Need advise regarding uncomfortable, disrespectful situation

[Maria Crocker]

I am hoping some fellow nurses can help me out. I had a hysteroscopy and D&C at a surgery center yesterday. I was the first pt in pre op in the am and was awaiting my GYN to show. Mind you, I had no choice in Dr.'s with my HMO and I don't know him very well other than the fact that I find him to be a very quiet, meek person. I noticed a male in scrubs looking at my chart a couple of times but he did not introduce himself and the scrubs appeared to be what he wore to work along with a outside jacket on. Meanwhile, anesthesia introduced himself and I felt very comfortable with him. A few minutes later, the male in scrubs walked by again and informed me he was going to be the circulator. Never interacted with me other than that. I voiced my dissatisfaction with the RN who was pre-oping me; stating I did not understand why I would be assigned a male circulator for a GYN case with other GYN cases to follow. I found that unacceptable in a ambulatory setting. So here comes the ORT and says "hi" I wanted to say "hi" since I am the only other girl in your room. Meanwhile anesthesia comes out with the Versed and then the charge nurse comes up to me stating she had heard about my concern and she does not have a female circulator. Now the circulator is at the foot of the bed. I proceeded to tell her again that I thought this was handled very unprofessionally and that it is probably not the right time to discuss it as I am getting sedated. The circulator never spoke with me, obtained a pmh or my meds/allergies. So much for a patient advocate. And for the record, he was still wearing those same scrubs and outdoor jacket that he came in with as he was wheeling me into the rm. I am so angry at the unprofessionalism and complete disregard shown to me. I would love to here others' in put. I am not male bashing, I have worked side by side with male nurses for the past 15 yr in a emergency dept setting. Thanks.

[Rose_Queen, BSN, MSN, RN]

21 minutes ago, meanmaryjean said:

Do circulators even do this?

In my facilities, the circulator does an abbreviated review during the patient interview. I ask about what they're having done, what allergies they may have (you never know, the repeated asking can sometimes trigger a remembrance of one they've forgotten), and a few other things that are pertinent to the OR role (metal implants = places we want to avoid for the electrosurgery unit grounding pad, etc). But no, we do not do the full list that preop does.

OP, did you notify the surgeon/care team/facility ahead of time that you would have preferred a female circulator? We make note of this on the schedule when the patient is contacted by preanesthesia clinic nurses, but they are also informed that based on staffing we may not be able to honor such requests.

[skydancer7, BSN, RN]

YES circulators absolutely are supposed to do their own pre-op interview and intake. It is abbreviated compared to the admission intake, but should involve introductions, name and date of birth, allergies, metal in the body, hearing aids/contact lenses, mobility limitations pertinent to surgical positioning etc.

Everywhere I have worked, which has been a LOT of places over the 10 years, circulators are expected to do a pre-op interview (abbreviated yes, though it sounds like the RN in this situation didn't even do that) and sometimes clearly it gets missed because people are in a big-*** hurry to keep the conveyer belt cranking along because $$$. Anyway, yes, it is redundant for a reason; if the pre-op nurse or someone forgets to ask about allergies, someone else can catch it. That's why the patient gets asked the same questions several times before surgery. It's so we can all catch each other's misses and mistakes before it causes a safety problem. I can't tell you how many times EVERYONE missed something, and it's in the OR that the circulator finds out the patient still has their contact lenses in, or is allergic to latex, or is still wearing shorts under their gown and we need access. System of checks and balances, and things still get through the cracks.

That said, yeah a lot of circulators just show up and wheel the patient back without so much as double checking the wrist band. Doesn't make it good practice.

[GilligansPlace]

I’m in the category of ‘who cares what sex they are?’ Seriously, do you think twice about taking care of male patients when you have to see them in more vulnerable positions? Probably not because hopefully, you’re a professional just there to do your job. Your business is of no more interest to a male circulator than a female circulator.

[NICU Guy, BSN, RN]

16 hours ago, skydancer7 said:

It's not about the male being a NURSE. Note how the OP stated the other two professionals INTRODUCED THEMSELVES. The nurse failed to act professionally by establishing rapport and doing a thorough intake during a sensitive time, and that is the problem.

It was all about the nurse being a male. She didn't say "I don't understand why this male circulator would be assigned". Instead she used the phrase "a male circulator".

On 2/28/2020 at 6:37 AM, Maria Crocker said:

I did not understand why I would be assigned a male circulator for a GYN case with other GYN cases to follow.

16 hours ago, skydancer7 said:

Don't let fragile egos of the #NotAllMen crowd make you feel otherwise.

Give me a break with the fragile ego garbage. This thread hit a nerve with me as a male nurse. All male patients feel vulnerable and embarrassed when they have to be exposed for a procedure. Except men realize that the female nurse is a professional and doing her job. She is not getting any sexual pleasure inserting a foley catheter.

