rbs105

I also recommend the book 'Introduction to the Operating Room' (its on Amazon). Different viewpoints from the medical students, surgeons, residents, nurses, etc. Consider how much time/money you have to dedicate to your schooling. You are looking at 8-12 years of med school, residency, fellowship (if you choose) vs. a few years of working in ICU as a nurse and 2 years of CRNA school vs a few years of ST school. Don't underestimate the roles of the ST-they are the surgeons right hand man/woman. That will be the quickest route to get you the closest to the surgery (all of this depends on your location/schools, etc). PA's and NP's do operate, but not all of them do so you would have to get in with a surgeon who does that. Our vascular, transplant, and CT PA's and NP's operate but for every 2 that operate, there are 200 that don't-again, depends on your area. Glad to see you are passionate about it. Keep up the love-we need more of us!

YES YES AND YES!!!! Please PM me. I have some solutions and have been working on this topic for awhile now. Please-anyone else who is interested in this. PM me. rbs105

There are many who have written posts about wondering if anyone 'out there' was willing to mentor them and offer some individualized support through nursing school, working as a new grad, changing specialties, etc. I am wondering....did you ever get someone? I have been researching and have found some who posted these questions, but if you look at their posts, there was no response. I have contacted some of you through PM to see if anything ever panned out. If there is anyone else who has reached out like this and I missed you, could you please let me know if you were ever able to find someone to help? Wondering how many fall between the cracks and how many posts asking for help go unanswered. Please share if this has been you-on either end. Thank you!

I just PM'd you. I have a possible solution-I am surprised at how many of these requests go unanswered. 110 views and no responses. I just happened to log on....anyone who has a similar issue is welcome to PM me. I am a nursing instructor with OR and peds background. rbs105

I agree completely-students will be grilled in this profession. I guess I would hope that instructors would focus on teaching them how to be grilled, letting them know that the situation is safe for them to stop and ask their instructor about how to handle a question they are unsure of. Focusing on how to critically think about a question they are being asked should be the goal of an instructor. Facts can be looked up. What we do with the facts is where the real skill comes into play and should be the where the real teaching takes place.

Dear Nursing Instructors Who Think You Are Doing Nursing Students A Favor By "Making Them Grow Thick Skin": Please find and post a peer-reviewed, evidence-based practice article from a nursing or medical journal that provides proof that the following behaviors are beneficial in the long run to future nurses: Raising your voice to students Impatiently grilling them Instilling fear towards asking questions (even if it is multiple times) Passively or aggressively humiliating or belittling them in front of nurses or other students On the contrary, your search will most likely indicate how you are contributing to attrition, trickling down to potential errors and patient safety issues. To the current nurses who say "We are getting you ready for the real thing" and "Time to toughen up!" Why are you encouraging/tolerating this behavior in your institution? In medicine, doctors are being taught about the dangers of this. Accrediting agencies have recognized the harm in this. Why can't you? Nursing instructors should be making it clear that you can ask questions, taking the time to talk to students, making sure they understand. Respect should be given for adults on both sides. Many nurses who are their future co-workers will not be tolerant, so school should be the place to figure out how to handle that when it happens-not with the goal of starting you off in the profession this way. I will 2nd Julie Reyes comments above. Signed, rbs105 BSN Nursing Instructor

Thank YOU! And I am so sorry.... You might be surprised-you may get to a unit that has a great dynamic and will totally help you. Talk to current staff about the nurses who work where you are interested and ask them what their orientation was like. Someone also suggested to me that you talk to a recruiter and get the turnover numbers for a unit. If they have high turnover rates, something is wrong. We have one unit that has an incredibly low rate and they are (amazingly!) one of the highest participants with our anti-bullying campaign. There is definitely a correlation. I found that just as their passive aggressive ways worked to take me down, I have fought back with my own ways like starting anti-bullying campaigns-Try it! There isn't a single person in quality who would shoot you down for suggesting to start one-unless they are one of those who are afraid of being identified as a bully. You don't need your managers approval to start a hospital-wide initiative that helps staff and patients! When you do this, you help others who are experiencing it, you increase awareness about the issue and you help yourself in the process. It has been very invigorating for me! I think that nursing PTSD should be recognized as a true condition though. And that there should be more attention to it to help. You'd think it would be in the best interest of everyone, but not everyone sees bullying as a problem! Good luck--thank you for posting! rbs105

I am absolutely sickened to see recent postings supporting the concept of bullying in nursing and it being acceptable. This is another form of bullying! To say that 'they just can't take nursing' or other lame, selfish excuses. It is nothing but that-selfish excuses from a bully. I just want to re-emphasize, as the original author of this post, and spending the last 3 years researching bullying in medicine and nursing especially, that it is NEVER OK for you to be a jerk! You compromise your patients' safety when you are. With patient satisfaction becoming more and more prevalent, I will remind everyone that when your patients hear/see you acting like a jerk, they are going to have poor experiences to report. Those numbers will come back to you. As an instructor of nursing students and medical students, I tell them: if you get a nurse-or anyone, for that matter-who treats you like a jerk, go to your instructor and ask for a re-assignment. That person is not helping anyone except for their insecure ego. I'm hopping mad about this. It is NEVER okay. Don't let anyone tell you it is. rbs105

Just curious, but did you ever find a mentor? It is a year and a half since you posted this....I'm just wondering how it turned out and what you did?

