RogueRN

Pagers and cell phones are getting to be such a distraction (disrupting counting, etc.) that our healthcare system (not just hospital) might take action. They are thinking about piloting a project where surgeons and residents leave their pagers and cell phones at an "answering station" by the charge desk. If it is urgent, then they are called in the OR suite. Otherwise, forget it. I hope this happens!!!

Definitely report this. As soon as you get Risk Management involved, an investigation can be conducted. The last thing the hospital wants is a lawsuit!!! Always CYA (cover your ass) with documentation...

When I'm with a nursing student, I don't look at it as "selling" my specialty --- more like sharing my passion and enthusiasm for what I do. I have found that they appreciate it when I take the time to walk them through a day in the life of an OR nurse in both the scrub and circulator capacity. I try to do this when the case is calm and I can actually talk. With a little perspective from an OR nurse, the students eyes are opened; they can connect the dots between what they are studying now and what they could be doing in the OR. For example: CIRCULATING... *Pre-Op Checklist: Before taking a patient back to the OR suite from the holding area, we go through the checklist of vital info. Anything to eat or drink? (Might compromise breathing) Any allergies? If so, are we going to be using anything for the procedure that might be contraindicated? Any unusual lab values? Sometimes the pre-op nurses and physicians miss this in their haste. (If a value indicates that the patient is fighting an infection, a joint replacement procedure can be cancelled.) Health history? Surgical history? Sometimes the info can point to something important like the need to have blood products ready. I have found that if I share my love for what I do, those who might have seemed disinterested might show a spark for OR nursing. Some change their minds or simply have an appreciation for the hard work that goes on. If they end up on a floor or in a unit, they can at least share their positive OR experience with their colleagues. To me, that's worth it.

I'm so sorry that you're going through this. As someone who used to work in HR, I would DOCUMENT, DOCUMENT, DOCUMENT her behavior and include exact quotes on what she said. Always act as professional as possible. It will just make her look like the jerk that she is. Don't ignore her, just speak to her as if she is a psych patient (which is how she is behaving). What I mean is, speak in a calm manner and kill her with kindness. This will absolutely drive her crazy. Believe me, it works (from personal experience). Plus, you can't be accused as being unprofessional. Do you have someone, like the nurse educator, that you can talk to about these issues? Perhaps if you find someone in an administrative capacity to talk to, they can better direct you on how to handle the politics of the environment. If not, I would make a phone call to HR and they can advise on you on next steps. Be sure that you have your documentation handy. You have a right not to be harassed on the job. I really think you need to consider stepping up and talking to management. How are they going to know what you are going through if you don't speak up? And how many other nurses will have to put up with this behavior from this tech? It costs hospitals to hire and train new people. Do you think they would be happy if you and other RNs leave? No! I recently went through a similar situation. As an experienced OR nurse, I felt that I could put up with a lot as an orientee. I had no qualms letting the management know about challenging staff members. What was completely disappointing was the fact that they did not hold people accountable for their behavior, which is what proliferates it. That being the case, I left that job and have not regretted it. There may come a time when the best thing to do is leave. You'll know when the time comes. In the meantime, act professionally, take notes, and stand up for yourself! Good luck...

How about YouTube? Draping FYI... AORN has videos on draping. Ask your nurse educator if your department has these or if they can order them. Good luck!

Do your preceptors fill out eval forms for you every day? If so, can you look at them and get feedback right away? Sometimes the feedback varies from preceptor to preceptor. If I were you, I would keep notes and evaluate how good my preceptors are at teaching. Write down your observations and concerns about your day plus your learning needs. When management pulls you aside, at least you have something to back you up. Good luck!!!!

I don't think you need to send any details of the patient's condition or identity to the hospital leadership. All they need to know are the details of the surgeon and anesthesiologist's bad behavior. For example... Dear _______, Because I understand that patient safety and satisfaction are at the top your priority list, I am writing to inform you of very disturbing behaviors that I witnessed during my observation time in surgery as a VISITOR and not part of your staff. * Dr. Surgeon and Dr. Anesthesiologist made cruel remarks and jokes about a patient's condition and situation. (Insert direct quotes here.) No staff members objected to this behavior. * Dr. Surgeon took heavy mayo scissors and repeatedly tapped a patient's head with it during the procedure so that I could hear it clearly from the across the room. Again, no staff members objected to this behavior. While I understand that the patient is sedated, there are instances when people can recall what doctors and staff discuss during a procedure. Not only is it not appropriate for a patient to hear, but as a teaching institution I am concerned that these behaviors are being handed down to the next generation of healthcare providers. Should I assume that professional standards of behavior don't apply to physicians that work at your facility? What about the physical assault of the patient under anesthesia? There was no one who acted as a patient advocate leading me to believe that this hospital is not one I should choose for my own care or that of my family. Etc. etc. etc. ************** Sorry, I got carried away there. Didn't mean to write the letter for you! :) The only department that might want to know the details is Risk Management. If you're filling out one of those anonymous online forms, then it usually asks for those details anyway. U, you are doing the right thing. Even though you're still a student, you are thinking like a nurse and, more importantly, like a PATIENT ADVOCATE. Great job! No matter what position you're in, remember that knowledge is power... In this case, you know that what they did was wrong and now you know who to report it to. Hopefully, the powers that be do their job and advocate for the patient as well. GOOD LUCK!!! Keep us posted on what happens...

