Verbal abuse in the OR

Red Kroovy · Jan 20, 2006

Here goes...my first post. For the past 15 years I have worked as an OR nurse...at some point in each RN's career, we have been or will be subjected to some form of abuse. I have always contended that the OR is the only job in which you are virtually locked in a room with a sociopath for 8 hours. Yes, you do feel humiliated and powerless...that is his goal. I have even seen a surgeon throw a wet lap at the LPN across the table from him and strike her in the chest with it...without any repercussions. Unfortunately in may locations, especially small hospitals, busy surgeons are the largest generators of positive cash flow and are less likely to be singled out by the administration. I encourage those like you never give in to pressure. This article provides some interesting insight: http://community.nursingspectrum.com/MagazineArticles/article.cfm?AID=13028. Always inform your immediate supervisor and if the behavior warrants, provide written documentation. As a manager, I encouraged my staff to call me when they felt that typical physican behavior trancended into abuse so that I might come to the room and assist them. Truthfully, from my experience, I removed the staff immediately and would deal with the physician's behavior after the case...if necessary, I wouldn't leave the room. At the last hospital I worked, out of control physicians were referred to anger management classes and one surgeon was removed from staff due to repeated DOCUMENTED verbal abuse of the nurses. Don't forget other avenues of assistance such as Risk Management or the Medical Director but follow the chain of command if that is the norm. Most hospitals have procedures in place to report workplace abuse but these systems are useless unless upper level administrators are willing to discipline the physicians who are abusive and protect the nurses who report them.

After only 6 years in the OR as a circulating nurse, I have burned out and retired. The surgeons have humiliated me and my collegues relentlessly. We just have to take it. Personally I felt powerless until someone in P.T. asked me to write up a certain orthopod.....gee....go figure....an orthopod! Between the both of us writing to administration, he was booted from our hospital. He took his entire ortho group and all of his patients with him. Now we are stuck with all kinds of instruments and special orthopedic helmets, batteries, etc we bought especially for them. Not to mention we enlarged an entire OR room for them at an exhorbitant expense. Does it pay to write them up? I say yes, but we need to go further with it. I've written newspaper columnists about this problem, 20/20 and MSNBC Investigates. Any other ideas from you?

orthorep · Jan 20, 2006

Where in the blue ridge are you?
Jim

Asheville, Hendersonville,Brevard, That area.

Marie_LPN, RN, LPN, RN · Jan 21, 2006

I have always contended that the OR is the only job in which you are virtually locked in a room with a sociopath for 8 hours.

Too bad this isn't a bumper sticker.

And God help the surgeon that throws anything at me.

felixfelix · Jan 21, 2006

I am really afraid of ending up in a situation like this sometime when I become a nurse....cuz I'll get right up in his face and maybe more....I just don't take that kind of abuse and no one else should have to, either. It would be a shame to toss away my career on some A$#@'s M.D.'s egoplasty, but somebody has to do it.

NoCrumping · Jan 22, 2006

question.......I am *gasp* starting in the OR in the beginning of FEb.....

I am curious....what kind of verbal abuse are we talking about? can I have examples? Situations? If experienced nurses are going through this, I can only imagine what I am in for being new.........

Marie_LPN, RN, LPN, RN · Jan 22, 2006

question.......I am *gasp* starting in the OR in the beginning of FEb.....
I am curious....what kind of verbal abuse are we talking about? can I have examples? Situations? If experienced nurses are going through this, I can only imagine what I am in for being new.........

Typically smart-orificed remarks and such.

grimmy, RN · Jan 22, 2006

question.......i am *gasp* starting in the or in the beginning of feb.....
i am curious....what kind of verbal abuse are we talking about? can i have examples? situations? if experienced nurses are going through this, i can only imagine what i am in for being new.........

[color=darkslategray]oh, the little things...and they are insidious. they creep into your vulnerable, insecure soul and nag at you. i remember all too well. i was scrubbing a micro/neuro/spine case, something i definitely hadn't done more than a handful of times. the instrument heads are extremely small (micro, yanno), and very hard to see. oh, yeah, and the room is dark. and...the instruments are dark blue. so, the neuro resident asks me for something like, a penfield one....mmm...i know a penfield four....so i guessed. it was an incorrect guess, and he hands it back and haughtily says, "i asked for a one." i apologized and said i don't do this everyday. well, that was all he needed to run over me with the following snide comment: "yeah, i can tell." at that point, the circulator, who was much more more assertive than i (at the time - i've since grown some cujones) said - "help her out, dammit - she's trying to help you!"

a far more obvious incident would be the cardiovascular surgeon who, when called away from a carotid to fix a bleeding iliac that another surgeon mistakenly severed, literally ripped off his gown, threw every bloody thing piece by piece to the floor, yelled "f#*k!" stomped out the door, kicking the giant metal scrub sink outside the door, and it rang for a good 20 seconds. i wasn't too happy to have to pick up his bloody clothing from the floor, certainly. and the scrub, an evangelical christian, didn't appreciate his language. but we knew why it happened - and yes, he acted like a child. we actually laughed while the scrub sink was still ringing.

the trick to all of it is to not take it personally - something that's really hard to do when you're learning, and you feel particularly stupid. just remember, its usually not about you.