Hi Elisgirl- Can you talk to a nurse recruiter to find out what the stipulations are? These are questions that would only be able to be answered by the company. I guarantee you are not the first though. There are usually 'outs' but you might have to do some digging. I had worked about 6 weeks in my first job and was in the exact same situation as far as anxiety, dreading going to work, crying all the time, etc. You are right-it's not worth it. I managed to transfer to a different specialty and it completely transformed my experience. It is worth it to ask. If you are stressed out you are going to be functioning in fear. If you are functioning in fear, you will make mistakes. It's just too hard to focus when all of that is going on. Ask....and hang in there. You aren't alone. Trust me. They planned on this when they made the contract. Keep us posted....good luck! rbs105

Vanderbilt is the LEADER in this! Gerald Hickson's articles have been my guide in the program we are working on. And yes-the JC SEA#40 is also a top document for this. Not only is it a mental/physical health issue, it is causing mistakes. I think that financial loss will get more of the administrations' attention than compensation claims, sadly....whatever it takes!

To everyone who has responded, thank you. As I stated, I originally posted this somewhere else and got a TON of feedback from other professions. Your comments are not only personally comforting, but strongly backing my project with the evidence-based proof that this is going on in multiple areas, professions, and specialties. In addition to nursing, this bullying exists physician to physician, physician to resident, resident to resident, med student, so on and so forth. In response to silver2009, we are working on a program to address this on the physician and staff level and have been successful with buy in from hospital staff in 2 hospitals. The physician level has been the toughest part, but we are steadily pushing forward-especially since this is something that can be tied to error and increased cost for facilities. I would encourage everyone to continue posting your experiences-examples of being bullied by physicians, residents, and other staff are very helpful. We have a few universities that are interested in collaborating on our project and collecting data and implementing trial changes. In the meantime, I have used resources from Vanderbilt-Dr. Gerald Hickson has pioneered the way in dealing with disruptive behavior. I also base a good deal of the program we are trialling on the Joint Commission Sentinel Event #40 that explains the tie between this bullying and disruptive behavior to errors and cost. To those of you who have insinuated that this is part of the job, that you should just 'deal with it', or that there should be any level of acceptance of this behavior, I would challenge you to search within yourself and determine if you are part of the problem, or if you are in a state of denial that this is going on. That can be the hardest part. The situations that I and so many others have mentioned are never acceptable. If you are someone who is enabling or facilitating this to go on, please read these stories and do what you can to commit to making a change at your facility. Thank you all for your input-I will keep you posted! We are hoping to have a program rolled out to multiple facilities by the end of the year! rbs105

I have worked in the system. Good job security. When you travel you can use your hospital ID and get government rates on everything (hotel, car, etc). Great credit union, tax-free shopping (similar to the military). Nice benefits, but you have to remember you are working for the government. In other words, changes are difficult to implement and everything moves at a snails' pace. You are working for a national system and although it may not apply really well to your particular area, because it is national, you still need to follow it. And don't park illegally-the cops that are on the VA campus' are federal police! One of my co-workers had to go before a federal judge because he'd gotten a few parking tickets! The other thing to remember that I found and never thought of before I started, is that because it is unionized and there are those protections in place, there were more than a few people working there who, if it was a private system, would have been fired for their laziness, lack of skills, unprofessionalism, etc. There were also some who would have quit because they didn't like what they were doing (which IMHO, if you are coming to work miserable and making everyone miserable, its time to find a new thing to do!), but because of the benefits, retirement, tenure, etc, they didn't quit and just came to work miserable! So that is the downside. I LOVED the patients! I am not military, nor is anyone in my family, so I felt like that was my way of serving the nation, by caring for the vets. I felt a lot of value in my job because of what i did for them. I loved stopping to give them directions, listening to their stories about being fighter wing pilots in WWII and comforting them when they had anxiety from what they had been through. I also thought it was REALLY cool that the first day of orientation was all history about the VA, taking the constitutional oath and learning about how the system works. So it isn't a great place for creative working freedom, or if you like to be in a place where you can be a mover and a shaker, and you may find yourself surrounded by miserable people (this depends on your particular area-and that could be said for anywhere you go!), but the security is nice (you can also transfer easily to other VA facilities if you move and keep your benefits) and the patients are wonderful…..hope that helps?

