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???

[GadgetRN71, ASN, RN]

I have to say that I'm pretty lucky to have a boss who doesn't tolerate this.. This happened to me yesterday, and since this has not been the first time this particular doc has been difficult, I wrote him up. My boss said that the head of the department(his boss) will talk to him. She also pretty much told me that I need to give it back to him.

[GadgetRN71, ASN, RN]

I work with many abusive surgeons. My facility does not do anything about this situation. Another local hospital has suspended privelages for an abusive surgeon. When a surgeon steps over the line with me, I give them one verbal warning, and then I write a formal complaint. At this time my facility is only giving the surgeons a "slap on the hand", however sooner or later I am confident that something will be done. This is a large part of the turn-over with staff in the operating room.

Many of the hospitals are waking up because disruptive physician behavior has been getting a lot of press lately in my area. Our paper had a long article about how bad behavior from docs is contributing to the nursing shortage in some areas and causing bad outcomes for pts too. For this reason, the Joint Commission is also targeting bad behavior from doctors.

In most cases, if you give it back, it lessens or stops. I wrote the other doc up because being that I'm relatively new in this facility, I wanted my boss to know about it.

[efy2178]

No one should put up with bad behavoir. It threatens patient safety, creates unneccessary anxiety and encourages frustarted nurses to leave good jobs because they cannot deal with the stress that administrators will do nothing about.

I worked with a physician who actually threw a scalpel between a nurse and an ST. He had to write a letter of apology but big deal. That is assault! My husband--union man--made me promise him if this ever happened to me that I file a police report for assault. If someone touches you--it becomes battery. Getting rid of the circulator RN in the OR would certainly make these behavoirs worse--in my humble opinion.

[efy2178]

Don't put up with this. If he throw a scissors at you that is assault!!! If it connects it is Battery!!! You can let him know the legal difinitions or you can go to the Police station and ask the police to discuss them with him. You might even be able to do this anonymously.

[GadgetRN71, ASN, RN]

Don't put up with this. If he throw a scissors at you that is assault!!! If it connects it is Battery!!! You can let him know the legal difinitions or you can go to the Police station and ask the police to discuss them with him. You might even be able to do this anonymously.

Oh don't worry. Here is one nurse that would be filing a report for assault if a surgeon ever throws anything at me or lays a finger on me. Wouldn't do it anonomously either. I'd also contact a lawyer. Barring that, I have some very large and protective guy friends.

Thankfully, like I said, most of our guys are pretty good to work with...I think I just need to tell this one guy off and now that I know my boss will back me, I plan on doing so.

[Shippy]

I am a new nurse, graduated in December, I was a PCA in the ED at a very world known childrens hospital where there are some of the best doctors from all over the world. I never had a run in with any doctors, which there were several skill levels that I worked with since it was the ED. If the facility that you work at doesn't have a "policy" in place for this type of behavior and is approved by the Joint Commission, stop right there! This is a huge no no by Jacho and this could interfere with the facility remaining approved. A lot of employees may not be aware of this, but it is definitely a fact, maybe the doc's need to be reminded of that when their having a temper tantrum!

[beanal]

Our OR management and administrators pays lip service to having zero tolerance for verbal abuse from anyone not just surgeons. I think this year since one of the patient safety goals deals with verbal abuse that the university hospital will start to enforce their "zero tolerance" policy. After working in the OR for over 25 years I have no tolerance for any verabal or non verbal abuse. I decided from now on I will write an anonymous incident report that will go to risk management as well as the OR director. I am going to encourage my colleagues to do the same. Once they start receiving enough of these reports admin will need to start ramping up their zero tolerance campaign and stop pretending to care about verbal abuse.

