Struggling with the culture...

[nurselisa207]

I started working as a circulator in the OR about 3 months ago after working on a card/tele floor for 2 years. Getting this job was a dream come true and I had so much hope for this change. The orientation is 6 months long and involves rotating through the different specialties for a few weeks at a time before moving on to the next. Circulating is definitely MUCH different than floor nursing but there is so much that I really like about it. I love having just one patient at a time to focus on and I feel like its fast paced and busy so the day goes by fast. I love being able to learn more every day and I get to see some pretty amazing things. It's definitely been more challenging than I was expecting and some days I truly feel like a brand new nurse all over again, but I'm willing to put in the effort because this is what I want to do. Aside from being pretty hard on myself and feeling like I'm a new grad every day, I've really been struggling with fitting in in this department. I've worked in two other hospitals before this on many different units over the last 12 years as a nurse and former float pool CNA. I have never had any problems getting along with co workers or fitting in to a unit. The culture of this department is brutal I feel, and I constantly feel like I'm the outsider. This department has lost a lot of people and staffing is pretty rough. There are a lot of travelers to try and compensate. Every day I hear gossip mostly from the STs. I hear them mostly complain about how the new people and travelers don't know anything. I constantly hear people whispering and or pointing and have straight up heard people talk about me when they didn't know I was within ear shot. I wear a different surgical cap than most of the girls because the bouffant was giving me a skin reaction on my forehead ( I wear my hair in a bun covered with a bouffant and a disposable tie cap over my head- same cap that the men wear) and people have straight up pointed at me and laughed (is this middle school?) It's been 3 months and people still make a big deal about it.... ridiculous.

I want to be in this OR but I don't know if I can handle being around people who constantly put every new person down and talk bad about others as soon as they leave the room. People who I definitely feel like I can't trust and who think I'm an idiot just because I'm still training and don't know everything yet. I thought three months would be enough time for people to get to know me and realize that I'm here to stay and I'm eager to learn, but it seems like I'm just an outcast. It almost feels toxic.

I haven't talked to anyone on the unit about this, but when I got to work yesterday they called an impromptu meeting that talked about how there have been multiple complaints from people WHO FEEL THE SAME WAY I DO and that this is why so many people don't want to stay after they finish orientation, so I don't think this is just all in my head or I'm being over sensitive.

Now that I know that management is already aware of the issue, what else can I do? I want to stick it out but I am also very against spending 40 hours a week in a place where people are literally making fun of me and treating me like I'm stupid.

Is every OR like this or is this just not a good place to be? What should my next steps be? Other than meeting with the manager myself and just reiterating everything that was already said in the meeting...

[missandei_32]

My goodness. I am sorry you are going through that. I myself am going through the exact same thing. I just cannot explain it and I am not as eloquent as you. But I feel the exact same way about my department. I work in Trauma and Orthopedics as a new scrub nurse (we do not have scrub techs where I'm from). So you can imagine how toxic and how busy and fast-paced it can be. The senior nurses can be very mean to new ones. I guess it's just the way it is... Until we gain their respect. It might take a looong time, maybe years... Until we can master the routine and be fully independent and then we won't need to rely on them for anything anymore.

[nurselisa207]

I just don't know if I want to be in such a toxic environment.... Nurses don't scrub where I'm at so I will always be the only RN in the room with the rest of the staff. The other RNs are actually WAY nicer and more patient than the STs. I don't know, its just very disheartening. I've never been in such a brutally judgmental environment before...

[Twinsmama28, ASN, BSN, CNA, RN]

Hello,

Sorry you are going through that. I work in Pre-Op as an CNA and work directly with the OR staff when they come in to transfer patients to the OR. I feel this may be something specific to OR's of course not all of them. There is definitely an elitist manner to some of them.

I actually befriended an wise OR Nurse, so much to the point she allowed me shadow her in the OR as she was circulating! I was so thankful. I asked her why aren't more of the OR nurses as nice as you, she informed me that a lot of the OR nurses let this position get to their heads. She said she however does not. Her career does not define her, its the things outside of the hospital walls, such as her family. She is very humble and knows she has a life outside of there and that's what makes her who she is in the OR.

I'm not sure of advice for you besides to just prove yourself by simply doing your job, showing them you know what you are doing, reach out to them more, talk to them and get to know them. I noticed myself when I started speaking to the OR nurses more and getting to know them then they were polite and open.

She told me that's how it is. It's like an fraternity, I guess once you are there longer then they will accept you? But then again some of the OR nurses to this day still have a bad attitude, so ultimately I would say don't take it personal. Do your job and go home.

That's one thing the OR nurse told me that she keeps in professional, hi and bye, small talk here and there that's it. She's not there to make friends if she does fine but that's not her focus. I mean she is very experienced and well respected among the staff and doctors and she still gets it. There is an CVOR scrub tech and she walks around likes she's a doctor because she is on the heart team. The OR nurse told me she won't even speak to her or the other nurses because she is not a doctor!

I knew one nurse that experienced something similar to you, she was a brand new nurse, the experienced nurses weren't very nice to her and she quit. Then I know another one that was new did the PeriOp training program and she's not finished and flourishing in the OR. So I think it's safe to say in the OR you need to have thick skin. This attest to why some will make it and others will not.

