Verbal Abuse from surgeons in the OR

[spineCNOR]

Just curious...

How commonly do you OR nurses out there experience verbal abuse and/or disruptive behavior from surgeons?

How do you or your facility deal with this issue?

In the facility where I work such behavior from surgeons is common - ranging from demeaning, condescending comments to yelling and screaming. Dealing with this on a daily basis is demoralizing and (I believe) has a detrimental effect on nurse retention.

The surgical department where I work has no policy in place that addresses this issue. Most of my co-workers feel that there is nothing we can do about this issue because we do not have the support of our nursing managers or of hospital administration, as they are so anxious to keep their surgeons (AKA their cash cows) happy.

Do any of your workplaces have policies or procedures in place to deal with disruptive physician behavior???

[passionate]

:nono:Use anything at your disposal. If your institution does not have a policy directly addressing this then find out from HR what is appropriate. Their are laws, local, state and federal that all employers answer to. These surgeons do not have the last word. I have had professional experience dealing with this topic and as hard as it was I know that I was supported by the other nurses, anesthesia, etc. that experienced it as well. You don't have to accept this behavior. Move forward for the sake of all of the people who in the future take care of our patients. We only have rights because someone before us fought very hard, long and sometimes without realizing those rights themselves so that we would have it better. I never cast a vote without thinking of all of the women who worked so hard, many dying before casting their vote, or thinking of those who still have no rights in the running of their government Often we take the rights we have for granted but someone before us worked very hard and felt the way you do so that we could carry on the torch of justice. We have a choice to do something--find the courage.

[elcue]

When they get "on their high horse" just smile, keep quiet, and picture them in boxer shorts. It will help you laugh

This does NOTHING to stop, or even ADDRESS inapprioriate behavior. It is this attitude that has perpetuated these poor behaviors.

[TravORNurse]

There is usually a board of Dr.s that deal with bad/poor behavior from surgeons. If you can find out who deals with that kind of behavior from Dr.'s at your facility maybe you can put something through to them or talk with your supervisor about using this avenue to deal with difficult Surgeons. I have experienced facilities where the Surgeons that were difficult were few and others where most were difficult. Most the time if the staff supporting the hospital in the operating room will stand unified against being treated poorly it shows the surgeon that work can be smooth or not so smooth depending on how they interact with the staff. Do you feel supported by the techs, scrub nurses, other circulators in your hospital?

[bakpakr]

Last week for the first time in my entire Nursing career I wrote up 2 Surgeons.

I wrote them up in relation to their appauling,unprofessional behavior towards

me. I especially wrote them up for a breach of patient confidentiality. I felt

good about it because I am normally a very quiet person who wouldnt say boo

to anyone. I have finally reached my breaking point. Well...........Who do you

think sided on the behalf of the Surgeons? Ofcourse, my Nurse Manager. She

was looking for any loop hole she could to justify their behavior towards me.

Unfortunately she couldnt find any.

As a Nurse or maybe I should say as a "human being", it angers and upsets me

to be treated like a handmaiden. I normally allow things in one ear and out the

other. But, since joining the OR 2 years ago I cant. The reality of "our" treat

ment is disgusting. The disrespect in untolerable. The lack of management

support is unforgiveable.

Today was a prime example. We just brought a patient into the room. The

patient went under general anesthesia. I was moving about the room trying

to set up suction,bovie,etc. All of a sudden the Anesthesiologist verbalizes

OK, I need my magical clipboard. I looked at him and continued on with my

work. Again the Anesthesiologist repeated his request and this time informed

me that his magic clipboard was in the magic drawer of his anesthesia cart.

As an idiot, I went over to him and the cart (which was exactly 4 inches from

his right hand) and asked him sarcastically what drawer is your magical clip

board in? Ofcourse,fumbling around looking for the ridiculous magical drawer

he puts his finger on the drawer handle. I open the drawer and find myself

placing the clipboard in the bast--- hand.