For the women that endured sexual abuse in the past, I fully understand their issue with male nurses. For the rest of the female population, what is their reasons for not wanting a male nurse? The availability of female nurses as an alternative, modesty, male nurses are perverts, or something else.

I wished that this male circulator had come from the locker room with fresh clean scrubs and no jacket, had introduced himself, developed a rapport with the OP. Would she have had the same objection for him being in the OR room? If so, why?

[Maria Crocker]

Let me answer that question for you NICU guy. Had the circulator come up to me and introduced himself and been professional, I don't believe I would have had a problem with it. What I did not mention in my initial post is that I currently work at a different ASC as a circulator. I needed this procedure since previous diagnostics indicated I have endometrial CA so to say I was stressed is a understatement. I feel like some of you have been discriminated against in the past and really have a chip on your shoulder. I wanted empathy and an advocate and since I do have some modesty, I did not feel a complete male team was an appropriate choice for the procedure I was having......I don't think that was too much to ask for. I have worked with plenty of male nurses that I have the utmost respect for.

[jena5111, ASN, RN]

8 hours ago, meanmaryjean said:

The circulator never spoke with me, obtained a pmh or my meds/allergies.

Do circulators even do this? I've never even really seen a circulator interact with a patient on that level. OP- you yourself said a separate RN did your pre-op. You wanted it done again? By everyone who came in the room? It gets put in the record for everyone who needs to have access. I am genuinely puzzled you are so upset by this.

Yes, the OR circulator is supposed to do a separate/independent pre-op interview/assessment to include meds, allergies, implants, previous anesthesia experiences, understanding of procedure to be performed (site/side), and etc before wheeling the patient back to the OR. It is a standardized interview with preset questions.

The OR circulator's interview must occur PRIOR to sedation.

I would even jokingly mention to the patient my awareness that they've been asked these questions like three times before...it's a surgical safety issue. I can count on zero hands how many times patients cared about answering the same questions multiple times. Many would notice and mention the redundancy but most appreciated the attention to safety and detail.

[JadedCPN, BSN, RN]

37 minutes ago, Maria Crocker said:

I wanted empathy and an advocate and since I do have some modesty, I did not feel a complete male team was an appropriate choice for the procedure I was having......I don't think that was too much to ask for. I have worked with plenty of male nurses that I have the utmost respect for.

So....it did absolutely have to do with him being male.

[trytounderstand]

5 hours ago, Maria Crocker said:

I wanted empathy and an advocate and since I do have some modesty, I did not feel a complete male team was an appropriate choice for the procedure I was having......I don't think that was too much to ask for.

So would you have advocated for a male patient to not have an all female team? Most times just from number standpoint men have to face the fact that they are going to be exposed to an all female team and expected to accept it.

While I sympathize with your feelings of modesty, I would have been more concerned about the fact that he was in scrubs that apparently had been worn to work and that he had just removed a dirty coat and that he was not following protocol.

[Subee2, BSN, MSN, CRNA]

Versed causes retrograde amnesia so the circulator may have done his job but you have no memory of it. One if the ASC's I worked in frowned upon Versed in the holding area so that the patient could participate in the time out done in the OR. The last time I had Versed before surgery....I couldn't even remember driving myself to the hospital. I didn't even remember that surgeon had to make an incision rather than a trocar stab. I didn't know I even had an incision until I went for a post op visit. Big duh on my part because the size of the dressing should have been a clue:). Of course the sx. and nursing staff explained this to me but I had no memory of any such conversation. The next time I had surgery , the CRNA asked me if I could forgo the Versed and I said YES!

[Kooky Korky, BSN, RN]

I would have been afraid to be sliced upon by a surgeon who was a total stranger.

I do understand your feelings about the circulator, OP. He sounds like a jerk, especially wearing the outside coat into the OR. It is true, though, that male patients have to endure all female staff.

You should have spoken up before allowing them to sedate you.

[NICU Guy, BSN, RN]

I have a theory for the ciculator's clothing. He could be lazy. He may be in the habit of wearing the scrubs from the previous day home. He puts the same scrubs back on to go back to work. Since the OP's case was the first case of the day, he came to work, clocked in, and reviewed the case. Once he was done, went the locker room, put his coat in the locker and put on a fresh pair of scrubs. Since the pre-op area is not a sterile area, he didn't feel the need to change before meeting the patient. I understand that it is still unprofessional and gross, but it explains him walking into the pre-op area with his dirty scrubs and outside coat on.

[Maria Crocker]

Wrong NICU guy. He was still wearing the outside vest type jacket when he wheeled me back to the OR. And to the person who suggested I can't remember from the Versed....wrong. The info I provided was before anesthesia pushed the Versed. I work as a circulator, so this was not a foreign arena.