JLynnOR · Mar 12, 2006

Yeah, NoCrumping, I think the trick with most surgeons is just learning who you're dealing with. There are some who are more than respectful, some who you just need to shut up around, and others who actually deal better with people who throw their **** back at them (if they give it to you, give it right back to them).

I used to work with an ortho surgeon who was as hot-and-cold as they come, but the fact that I stood up to him stopped him from continuing to treat me badly.

I was a green nurse learning the OR, and one day we were doing an elbow procedure (an olecranon bursa excision or something). Unlike any other surgeon I've worked with since, he did the procedure on a single, regular arm board (instead of an operative arm board, double-wide, ya' know--not much room to work). Anyway, I nervously handed him a 27" suture, loaded on the needle-driver, and accidentally let the tail drop. He had me cut off what'd dropped below table level and proceeded to lecture me on why this was wrong, yada, yada.

The next time I handed him a fresh suture, he grabbed it quickly out of my hand and, again, the rest of the strand fell over the side of the arm board instead of resting on the patient's arm. He threw the needle driver (loaded) across the room, yelling at me for another suture.

The rest of the procedure required a lot of clamping and cutting and more suturing. EVERY single instrument that he asked for, I handed him with a sharp SLAP into his hand. I mean, SLAP. His assistant later told me that she could feel the bad vibes flowing his way. At one point, he turned to me, smiling, and told me that his hand was stinging.

But the arrogant SOB NEVER treated me that way again and, in fact, seemed to get the hint that he wouldn't get away with messing with me as he did many others.

I've worked with others since then, and showing them that you're intelligent enough to stand up to them sometimes actually wins their favor.

Lammy · Mar 13, 2006

wow--maybe I won't work in the OR. I don't think I could handle a surgeon throwing things at me, cursing, or any of the abusive behaviors that seem common and routine. I realize they bring in money, but no nurse, no surgery. You have to have a nurse, so the hospitals really need to take a look at this. I believe if someone threw a bloody anything at me I would throw it back and not miss--game on.....

Marie_LPN, RN, LPN, RN · Mar 13, 2006

wow--maybe I won't work in the OR. I don't think I could handle a surgeon throwing things at me, cursing, or any of the abusive behaviors that seem common and routine. I realize they bring in money, but no nurse, no surgery. You have to have a nurse, so the hospitals really need to take a look at this. I believe if someone threw a bloody anything at me I would throw it back and not miss--game on.....

Luckily where i work they do take a look at it. If the facility you work for brushes it off, time to find a new job.

Not that long ago, i had a surgeon throw a dry lap at me, you heard the plastic ring slap my stomach (he was mad because he couldn't get a bleeder to stop during a TAH, nevermind he was a horrible surgeon and had a rep of such behavior) and said a few curse words. I loudly said "That'll be the LAST thing you throw", and continued working till the case was finished. Went to the supervisor after that, who came with me (after asking) to the medical director's office, where we filed a complaint. The circulator wrote her own statement about the event, and so did the anesthesiologist and scrub tech. The doctor's priviledges were suspended, and we heard last friday that he wound up being suspended by the board for other reasons.

carcha · Mar 17, 2006

Yeah I've had enough too, enough of the egos, lack of communication, expectations that OR nurses can be used in any part of a hospital, yet no other nurses are expected to come to the OR and scrub. I am sick and tired of lack of support from my managers, tired of the bad language, the volitile outbursts, the feeling that my stomach is in knots. I am sick of having to work on call, of the lack of appreciation. I am so tired of being expected to be able to fix any equipment that breaks down while the manufactures and maintenance people of this equipment are at home in their beds or out enjoying a meal with their partners because they dont work after hours. I am tired of the nurses who come to the OR because they "hated the units", and spend their time sorting out their duty roster or hogging the phone to speak to their boyfriends. I am tired of people who have worked in the OR as long as I have but refuse to take any responsibility and get away with it. I need a change!

Crumbwannabe · Mar 17, 2006

Carry a digital microrecorder. They're cheap. Play hardball if that's what he wants. No one has to know you carry it, just transfer the day's events to tape, leave it anonymously in the O/R director's and the surgeon's box. Or the media, as someone said. Many states construe recording as a method of "keeping notes", look it up.

Throwing a lap ( or anything) is an aggressive act, especially a wet one. Call security or 911 and press charges. If witnesses want to remain mum, you have your recording, so long as you mentioned the fact and he responded.

Finally do you think htese guys have the guts to act out like this in public? They'd get arrested, or lose a few teeth. I know I won't be spoken to in this way anywhere, or touched without permission. Being in the confines of a hospital changes nothing except to prove cowardice, kind of like standing behind a plexiglass barrier and provoking someone.