "that way." Hopefully, management speaks to surgeon about it when she is cooled down. I am thankful my management does not let them act "that way" towards the staff repeatedly.

I guess I don't have a solution to offer, but perhaps speak to your preceptor again about how to be successful and communicate better with the surgeon. Maybe he or she will have some tips.

[2short2RN, ADN, MSN, RN]

I'm so sorry this happened to you. I recently started a new OR job too, and an interaction with a surgeon who is "that way" has left me rattled and in a funk. I don't know how to break out of it. My experience with surgeons who are "that way" is that they will always be "that way" and no one will do a thing about it. Good luck to you. Sorry again for the terrible interaction.