I could bring out parts of each of your comments and agree! I made an attempt to confront at one point and one of the three went walking around the OR yelling about how I exaggerate, I'm too sensitive and can't take anything. Then they got the other two involved. It made everything even worse. I requested an assignment change at one point and paid for weeks. So what happens when your manager is part of the problem, or in close ca-hoots with the offenders? I have moved into a new and more rewarding position so I have no regrets about leaving. I still get to work with my favorite surgeons but without the drama. And I will agree it tends to be a female thing….my best days were working in an OR with a male surgeon, male resident, male CRNA and male scrub tech. No bull….just get in and get it done!

I just posted a blog and wanted to share it here because of the reactions I've gotten...this has become a topic of great interest for me in nursing and it is being tied to patient safety. If you have an institution where this has been successfully stopped, please comment. My 12-year-old daughter has recently been having problems with other kids at school. It's the usual, I-can't-figure-out-who-I-am-so-I'm-going-to-torment-you, 7th grade problems. Unfortunately, many similarities exist between 7th grade bullying and workplace bullying. You'd expect that maturity would kick in, but I have found that sadly, even though the setting has changed, the behavior has not. A few months ago, I discovered the book called The No ******* Rule-Building a Civilized Workplace and Surviving One That Isn't by Bob Sutton I do not receive any benefit for plugging this book, but I have to highly recommend it-regardless of your profession. I am typically an outgoing person, but as an OR nurse working with a small staff, I found myself being torn down to the point where my self-worth was squashed, and my motivation became non-existent. My bullies were referred to as the Triangle of Terror- three women who did what they could to tear down, intimidate, and spread rumors about others. I have to mention that each member of this Triangle had worked there for an extensive amount of time and were very skilled at what they did. Their talent and seniority ensured their value to the department and many surgeons preferred to have them in their case. It started at the beginning of my employment. Nit-picking my skills, telling my manager that I should have never been hired. If I presented an idea, it was quickly shot down or mocked by one of them. If I worked well with a surgeon, they would loudly point out my imperfections-sometimes right in the middle of the case. After time, I began to believe them. I should have never been hired. If I did well, it must have been a fluke-surely a failure was right around the corner. My paranoia grew as I was certain they were sharing every faulting detail with anyone who would listen. I had allies, and I was not the only target. Frankly, these friends are what kept me coming back each day. However, because of the environment of fear, even though they witnessed the bullying, and knew it was going on, no one wanted to stand up. Speaking out only reserved your spot as the next victim. It was best to just come, do your job and go home. The ripple effect from their behavior was crushing. I took my stories home and dumped them on my husband. He could do nothing but helplessly watch and try his best to keep my spirit alive. My attitude and mood were sour every day when I came home and I'm certain my children felt it. My health took a hit and my sick days were used to the max. After 19 months of being slowly broken, the best thing I did was to quit-even though I was stepping away from my benefits and a job that I loved (I didlove the job itself). Nearly two years after leaving, I think I am finally healing. Writing about it, hearing the experience of others and knowing what they went through has also helped. Workplace bullying is rampant. From my experience, the same stress, insecurity and competition that drove the 7th grade torment has the ability to manifest it's ugly head in adults-and for some WRONG reason, especially in nursing. In writing this, I am hoping to bring comfort to those who are bullied and awareness to those who might be bullying others. If you've ever wondered if you might be the problem, I encourage you to test yourself and find out! Share your story, speak out and support others....you never know who may be experiencing the same pain, or who you might be able to help!

I do advanced med surg clinical so they are getting ready to graduate. I give them 4 NCLEX questions at the beginning of post conference in different topics. That wakes them up and they get quick nclex test taking strategy reviews. Check w/your hospital- I get my students to AirMed to talk to a flight RN and see the chopper. Someone from pastoral care can talk about meeting spiritual needs. Find someone from the ethics committee. They love that stuff and it puts it in concrete instead of just reading it or getting lectured on it. They present cases but I have had them teach too-someday they will need to give an in service wherever they work. Why not start now? Too much of nursing school is stressful. To me, clinical is where we get our hands dirty and really learn. Rbs105

Sorry for the delay...I have been a RN for 6 years with mostly an OR background. I was the OR educator in my previous job and was over general surgery so I worked with the surgeons who are also faculty here. Have my MSN and have been teaching adjunct for 1.5 years....basically the stars aligned! Rbs105

Let's just say I'm in the west.... Still wishing to remain somewhat anonymous on here as I am the only one at the University and you would easily be able to identify me! If you go to the Association for Surgical Education website, there is a committee for nurses in surgical education that gives more information about the specialty. I have contacted some of the nurses on there and talked to some at other universities, but wondered if any were on here....! rbs105

