Not sure what to think...

[MrNurseOR]

I am a new nurse who has recently just graduated college, and have landed my first nursing job in the Operating Room. I had completed my senior practicum in the OR at another hospital, so I already have a fair amount of knowledge. The hospital I work at is a very large, level 1 trauma center with 28 OR's and has a year long residency program for new OR nurses. However big the OR is, it consists of a very tight knit group of employees, which has proven to be somewhat problematic. I have a couple of questions that I would like to get answered from other nurses or scrubs based on your own experiences.

Having been employed over two months ago, I have only seen the inside of an OR maybe 5 times. All of these times I have been the assistant circulator, however one concern I have is that every time I have been in a room, it was on a different service. I had started out in Neuro, then a week later went to GU, then General, ENT, and Ortho. I have had a lot of difficulty adjusting to this very infrequent exposure to the OR, and even more being shuffled from service to service. It is impossible to learn how a particular service operates in a day, and as soon as you start to feel somewhat comfortable you are no longer with them again, and as we know every service does things differently. I am just getting extremely frustrated. I feel as if we should be placed in a service for at least a couple of days in a row in order to start to feel somewhat comfortable.

Another problem that I have been having is jokes about homosexuality. I am infact a gay male, however you would never know it unless I was to tell you. On each service I have encountered some kind of homophobic remark. One time I was tying up a residents gown, when the scrub tech says "dont goose him, we are not tolerant to that sort of thing." To which the resident replies "No Fags in this OR!" I do not know why they would even think that was acceptable, one to say something like that to a new employee who they know nothing about, and secondly to say it in general. If i was straight I would take offence to that.

One of the distrubing things happened right after I was hired and was being shown to the locker rooms. One of the female employees made a comment about the male nurse that was going to show me the locker room and said "Make sure you watch your a** while you are around him." I couldnt believe it! I am just not sure what to do as I definitely do not want people here knowing about me.

One problem I have been having is how close everyone is to one another. My boss had approached me because another employee told her I had been wearing my Pyjamas to work, and that I had also been coming to work already wearing scrubs. Both of which are totally absurd accusations. I had one day a couple of weeks earlier worn gym shorts and a sweatshirt to work as my dryer had broke but thats it, and when I told my boss that she flew off the handle at me, and gave me a written warning. I just dont understand how it is appropriate for Residents to cycle into work and walk into the hospital extremely sweaty and wearing spandex.

One final question I had for everyone was if they found that more Scrub Techs were being hired and scrubbing in, or if RN's were still doing a fair share. One thing that was never told to me when I signed my contract at this hospital was that nurses do not scrub in, only scrub techs too.

I am sorry if this has sounded like a long complaint, I am just becoming very frustrated and upset over many situations that have kept arising for me at work. Any insight or suggestions?

-Thank you

[canoehead, BSN, RN]

All good questions...and the remarks were inappropriate.

[fracturenurse]

Wow, I am so sorry to hear this. The remarks are totally unacceptable. Back in 2001 I worked with a female who had a gay lifestyle. She was completely open about her sexuality. Nobody EVER said a word, and that's the way it should be. I don't know exactly what is going on in your OR, but it needs to stop now. The OR that I work in is very close but would never make comments such as this. I think this warrants a visit to HR. Please keep us updated.

[MrNurseOR]

Thank you for the advice. I definitely think I will be talking to someone from HR soon. I also had another question I wanted to ask but forgot to put into the original post. At this institution they also do not count instruments on open abdominal cases. When I found this out, I asked the nurse educator, who is the Periop 101 instructor several different times giving different examples each time. They stated that the reason why they do not count instruments on open cases is because their "instruments trays are to big!" I have never heard of such a thing! I was always taught that whenever a body cavity is opened, or if the potential to open a cavity exists that you count your instruments!

Their philosophy is that the tech/nurse should know what instruments are in the pans, and would be able to know if something is missing. Has anyone else experienced this?

Again thank you, keep the suggestions coming!

