sop832

He is crazy as a ****house rat, although I think his substance of abuse is bacon. He has been written up 4 x in the past 3 weeks ( yes I am one of the four). I have never gotten any kind of feedback any time that I have written any surgeon up, so I don't expect any now. And yes, he's been to anger management, and I don't think that he has punched out any computer monitors since then ( that's why he was sent). It hasn't changed the verbal abuse, though.

I would like to smack the nurse that first told a surgeon that we keep preference cards!

Sigh. I know, you're right, I just have to stiffen my backbone and do it. Thank you.

When I woke my DH on Wednesday morning with the words "Honey, I have some bad news", he said"Oh, no, do we have to move?"

A surgeon ripped me apart today in front another nurse, a CRNA and a PA. I fully plan to write him up, but now I'm not sure that I should submit it or just keep it in my files at home since I received an apology which I felt was sincere after the case. The incident that prompted the behavior was actually rather minor, but he was particularly irritable today andI think that it was a "straw that broke the camel's back " kind of thing. He is pretty volatile, and does have a reputation for not apologizing, and in fact seemingly forgetting the incident quickly. He has been written up many times before and sent to anger management. So do I give him a pass on this one time? I honestly think he was sincere in his apology.

Yes, very often it did work for that shift, but it really p*****d off the oncoming shift, so we used it judiciously.

It took me a while to learn to accept my physical limitations, and to say, "thank you" when someone younger/stronger offers to lift a patient or a heavy basket of instruments or a traction setup ( I work in an OR). I resented it at first, but I decided to accept the offer in the spirit in which it is intended. I intend to retire in 5 years, not go out on disability from trying to show that I can do anything that anyone else can. And I, also, am 61.

I actually love the smell of benzoin, but not in the amount that you describe! We used benzoin on the skin to both toughen the skin and hold the adhesive tape on the dressing. We changed dressings once a day, and if the skin wasn't protected by the benzoin, it would blister and rip when the dressing was removed.

I work in the OR now, but worked on a post-op/stepdown ICU floor from 1976-1979. All elective surgery patients were admitted at least a day ahead of surgery, sometimes a couple of days if tests were needed. One OLD on-gym had quite a setup going for " his girls". Every one of his patients (with a uterus, that is), had to have a D+C every year. The patient was admitted on Friday afternoon, and he had usually a dozen cases posted every Saturday. The patient had her procedure, relaxed for a day, then went home Monday. He felt that every housewife deseved a weekend off and the hospital was the perfect place for that, 3 meals a day (except for that pesky NPO past midnight on Friday), and being waited on hand and foot by the nurses. He was a real piece of work, paternalistic and condescending. He threw a fit when we quit wearing our caps ( mine got knocked off by a bedside curtain and fell into a bedside commode which a patient had just used), and would look at a nurse (sans cap) and say, " I need a nurse to help me." When the nurse informed him that he did indeed have a nurse, his reply was, "How would I know that? You don't look like a nurse." Patients stayed in the hospital for a (now) laughable amount of time. Hernia and hemmorhoid patients a week, cholecystectomy patients 10 days. And all patients stayed in the hospital until they were well enough to go home, there were no rehabs, and I don't remember any home health care. We would receive a discharge order, someone found a wheelchair, the nurse assigned to that patient packed up the room (and remember that patients were in the hospital for at least a week, usually more, and every one and their brother sent flowers, get well cards, fruit and chocolate baskets), and we wheeled them to the car. They left with our best wishes, but no discharge instructions or follow up instructions. By the time you got back from the discharge, there was usually another patient on the way up to occupy that bed.

We tied a knot in the bottom sheet to prevent the patient from dying on our shift!

Pick of the litter

Hmmm.. Why is an anesthesiologist criticizing your prep? And how is that telling the physician what to do? If you're on orientation, where was your preceptor? It sounds to me like you're well out of there.

You DO have patient interaction, and it is the perfect amount for me. You talk to the patient in prep area and when they enter the OR. Then the anesthesia provider takes over and the general anesthetic or sedation takes effect. My "personality tests"show that I am task oriented, so the technical aspects and the "only one patient at a time" really works for me. Some nurses think that OR nurses are stuck up, rude and mean. At the risk of bragging, I'm not. I'm a really nice person, but I will raise a fuss if I see patient care compromised. That is our task, the care of the patient when they are at their most vulnerable.

As I read over what I wrote, I don't mean to imply that you did anything wrong, you and the scrub nurse both confirmed the settings, he just wasn't listening.