I am an MSN prepared nurse who just landed a wonderful full time job but I am wondering if I am alone. I work for the School of Medicine at a large University and teach medical students (3rd year) and residents in general surgery. My background is OR nursing and I love this job because I get access to these doctors while they are young and have included in my instruction how to communicate and better work with nurses. This is a new wave of education for the med schools who are looking for RN's to assist in the education of doctors. I run the skills lab and act as a liason between students and faculty, pass off in suture and knot tying and will eventually pass them off on their lap skills. I LOVE it! But I wondered if anyone else is out there...I know you exist!! I am looking for others to collaborate with and bounce ideas off of.... rbs105

Hi everyone- I am wondering if you could share whether or not you allow sales reps to open implants, instruments, etc in the OR? Or do you have a policy that requires them handing it to the circulator to open it? Does anyone know if there is anything in AORN about this? I don't recall seeing anything in Recommended Standards and Practices. Let me know. Thank you! rbs105

I am going to post a new, original comment with a suggestion to start a thread for those who are looking for a preceptor to post and those who are willing to precept to post. That would be a great way to connect with someone! rbs105

To play the devil's advocate here, I feel my preceptor got 2 semesters OFF from having to do quite a bit of work that I took over for her as her student!! I wrote her exams, planned her assignments, solved student issues, oversaw clinical, etc etc. There were entire classes that I taught for her! I appreciate her, but felt I lightened her load quite a bit. How to find a preceptor? I sent a letter around to all the directors of nursing schools in my area with an explantation of what I needed (type of teaching, hours needed, description of my university, etc) as well as my resume with contact info on both. I followed up 2 weeks later. I made sure to send them to schools where I wanted to eventually work for. I interviewed with 2 schools and turned down an interview with another. I spent about 4-5 months teaching, doing clinical, etc, while my preceptor got a nice bit of a break, if you ask me. I did not apply for a job with that school (this is the other nice thing about precepting where you THINK you want to teach-you may get in there and realize you DONT want to teach there!) but got a very nice job doing clinicals for a very good college. I started looking 4 months before I needed to start the preceptorship. I feel I was very supported by Drexel University, where I was getting my MSN from and that was with me doing my preceptorship on the other side of the country!! It was a great, eye opening experience. I had to video tape my teaching and send it in for evaluation as well as be evaluated by my preceptor. Happy to be done and I hope to help another do it someday! rbs105

I got a job on a pediatric floor after being in the OR for 3 years....but that was only because when I moved, there were no OR openings. As soon as one opened, I applied. Fortunately I got it because I am not a floor nurse. Give yourself time- OR nursing is tough if you are someone who wants to know it and be able to do it quick because it is a much longer learning process. However, if you don't like it, i know how nothing stinks more than being someplace you hate for 36-40 hours/week. Just keep in mind the exact same thing could happen on the floor.....good luck and go with your gut!Rbs105

Holy crap, Lemonator....did you work where I worked? The doctors bring in the money, therefore they got away with all kinds of stuff where I was at! Fortunately, where I work now is not so tolerating, but I have seen items thrown, equipment broken and even a scrub tech who got a fist to the chest (surgeon got sent to 'anger management' and the scrub never had to work with him). I have seen towels get stapled to all kinds of body parts-many over the groin for protection. Its not so much the staples going in that is the problem as how they are pulled out, but you can take care to remove them gently and spare themselves. To Not_A_Hat_Person, I LOVE the OR!! It is an aggressive, fast paced environment, but I laugh my butt off harder and enjoy myself more than any day I had working on the floor! When you learn how to put up with these docs and they realize you are just going to give it back, they back down and will start to joke with you. We had an orthopedic surgeon who was screaming about his instruments because they were so loose (clamps were just falling open) and he was getting really mad and starting to pitch a real fit. He yelled, "I like them to be stiff!!" Without even thinking, I yelled back "That's what she said!!" and he just started laughing. It's awesome! Where else do you get to watch grown men act like 3 year olds who haven't had their nap and then make fun of them for it later?? Have been in the OR for 5 years now and wouldn't trade my job for the world. Humor is essential as well as the ability to stand up for oneself, refuse to take crap, own up to your mistakes, work hard and not take things too seriously. It's the only way to survive! rbs105

As a nurse who struggled with infertility, adopted a child w/special needs and finally had an IVF baby, I feel for you! Why is it so simple for some? Now I work in the OR and do pediatric home care. I consider myself to be a temporary mom for all my pts. Maybe you can see it that way-sometimes I think kids get more love from the rn than the parent-but I am happy to give them that love and feel some satisfaction from that. Don't get me wrong, there are some extremely fertile idiots out there who would kill plants and we have to stand by and watch them handle a child! I feel for you!