It's not like that everywhere, but if sure feels like it's starting to become that way. Hang in there!

The behavior of the surgeon is COMPLETELY UNACCEPTABLE!!! You definitely have to step up and report it. There are several options... 1) Many hospitals have what is called a "Business Conduct" hotline where you can report that kind of behavior. You can anonymously report this horrific behavior and that surgeon will be investigated. 2) Write a letter (anonymously, if you want) to the Chief of Surgery at that hospital and send copies to the Hospital President, Medical Staff Director, Director of Nursing, and Director of Nursing in Surgery. 3) If nothing happens after you've done the above, I would tip the local investigative news teams of all the major affiliates in my town and hopefully, they can get somewhere. Good luck whatever you decide to do. Just make sure you do SOMETHING. Please!

You're right... Sometimes you don't know until you are in the trenches. In retrospect, when I was considering this job, I broke one of my basic rules of thumb and went against my gut instinct. I was so busy looking at the actual opportunity itself instead of considering some of the red flags I saw along the way (during the interview process). They were little things, but as usual, I brushed it off as being insignificant. I have been in nursing for five years and spent a significant amount of time in a previous career. When it comes to choosing a job, my gut instinct has always been spot on. Next time, I'm going to ask more questions about the actual work environment (which I also didn't do) and make sure that follow my instincts and watch for red flags.

No exposed clothing in our OR. I wear a tank underneath and a cover gown or two!

When you first start in the OR, whether you are a new grad or an RN w/no large OR experience, it is going to be very challenging --- knowing where supplies are, surgeon's preferences, process and procedures, and difficult personalities. It's a different world - that's for sure! Eventually you will get used to the flow of things, you will make some friends, and it will feel much better. BUT I would just like to caution you to think about the personality/professionalism factor. In my opinion, if 80% of the people you work with behave like professionals towards you, then you're in a good environment. However, when it feels more like 50% professional and 50% not, you need to seriously consider a change. Not all OR's are the same. I am an experienced OR nurse who has worked at 3 large hospitals and in my experience, environments vary from OR to OR. At my last hospital, 90% of the people (staff and physicians) acted professionally - whether or not they liked me or other people they put their attitudes in check and focused on patient care. As the the years went on, many of us even became friends which made it great to work in that OR. The only reason I left was to move up into leadership position. In my current environment, I have been killing myself to be professional - even NICE - despite other people's bad behavior. I thought I could stick out. Now unfortunately it has taken its toll on my health (my blood pressure). This has NEVER happened in my past OR jobs. It is time for me to stop making excuses for people and take care of myself by getting out of there. Sometimes is just isn't worth it to put yourself through hell, compromising your health and happiness, in the hopes that things will get better in a year. It's just something to think about... The good news is that there are options out there. If you do decide to quit, definitely don't burn your bridges because OR nursing is a SMALL world. And for future interviews, make sure you ask about the OR environment, support programs for orientees, and perhaps request a meeting with a staff member. Good luck!

Just to add to what Kingbandit said, you will see the worst of the worst type of injuries. Make sure that you've got some good coping mechanisms because at the end of the day, it can affect you. I've seen... ***Lots of teenagers come through our doors with multiple gun shot wounds (2 - 27 bullet wounds). They may be gang bangers on the street, but they are somebody's kid. Some make it, some don't... ***Industrial accidents where you hope you can save someone's mangled hand/arm. Once there was a pt that had a granite slab falls on his head. His skull was dented in, both arms were broken, one leg broken. Multiple surgeries (crani, ORIF on both arms) were being done to save the guy, but sadly, he didn't make it. ***A car accident victim who hit a tree. He was just a kid (16 yo). His leg was mangled and we had to do an above the knee amputation. ***A horrific accident where a little girl is run over by a ride-on lawn mower. One of her hands was gone and the first responders could only find her fingers. On the same side her leg was badly injured; we had to do an above the knee amputation. This is only a taste of what I've seen and something for you to consider. Good luck!

In the beginning, I usually call them Doctor, but usually we wind up calling each other by our first names, especially when you work so closely with them. In front of the patient and when I return pages when they are scrubbed in surgery, I always say "Doctor."

Chicago, IL Level I Trauma Center (very busy) $5/hr Time and a half when we get called in, 2 hr minimum