[Froggybelly]

It sounds like you have a tough work culture in a couple of ways. The nurses are going to be hard on you because your split-second decisions in the OR have lasting consequences. If you prep, position, or handle a specimen incorrectly, the patient can be harmed. You must be fast and accurate, even if you feel overwhelmed. The scrubs can be hard to win over if they are insecure. After all, they're being asked to help train some clueless RN who has less experience and makes more money than they do. You will win most of the staff over in time, but if you came to the OR and didn't expect to be surrounded by "strong personalities," you were uninformed. Give it a few more months and see how things change for you. If you are upset by snippy staff now, it might not get better when the physicians sink their teeth in. However, once you're on your own and have your own little nurselings to mentor, you'll see it from the other side.

[Rory8]

I was struggling with the same thing when I was in the periop program for my job. It took quite a while for most of the staff to even smile back at me. However, now that I've been working there for a couple years I understand that they were just standoffish because so many of the new people don't finish orientation, quit soon after finishing, or get moved to a different OR at our hospital, and it gets frustrating to put so much effort training these new people only for them to leave.

I try to be welcoming and kind to the new staff because I remember how it felt to be new and feel like everyone hates you, but many people in the OR will make you earn their trust first. Now, the STs and RNs are my friends and we all help each other out, but it did take a while to get here. We do have to depend on each other quite a bit so maybe they just don't quite trust you yet. It takes some thick skin to work in the OR, especially with some of the surgeons yelling at you over ridiculous things, so I think the staff is also trying to prepare you for that.

My advice is to stick it out if you really like being in the OR. If you enjoy being a circulator, then just focus on learning and doing the best job you can and eventually your coworkers will come around. And if their behavior continues once you know what you're doing then get out of there! Good luck, you can do it!

[imanurseintheor]

Every OR is tough, but in my experience some are much worse than others and yours sounds worse. I repeat, all ORs have a very particular culture....but some are much more toxic than others. They do say you have to prove yourself and sometimes that takes awhile. Since you are new, three months in, I would say give it more time (if you want) and once they see you are not a fool things may get better. I had a horrid time when I was brand new, a new grad, my first year was really tough. But now, 3 years later I see how far I've come. The OR really tests you it truly does. They do say it's not for everyone, you either make it or don't, but also like I've said not every OR is so horrible. You could quit and go to another hospital/OR and it may be better.

[RN_JuJu]

I'm so so sorry to hear about this. I honestly feel like a lot of OR environments are like what you're experiencing.

I've been working as a circulator in the OR for about 6 months now and only really recently started being comfortable in it. I remember for the first 3 months, I felt so lost, misunderstood, and bullied. The nurses that I worked with were all SO wonderful and understanding, but the scrub techs and sterile processing techs (mostly the veteran ones with years of experience) that I worked with were extremely mean to me. They would talk behind my back, belittle me, yell at me in front of the patient & surgeons, and have no patience even though they knew I was new to this (and new to nursing in general). It was horrible. I dreaded going to work each day because of them and contemplated whether or not the OR was really the place for me. However, I knew deep down that the OR was really where I wanted to be. So I worked harder, smarter, and had to show them that I was capable of handling the pressure. Eventually they realized that I wasn't as stupid as they made me out to be, and I basically proved to them that I was good enough to be part of their team.

I actually just had my 6 month evaluation and my boss said that she's been SO impressed and in awe with how fast, organized, and how well I've adapted to the OR! (I started off in pre-op and PACU). I also had the head scrub tech pull me aside and say that she's talked to the other nurses and STs and they all think I'm a really great nurse. She even said that I'm better than some of the circulators that they've had in the past with 2 years of OR experience under their belt :) *feels good*

So my advice to you is to stick it out of the OR is really where you want to be. Work hard and prove to them that you're capable. The OR is an environment where newbies are going to be looked down upon until they can prove that they can handle the stressors of the environment. I know it's hard and at times miserable, but I do think it gets better with some hard work and dedication. You got this!

[ggoodman]

Each of us get to know our service, the doctors their preferences, you are relied upon and counted on. unlike the floor there is direct communication with the MD. when something goes wrong or is delayed they don't call your boss they call you and ask WTH, we form a team some even take call together this leads to a tight bond. This tends to make the OR a little hard to get into. Most of us are type A control freak. What I look for in a new team member is: are you self motivated, can you keep up with the pace, and can you learn. I am happy to teach some one the same thing one twice, three times number four i'm frustrated and the doctor doesn't want you in the room. I have yet to find a surgeon unwilling to teach. While your new, you should NEVER be sitting there is always something to do if you have nothing to do watch the surgery until you KNOW what comes next. Stick it out and you'll find your nitch, at some point you'll fiend that work is not work and it's hanging with friends. I'm on a first name basis with a few of my doctors and all of them know when I tell them it cant happen it cant, and when I bring something to their attention they need to address it. This can be a great job but it comes with a hell of a learning curve.

one more thing, stand up for your self. Dont be rude but show your confident and you'll find people will treat you like it.

Sorry for ranting.