I informed my manager that I was not impressed with this nonsense. This is

a waste of my time and is truly belittling. I was told to get over it.

I just want to say :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire Am I over reacting?

My favorite reply to a situation such as this is " You have two arms and two legs, they work, use them"

Abuse such as being mentioned here is not confined to the medical profession. I see it everyday in my job. But I hope to be a nurse one day.

[TravORNurse]

My favorite reply to a situation such as this is " You have two arms and two legs, they work, use them"

Abuse such as being mentioned here is not confined to the medical profession. I see it everyday in my job. But I hope to be a nurse one day.

When that happens to me I ask them if their fingers are broken. Sometimes they push to see how far they can push you or how far you will go to please them. If you have anesthesia techs in your hospital you could call them and ask them to come help the anesthesiologist. It will make him look like an ass and you have done what you can to help him while using the resources that are available to him and to you. Not only that, but it brings in another person to offer perspective on his rediculous request. If he keeps it up he becomes the "boy who cried wolf."

[lenjoy03, RN]

Whoaw! That is really something! I'm a newly grad here in the Philippines. When I was still a student, I encountered verbal abusive surgeons. But after the operation, they thank us and even laugh with us. In here, we consider surgeons as visitors to our hospital. yes they bring money but that doesn't give them the right to abuse us even if were just students! That's why I was really shock by all your stories! COnsidering I want to be an OR nurse! You see... for me, when we're in the the field, we're dealing with life here. One mistake might kill someone here.... That's why (case to case basis) we should also consider the situation why the surgeon is acting that way! But if his already doing that just to please himself like a sadist, why not approach him one on one! If you dont have the guts to do it, talk to your headnurse or manager!!! If that doesn't work, well I guess, you just have to fight back... Surgeons can't work well without nurses! They're like a car without an engine!

[robinrene]

I have been an O.R. nurse for 16 years and have never been as frustrated as I am right now. I work in a hospital whose ad logo is "Expect Respect" While at work recently a surgeon was unhappy with a dull pair of "sharp" metz that had been placed in his tray. He turned around and threw the scissors at the doorway ( I was seated about 3 feet from the door myself) with full force. I reported this incident to my supervisor and she said I needed to work it out. I dont have ANYTHING to work out...this surgeon needs discipline pure and simple. However, the hospital did not support me. Now I still work with this surgeon almost daily and he continues to bully and abuse me. The lack of action by the hospital on my behalf has demonstrated to me that my job will definately be at risk if I defend myself from his actions. Since I am the sole provider for myself, husband and two children. I dont dare say a word. Im only grateful no one was entering through that door at the moment he decided to have his little tantrum. I dont feel I should have to go to work and deal with this everyday just because he is the cash cow for the hospital.

[Marie_LPN, RN, LPN, RN]

I reported this incident to my supervisor and she said I needed to work it out.

Not only would i go the next step up and report the doc, i'd report the supervisor as well. Sheesh. It's only a matter of time before th scissors actually hit someone!

[mikethern]

Since I am the sole provider for myself, husband and two children. I dont dare say a word.

Next time he abuses you, scold him. If you lose your job, sue the hospital. As an O.R. nurse, You can find another job easily.

[ebear, BSN, RN]

I agree ENTIRELY with StevieRae!!!!!

ebear

[yogacat]

I work in a small, physician-owned, for profit hospital. I have seen abuse and have experienced it. You really have to pick your battles depending on surgeon. There are times to report it and times to deal with it yourself. One of our "big time" owners is truly a sociopath. Among other things. HE is the ONLY surgeon who has ever belittled me routinely. I have NEVER been treated so rudely in my life. I chose to do nothing - except refuse to EVER work in his room. There are some personalities that should absolutely NOT work together. This works very well. Other surgeons and/or anesthesiologists? I get along with all the rest. I have a VERY strong personality and if someone starts being an a***ole with me, I either give it right back, or start treating them like a child. It works for me. Going to HR? Or management? At my workplace? Hahaha! That's funny. The Golden Rule applies there. "Whoever has the gold, makes the rules." Pretty much true for all of healthcare. ESPECIALLY in a for-profit hospital. I usually enjoy "managing the personalities." Works well for me.