[Scrubby]

Document, document, document every comment and incident. You are being discriminated against because of your sexuality. The kinds of comments being made such as 'watch your ass around this one' etc are sexual harrassment and bullying.

Have you said anything at the time when these comments are made? If not, then now is the time to make it absolutely clear to them that you don't really appreciate their comments. If they try to say your overeacting, they are just joking then the best answer (IMHO) is 'isn't there some sort of hospital policy against this? '(I'm sure that there is some sort of anti discrimination/bullying policy, there is in most places). This may cause a few waves but if it stops the behaviour then it's worth it.

As for not counting instruments during laparotomies my reponse to this is get the hell out of this place if they are that lax about the possibility of an instrument being retained. During big open cases we can use multiple trayts full of instruments...funnily enough we manage to count everything. The trick is to count groups of instruments instead, i.e instead of labouriously counting every individual instrument i.e 1 metzenbaum scissor, 2 curved mayo scissor you group them into the type of instrumen they are so 6 scissors, 7 forceps, 10 vascular clamps, 4 retractors, 2 suckers. It makes life a lot easier and you can count trays really fast.

If the scrub nurse or tech refuses to count instruments (and I have been in this situation) then you refuse to sign the count sheet because the count has not been done properly.

[fracturenurse]

OK, time to find a new job. I cannot believe they don't count instruments! Have these people lost their mind? :confused:

[linda2097]

One of the female employees made a comment about the male nurse that was going to show me the locker room and said "Make sure you watch your a** while you are around him." I couldnt believe it! I am just not sure what to do as I definitely do not want people here knowing about me.

If you complain about anti-gay remarks, they will all figure out that you are gay. You need to make a decision.

[TakeTwoAspirin, MSN, RN, APRN]

You said that it was a level I trauma hospital... are you not counting on level I trauma cases (OK in some circumstances not to count, esp. if it is a multi-system trauma and they are taking x-rays throughout the procedure, or there is a threat to life that makes taking the time to count instruments medically inappropriate), or schedules cases (inappropriate not to count in any circumstance)?

I just can't conceive of not counting for routine cases! There has to be more to this...

[MrNurseOR]

We do not count regardless, routine or emergent.

[Pitbullgirl]

Hi,

I don't know if I have any answers for you, but I feel the same way, and wanted you to know you're not alone. I am a fairly new nurse, and started at a local hospital in their OR internship recently. It is a 6 month internship. And I have to tell you -- I have NEVER experienced this level of territorial nastiness and rudeness anywhere else in nursing. No chance for scrubbing at my OR either -- only circulating.

I signed a contract, so I'll have to suck it up until my time is paid up. The sad thing is, I went into this with the best of intentions. I really thought this would be a good move and an interesting, challenging place to work. But it's so hard to tell if the OR is a good fit when the people are being so difficult. I know this doesn't help you, but I wanted you to know it happens at other ORs. Maybe it will get better if we just hang in there and tough it out? I send you all my best wishes -- if you ever need to vent, you can send me a private message.

God bless & best of luck, whatever you decide to do.

[LocKNLoaDxRN]

Im in the Neuro/ortho OR and we count for any large back cases. We do not count instruments for cranies…. But not to do a count during open bowel is an X ray waiting to happen….then a PSN report. I would go higher up the chain for a concrete answer to that.

As far as the multidisciplinary style of orientation..its a common approach taken to give a slight Indoc to the other services….if you haven’t picked a specific specialty I imagine they will ask you after the year long internship, which specialty was more appealing to you. My indoc was 6 months and I “shuffled” from service to service for the first 4 months then was all neuro for the last 2.

As far as the homosexual remarks. In our OR that’s never been an issue…I cant imagine with high rate of lawsuits that individuals would risk their licenses to make idiotic remarks. Do you practice in the South? I only ask due to my experience in the Military where remarks such as these were heard openly.

Im sorry for your dilemma…hope it changes for the best!

[MrNurseOR]

Nope, this is a very prestigious New England Medical Center. Thanks for all of the support everyone. I think my best bet at this point is just to finish my training and move on.