[momforever1]

Hi I am new to this board but I am in desperate need of some advice about an incident that happened in our OR. The surgeon I am familiar with but does not practice at our OR all the time was doing a lap chole, and long story made short he was "playing around" with the suction irrigator squirting it on the drapes AFTER he used this same instument to suck blood and bile, etc from the patient. It was causing backsplash, and I put my hands up, turned my head and leaned away saying DR!! when he pointed the darn thing at me and squirted me..hitting me in the side of the face with it and dripping inside my mask. I stepped back from the table, just basically in shock, he said "oh, did i get you" and I said yes you got me its on my face and in my mask..as I was disrobing he was saying he was sorry but I was about to blow. I walked out to the charge nurses office and was so angry crying I couldn't breathe...she "talked me down" then it was back to work b/c we are so short staffed and very busy that day. The next day I contacted the employee health nurse, who was very rude to me and my concerns, but I did have HIV, HepC and the hepsurface antibodies drawn. My concerns: no one from administration or my nurse manager has come to me yet to address this. This is really a very nice dr and I truly believe in my heart he was just trying to be goofy, not malicious, and it backfired in a big way. I mean it when I say I believe he is sorry but sorry doesn't help ease my mind. For example, the EHS nurse told me to be "professional" when I was crying, that we are at risk for things to happen.....I told her I am prepared and well aware of risks involved in my job but not crap like this. THen she tells me I am being upset too soon to just "put it out there" then the next sentence..pick up a box of condoms on your way home since you have been exposed. I asked her...how is a box of condoms going to help my small children? I shouldn't have to be dealing with this. I am so sick with worry I am not sleeping, my husband is having an absolute fit. I talked with the medical staff director today, who seemed genuinely concerned, and has promised to look into it. I think I am going crazy.....and help advice anything .... am I over reacting?

That is assualt with a deadly weapon and you would be advised to contact risk mgt., and if they don't listen a lawyer. Completely unprofessional and unaceptable irregardless of how "nice" the surgeon is

[Scrubby]

Dawn I would refuse to scrub or even scout for a surgeon who doesn't understand the basics of infection control and safe handling of bodily fluids.

I've heard a lot of verbal abuse, most of it's just whinging and complaining. Some surgeons can get downright nasty. I haven't seen a surgeon get physical, but I've seen an anaesthetists assault a nurse. I'm waiting for the day when a surgeon throws an instrument because whether I'm scrubbed or circulating, I will remove the instrument trolley from them to prevent staff injuries even if it means deliberately contaminating instruments.

[Mas Catoer]

In our Hosp, surgeon complaint is OK. Happens everywhere. But when it comes to verbal abuse, assaulting, or throwing any instrument, the OR staff may come to me as nursing supervisor. Then we make verbal or written report to the hosp admin. The surgeon will be called up and get some friendly advice from him. If he did it again and the nurses objected him sure the surgeon will be kicked out. It happenned already to some surgeon. I'm happy to see that.

Doctor and nurse retention is important but more important to keep the work climate in an optimal condition. We need doctors but we surely want friends.

Any issue about patient safety might decrease.

[muffin7]

I worked in a prominent hosp on Pasa, CA and worked with two surgeons who were absolutely horrible.

Both are probably in their 60's and need to retire. The female surgeon (peds)was calling everyone stupid, and she was so off the wall my scrub tech passed out (and she is no wimp, she ended up contacting an atty to file a lawsuit against the surgeon). The male surgeon (ortho) was such a jerk I was waiting for him to have a stroke.

[surggirl]

Got out of it. I was surg tech for 11 years and then became an RN. Natural progression seemed to have it that I got hired right out of the hat to the OR as a circulator. It was a role change, and I had to learn it like everyone else, but because they didn't give me a chance to learn my new job and wanted me to be able to just waltz in after a couple of weeks and "get it" I was hounded. I was hounded by my nurse educator, by the other nurses and staff and I swore if I heard one more time..."BUT YOU WERE A SCRUB TECH" with that pitiful pained look on their faces I was gonna snap. And I did. I quit after another one of those "meet me in my office" routines I had gotten so weary of, and now I am happy to say that I am working in a low key plastic surgeons office where we get to do surgery twice a week in a very non-judgemental atmosphere, it was here that I proved to myself an everyone else that I CAN do this job where I am embraced and nurtured in my new role. I have the best of both worlds as I've learned Laser skin tightening and hair reduction and I also pre-op patients so I get the IV's started and all the pre-op skills down. Its actually been perfect and that huge hospital actually did me a favor by being jerks, and don't even get me started on the ***hole surgeons I had to deal with.