[efy2178]

I received a couple of newsletters today discussing a bill in the Iowa subcommittee to make the circulator RN mandatory. It is being disputed. Hospitals have called and want to eliminate the RN and surgeons said they do not need to be told how to run their OR.

I am responding to this news by writing to my senator, Swati Dandekar. If you would like to share some stories as to why the circulating RN should be mandatory in the OR, please e-mail her or other Iowa senators. and reps.

Thanks!

Dear Ms. Dandekar,

Thank you for newsletters. I always enjoy reading them.

I received a newsletter form the Iowa Nurses Association concerning Bill RN Circulator SF 394. "The RN Circulator bill did not fare well in the subcommittee on Monday. It was a 2 to 1 ratio of lobbyists for hospitals and doctors against passage to nurse lobbyists for passage.

The petitions in support of the legislation gathered by INA member, Jane Krogmeier, were shared and it was explained that the bill is to assure patient safety. Patients are safer with a circulating RN present in the operating room and they are being threatened with being substituted by surgical technicians. The effort is to preserve current practice."

As a certified operating room nurse with many years of experience, this truly concerns me. For years, surgical assistants/technologist (ST) have been trying to eliminate the circulating RN from the OR in order to gain more control. The ST role developed originally from the RN position with the RN supervising the ST. This is how it is today. Now, the ST want to be supervised by the surgeon. They are not licensed, nor are they certified in many cases. They have one year of schooling.

Surgeons support this effort to be in complete control of the OR suite. You may wonder what is wrong with this position. The circulating RN has the primary responsibility of patient advocate. They speak for the patient who is vulnerable because they are frightened or under general anesthesia. Surgeons and hospitals are often trying to speed up the OR processes, since time is money. Occasionally this results in cutting corners--occasionally this creates hazards.

I have been in the OR when the surgeon did not want to perform a sponge count because it would take too long. Fortunately, this is a mandated RN responsibility. Since the RN is legally liable she/he will insist it be done. It was the Association of peri-Operative registered nurses who developed the "time-out" policy and encouraged its enactment into law. This increased the safety of performing the "right surgery on the right person at the right time".

I have also been in the OR when a surgeon did not want to honor a patient's wishes not to have a procedure performed (believe it or not, this truly happened to and the hospital was not supportive even though the surgeon did not have patient consent). Ensuring patient consent is another responsibility of the circulating RN. Having these legal responsibilities are a couple of reasons why nurses should remain in the OR. We are patient advocates. We are taught this from day one in nursing school. The ST does not have this obligation, nor do they have the education to develop policies such as the "time out". It is doubtful they will suddenly develop these skills after the circulating RN is eliminated from the OR since they will be supervised by the surgeon and take their cues from him/her. They will not suddenly have the power, liability, responsibility, or authority to stand on their own.

Most of the surgeons I have worked with are compassionate, caring human beings who went into medicine for all the right reason, however, when this is not the case the circulating RN is needed to protect the patient.

Nurses are regarded by the public as being the most trusted professional--even above physicians. There is a reason why this is the case--it is not because we are paid more, it is because we truly care about patients and are less motivated by financial gain. Indeed, we are often underpaid. In Iowa, nurses are usually the 49 or 50th state in the country in regards to salaries. In spite of this, Iowa hospitals would like to make their OR profits even greater by eliminating the circulating RN. However, in the long run it will cost a great deal more in health care dollars.

Please do not let this happen!

If you would like to learn more I would be happy to discuss this with you.

To get an idea of what happens in the OR please read a few of these blogs on Allnurses:

https://allnurses.com/nursing-articles/the-operating-room-379235.html

Eileen RN, BSN, CNOR