No matter what you say, or what format is used for timeouts and/or giving information about the case ( bovie settings, tourniquet pressure, Meds on the field, or anything either routine or out of the ordinary, ) my experience is that 97% of surgeons hear, "Whaa, Whaa, Whaa" just like Charlie Brown's teacher. Most surgeons (men and women) do not deem what nurses (men and women) say as important, even if they mouth the platitudes about being a team, blah, blah, blah. I can only count a handful of surgeons that are actually interested in what I say. Since I have a very soft voice, I have had to enlist the scrub nurses' help in not handing the knife until the surgeon acknowledges that I have been heard. Only when I think what is important has been acknowledged, is the case allowed to proceed. The ball is then in their court, and if there is a dispute over what is said, I will have made others aware. And if it comes to an incident report, believe me I will document that. Excuse my tangent, I know that wasn't your question, but this is what I find in the real world.

I worry a lot less about driving in to work than walking from the parking lot into the hospital. The sidewalk and street is usually very slushy/icy, and I am very nervous about walking on them. The maintanence workers usually do a path, not the whole sidewalk, and they can't do anything about the street [it is city owned, and the city won't allow them to do anything to it]. I just know that I'm going to break my a** coming in one of these snowy days!

For me, it's SO much more fun to scrub! You're right there where the action is,you know what is going on at the field. Whether I scrub or circulate, I take pride in taking care of my patient, it's just that it's more technical when I scrub. As I have said here before, I am task-oriented,so I can concentrate fully on my tasks when I scrub. It is an acquired skill, to be sure. I was so nervous when first starting to scrub, but the more you do it, the more fun it is. That being said, the best nurses know what it's like on both sides of the sterile field.

Oh no, Spiker, I wasn't clear. I have worked in the OR for 36 years! I meant that the OR is my niche. I'm good at it because I have to only concentrate on one patient and one case at a time. As a floor nurse, I was too distracted by having 5 or 6 patients at a time. Plus, I was too emotional about my patients and their families- this was 36 years ago, patients stayed in the hospital for a LONG time postoperative, usually a week to ten days. Which meant that we really got involved with patients and their lives. I am much more emotionally healthy now as an OR nurse. I'm very task oriented, as I guess you are, too!

I love taking care of one patient at a time, as I have taken the personality tests, and I am very task oriented. I can multi task within the parameters of one surgical case, but I was a terrible floor nurse, as I was disorganized and distracted by having several patients at a time, and I am not emotionally able to be in charge. I haven't seen anyone else on this thread say this, but I love working with guys!

What is "an 15-18 puffs"?

Write it up. There should be a physician behavior form, or if not, write it in longhand or word processor. This should go through the chain of command, starting with the charge nurse, service co-ordinator or nurse manager. No one can do anything if there is no written evidence. And check with the nurse manager or HR to make sure that there is a no retaliation policy. If you think about it, will this surgeon tiptoe around YOU if you are grumpy? I don't think so- you couldn't get away with that! And neither should he. This is a problem with the culture in your OR if this is brushed off as "That's just the way he is" . It will ultimately affect patient care. PS Keep at least one copy of what ever format you use to report this in a file in your desk or computer at home.

As a new graduate of about 3 months, I was running a post surgical floor with 2 aides that spent most of the nights hiding in the utility room, when I had to call a surgeon and tell him that one of his patients had pulled out a central line, and we (me, nursing supervisor and the house Doctor) could not get a peripheral line started, and I had 3 IV Meds to give. He lost his **** and told me that his patients would get better care laying out on the boulevard in front of the hospital than when I was caring for them. I was DEVASTATED then, but now (almost 40 years later) I have to laugh and say that was a pretty impressive turn of phrase.

Every time I have a heavy/ obese patient, and someone has a snotty comment about the patient's weight, I always ask if they would say the same thing about me. There is no correct answer to that question. If the answer is no, then they can't talk about the patient that way. If the answer is yes, then "Go **** yourselves"

Haven't been on the site in a while,so forgive the late response. PLEASE cut yourself some slack! You're brand new to the OR, and you're starting in the heart rooms and you're feeling rattled?I guess you are! You have to give yourself some time to get your feet under you. Please tell me that you have a preceptor, and you are not on your own. I had 5 years of General OR experience, and it took me a year before I scrubbed on my own. Are you only going to circulate? If so, you should ask if you can n back-scrub a few times. There's no better way to get a grasp on what happens at the field. If your surgeons are open to questions, ask lots of them. You will make some mistakes, just try to learn from them and ask for help when you need it. Try to be a little easy on yourself

No you're not the only one who can't stand Dr. Oz. I saw an episode where he went into the OR nurse's lounge and actually criticized what people were having for lunch! Any surgeon that even came into our lounge, much less criticized us, would be strung up! He is an arrogant, pompous d##k who has an ego the size of all outdoors. I don't watch that stuff, either