Surgical Assistants with more attitude than skill

Editorial Team / Admin · Oct 3, 2015

Sounds like something that should be addressed by your management with fully delineated job descriptions. Has the issue been brought to the attention of the management team?

andimcki · Oct 3, 2015

Our director went on med leave, we have an interm director, but I think you're right she should be made aware.

WhoDatWhoDare, BSN, RN · Oct 3, 2015

In my facility, the FA's that are employees of the hospital do pull cases, open for the case, get the room ready, etc. They are awesome. However, some of the surgeons bring in FA's that are NOT hospital employees. They don't do much, but they will help position pt and offer advice on what equipment might be needed or what suture will be used if we don't have an accurate DPC. For the most part, the "private FA's" are all cordial and professional. I don't have this issue you describe.

TakeTwoAspirin, MSN, RN, APRN · Oct 3, 2015

WhoDat hit the nail on the head. You have to be clear what their status is before you start fighting the good fight on this.

If they are sub-contracted by the hospital by a third-party company then they may be paid by the hour and only get paid from "incision to closure" because that's the only time they are allowed to bill for. All the time they are waiting for cases to start is unpaid. If they help out with room set up it's because they are being nice, not because they are paid to do that. And no, they should not be asked to scrub or perform other roles because they won't get paid for that if they are contracted as SAs.

If they are employees of the hospital, then they need to get in there and help because they are being paid for their shift and should be prepared to do whatever is asked of them.

springchick1, ADN, RN · Oct 3, 2015

In the OR we have PA's, RNFA's, and SA's(surgical assistants). Three of the SA's act like they're gods. They drink coffee while the nurses get the room ready. They refuse to take on the scrub role because it's beneath them. Our RNFA's circulate, scrub, and assist. One of them couldn't scrub a total shoulder, he messed up the cement, another could scrub a TFN. If RNFA's are expected to be competent in three roles, shouldn't these SA's be expected to fill the scrub role when needed?

Our doctors who use SA hire them personally so they are not employees of the hospital. They scrub in with the surgeon and pretty much leave as soon as the dressing is on. They don't help get the room ready, open supplies, or check trays. But there is nothing we can do about it because they aren't our employees.

SurgicalTechCST · Oct 14, 2015

It sounds like only a few of the SA's are participating in this "we're too good to do the grunt work" not all of them, when you said "three of the SA's act like they're Gods". So, are you saying there are others who don't behave this way? Are all your SA's employees of the facility, employed by the docs as their own personal assistants, or come from a third party contractor? Each of those situations require different thought processes and management techniques.

If all are facility employees, and only a few (the three you mentioned) are participating in this egregious behavior, it sounds like management of the department needs to be aware of this, and handle it. It also sounds like there's a " ring leader" who has decided that their job position makes them above doing any of the "lesser duties" (in their minds, not mine) and they have managed to find two like-minded individuals to encourage along their path. Have they been this way the whole time, or just since your director has been away on leave, with a temporary replacement in place? In any case, whoever is in charge of staff needs to be aware of this nonsense.

I worked in a facility once, and not for long either, because there was an "old guard" group of people who tried to get me to join in on their lazy ways, and I refused. They had a bad habit of disappearing when there was real work to be done, or would only put a half-hearted attempt at it when cornered, and disappear again, to be found in the lounge, the locker room on their cell phone or "looking for something in their purse", or on the "smoking dock" (which tells you how long ago this was!)

The director made a point of pointing out that "some of the girls" were catty and gossipy and very clique-like, but I thought she had to be kidding, because what supervisor would be aware of this kind of behavior and not only do nothing to discourage it, but point it out to a new hire??

She wasn't kidding, she was just lazy and ineffective management, and figured that pointing out their behavior from the get-go was as far as she needed to go with it. (This also explains the comment I made about not being there for long, too!) They tried to get me in on their horrible behavior, but I was having none of it. Then, since I obviously wasn't one of them, I then must be one of their enemies, and they treated me that way. ("Teacher's Pet" or "sucking up" or "brown nosing" etc., etc.) Didn't take me long to figure out how long it would take to find another job, because I surely wasn't going to be able to function in that one!

The supervisor was actually surprised when I handed in my notice, and just couldn't understand why I didn't want to stay there in their "nice little hospital." So, since I already had handed her my resignation letter, I figured I had nothing to lose, and I explained it to her! In detail, and using names, including hers. I was nice about it, not using foul language or anything, but I didn't pull any punches either. I was a middle aged woman even then, and not a newbie to the job or the job market, so it's not like I was a fearful, tearful child just out of school. She was surprised, and just couldn't understand why encouraging those others in their behavior by ignoring it in them while warning new people about it wasn't effective leadership. I realized I was fighting a losing battle in her and in the rest, so I abandoned that rat-infested ship asap. And continued to see the ads posted in the classifieds for my position there every couple of months.

Anyway - I digress. If your SA's come from a third party of any kind, either a contract company, or as Doctor's private scrubs, then they are likely doing what they get paid to do, which is assist at Surgical procedures. If they get paid by billing out through their contract organization then they only get paid to be scrubbed and at the OR table assisting the surgeon in their procedures, "skin to skin" as most call it. If they work for a specific doc, then they do what that doc pays them to do, which likely involves a great deal of office work and patient follow up, in addition to the OR.

There needs to be some clarification of job description for these people if they are facility employees, and it should be clarified to everyone, so all have the same expectations, and management is the only one who can do it, and enforce it.