Verbal Abuse from surgeons in the OR

bestblondRN · Aug 28, 2002

I start my new job in the OR on Tuesday and am kinda nervous.....I've never done OR nursing before, and although I'm an experienced RN, this is a whole new gig for me.

I am not one to take a lot of guff from docs--I try to be "pleasantly assertive" with them when I need to flex a little muscle, so I'm not too worried about being able to carry myself with that, but what worries me is memorizing everything--the case carts, instruments, knowing what to anticipate in cases, etc.

Any tips from all of you experienced folks would be very much appreciated!

Thanks! :kiss

DIPLOMATICRN4HIRE, MSN, RN · Aug 28, 2002

Grab the inserts out of the case caskets and that will have all the instrument names on them. also there is most likely a preferrance card to each procedure and each surgeon. Know them like the back of your hand and keep a little tab card on each of the surgeons that you will work with.... bovie settings and little tid bits of thier wants and needs ... also you will need to watch and babysit the all of the people in the room, Anesthesia Drs,CRNA's, Dr, (can be multiple in room at one time), scrubs, and other and anyone esle that comes in and out.

You will grow multiple hands to handle the multiple tasks that you will be doing at one time so it comes with time spent in the OR.

Also you will be able to feel out the Drs when they are in your room, Do Understand this, Know the difference in the "Situational and the Personal", If a Dr freaks it could be the case and thats situational so watch your techs..... Dr may easily go off on them. But understand that is the case itself but do monitor if it becomes a personal issue..

If its personal You will know right off the bat... This is your time to make the impression that you want them to have of you , Some may test you just to see what they can and cannot get away with (the techs will do this to you also), so Give them the side that you want them to see and If you wish not to stand for crap then make that a point up front...Other than that you will have an orientation time and I suggest you use that wisely, become as aquainted with every knock and cranny in that OR find out where every drsg,bovie tips,suctions and the clean core lives, In the most inconveint time is when No One is in the clean core to help you locate what you need , so you need to learn the locations of everything and where it lives.

Just a few tid bits

Zoe

spineCNOR · Aug 29, 2002

Dear bestblonde,

First of all, I wish you the best of luck in your new OR career!

Zoe's suggestion's are all right on. Many people find it helpful to keep a small notebook handy in their pockets to record things you want to remember-surgeon's preferences, specifics about cases, etc.

What to anticipate in cases comes with practice--just keep your eyes and ears open for things such as a sudden increase in blood loss, abnormal alarms, a sudden flurry of activity from the anesthesia provider, etc....

It is important to be patient with yourself- there is a LOT to learn, but you can do it, just give yourself time.

There are many published resources that can help you -- some that are probably available in your department or hospital's library. A must read is the AORN Standards and Recommended practices. Another book that I found helpful whn I was studying for the CNOR exam is "Perioperative Nursing Core Curriculum" by Rosemary Roth - it has good, basic information on different aspects of the OR, such as patient positioning.

Be open--there is something you can learn from everyone in the OR, even the nursing assistants. Most people, surgeons, anesthesia and other OR nurses are very willing to teach someone who is interested.

bestblondRN · Aug 29, 2002

Zoe and Spine CNOR:

Thank you so much for your insight and wisdom--I will make good use of your advice! I'll keep you posted on how it goes!

spineCNOR · Aug 29, 2002

Please do keep us informed. Support and commiseration available here free!

medman · Sep 14, 2002

Hospitals and doctors do not pay attention to us little people until it hits them in the pocket. Just such a situation happened in the town i am working in. Neuro surgeon called his scrub tech an unflattering name and threatened to have her fired. She sued him and threatened to sue the hospital if they did not back her. She won, she now has a very nice home, a bmw, and a new jeep. Now the hospital insists on incident reports being written and presented to the board of directors. The Nuero surgeon in question is now off staff because since he has had a couple of simular situations.

JoRn · Jan 19, 2003

I work with many abusive surgeons. My facility does not do anything about this situation. Another local hospital has suspended privelages for an abusive surgeon. When a surgeon steps over the line with me, I give them one verbal warning, and then I write a formal complaint. At this time my facility is only giving the surgeons a "slap on the hand", however sooner or later I am confident that something will be done. This is a large part of the turn-over with staff in the operating room.

liveintheOR · Jan 24, 2003

When a doc starts demanding and blowing up I just say "

Yes,sir" "No, sir" It usually freaks them out and they can't think of anything to say. I have one surgeon who wants everything under the sun opened for his cases. He then will complain how much the case is costing the patient. The other day he asked me how much telfa costs, that it was too much to charge the pt. If he sees something on the back table that he doesn't want he says "The cost of that should be taken out of your pay!!" I just say "yes sir' and give him a blank stare. He's always looking for someone to argue with, and I refuse to give him the satisfaction. Another doc said to me " I ought to slap you" My reply was "Oh please do. I have another child to send to college and I sure could use a new house. " He just looked at me then laughed. I guess no one had ever called his bluff before. He's always throwing tantrums so I just treat him like a child since he is acting like one.

I have reported one surgeon who was and is always verbally abusive. Thank God he moved to Reno.

spineCNOR · Jan 24, 2003

Good idea, liveintheOR--I will have to try that myself. Thanks!

Shevalove · Jan 25, 2003

I am really truly shocked that in this day and age Drs. still treat nurses like #$*%, not only that, but they are allowed to get away with it! I have had only one run in with a DR over the phone and it was because I was totally clueless about a patient (First day on the job) I am just disgusted that this is allowed. If you worked in any other field and you were spoken to like this there would be action taken. I do agree with one of the above posters about letting yourself be treated like this. I do think if you show right from the beginning that you aren't going to stand for it, you are less likely to have to put up with it

cwazycwissyRN, RN · Jan 29, 2003

Dr.s are not exempt from mental disease, I'm quite sure I know a few that need medication and counceling. Drugs many drugs, some are sicker than others. tee hee saw one lying on his back kicking his legs, looked like a bug. I do my best for the docs most are very professional and act accordingly. We all have our ugly moments, however there is a line and when one crosses it we do have a means of righting them up and having it identified and delt with.

MrsK1223 · Feb 1, 2003

My mother is an RN and has been for years in OR and she said that the nurses are who gets the brunt of some of the A__holes...but the surgical techs dont that she works with cause if they piss them off the don't care a bit to thumb the instrument swiftly and firmly into their hands causing some discomfort....she's seen it first hand and she said they don't ever bother them.