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.

[TriciaJ, RN]

On 3/3/2020 at 6:51 AM, NICU Guy said:

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.

Yes maybe someone should speak to him about that because the optics just aren't good.

[Subee2, BSN, MSN, CRNA]

On 3/8/2020 at 3:00 PM, Nurse_Mike said:

In a clinical once, while shadowing a floor nurse, one of the clients was due for a lady partsl exam. I had been shadowing the floor nurse for all of her clients, and she had said she would ask the client if it was OK if a student observes her perform the exam. The client, looked at me long enough to see that I was of the male variety, and said something like "Uh, no." I told the nurse OK and that I would sit this one out. When the nurse came out, she seemed concerned as to whether or not I was either upset, or was OK with the refusal or lack of a learning opportunity (although there was to reason to feel this way other than to make sure we were on the same page). I had to reassure her two or three times that I had not given it a second thought. The client had the right to make the decision, it caused no problem for us as we were well staffed, and with female nurses. There may have many angles to look at this, but for me the short version is, it was probably a more comfortable experience for the client without me/a second nurse/a male nurse in there during the exam. The job got done and all was well. I have not been in the clients shoes, nor would I need to be, and my training can come later. There will always be a certain percentage of refusals by clients for any and all medical procedures when the regular staff tries to integrate a student, male or otherwise. I have read all of the previous dialogue and it was a good discussion. Just putting my two cents in.

Shades if the 70's!:) Ate we back to "clients" almost 50 years later?

[jena5111, ASN, RN]

On 3/1/2020 at 3:36 PM, skydancer7 said:

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.

THIS. In my brief time as an RN circulator, I took my (abbreviated) pre-op interview seriously. That was most definitely time to catch details that had fallen through the cracks--which didn't happen often, but happened often enough to make me realize the value of my interview with the patient.

Moreover, that short time was my opportunity to establish a rapport with the patient BEFORE fentanyl. Introductions and role explanations from all peri/intra-operative team members are important. The patient needs to understand that an entire care team exists during surgery to keep him/her safe. The circulator should reinforce and establish the patient's trust.

I had an OR charge nurse yelling the 2 or 3 minutes late I would be wheeling the patient back WHILE wheeling the (luckily fentanyl-ed) patient back. "Jena5111, do you know it's 0733??!!" Super unprofessional and dramatic. Please note that this was not a consistent occurrence on my part. I understand the rationale for on-time case starts. However, the hair-on-fire mentality around case start TIME (among other things) made me realize that I prefer awake patients.

I found my way to a hospital-based surgery clinic and I love my job. Well, the nurse part of it. The admin part that happens in so many outpatient settings...not so much.

[MarkMyWords]

I understand this feeling in a way. I had no choice about the medical staff who assisted with my surgeries and procedures. The doctor, who was new to me did not introduce himself or even say hello, very unfriendly. Not much you can do except next time tell them your preferences ahead of time. Having a HMO or not is not so relevant. It is one thing for a male MD to operate and another issue when the personnel are male.

[DavidFR, BSN, MSN, RN]

On 3/3/2020 at 6:34 PM, Maria Crocker said:

I had a male GYN and anesthesiologist, so it is not that I have a "beef" against men.

This seems to be a case of "Oooh he's a doctor" so it's OK since he's just one down from God, but any other male staff are subject to different standards because I value them less. Coming from a nurse to a nurse, that's frankly, disgusting.

Look at what you said. Male GYN OK, male anaesthestist OK, but male nurse not? And the scrubs/jacket thing seems to be an excuse to justify your objection to a male nurse being present. Moan about his jacket as a seperate issue but don't confuse it with him being male.

I've had both urology and proctology procedures with female staff - didn't care a damn since I expect them to be professional, not behaving like they're at a Chippendales concert.

I have had elderly, covered, muslim women allow me to do stuff because "It's OK, it's medical" Sometimes their husbands have raised objections but surprise surprise, they never object to a male doctor. It's a case of doctors are demi-gods, nurses aren't worth two cents. That such an attitude comes from a fellow nurse is frankly, astounding.

Accuse me of anger if you wish because yes, your post made me angry.

[DJSexton, RN]

Lots-o-comments on this one. Being a male RN, can I offer a perspective? I'm in psych where the best of the best in this specialty actually are pretty damn good at what we do. When I had my clinical in OB/GYN for school, I had heard the nurses didn't like men. So, I expected the worse. And in turn, I had a most wonderful experience (they had a male NICU RN who was absolutely accepted). It's all about the respect for the human condition. We all know it. We all learned it in school. But being on the other side as the patient - that we're often not prepared for. We're either hyper-verbal in an attempt to make ourselves comfortable, or quiet as a church mouse assessing for the right intervention. We can't win.

I do not doubt it was an emotionally challenging experience for you. What makes me good at what I do is that I follow a simple philosophy. I become what my patient needs in the moment always. But that is dependent on my assessment skills right? Some people have it, and some people think they have it - LOL. In the end, if we are to consider ourselves a profession, we must admit that we must not allow gender to be an issue ever. Not even in rape cases where men can sometimes be instrumental as examiners (a compassionate, competent, and patient male nurse can actually provide a sense of control to the victim, through sharing of power - very important for the victim). Customer service though is critical in nursing. I would definitely write a letter if you weren't supplied a survey. Thanks for the opportunity to write to your topic : )