I'm so tierd of SCRUB nurses

[Mr. McDuck]

Ha. They made a robot that can scrub, but it's insanely slow and impractical. Then again, they also made a robot that could do a valve repair by itself, so none of us are irreplaceable (sp?).

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[Doctor Octopus]

I scrubbed on a surgery one time with a scrub nurse who told me that she gave the best glove around. Guess what....she was right. It was like warm apple pie. 🙂

 

[Noyac]

CRNA's can be a piece of work too. One time the CRNA was letting the pt brady down to 40-something pulse and BP 70/25ish while she just sat there and did paperwork. So when I finally said something, she used the Evil Eye on me for a good couple of minutes while she got around to pushing eppy.

😳

You better check your facts.
CRNA's can be a piece of work but "epi" for those vitals?
What level of training are you? Maybe that is why the crna gave the evil eye. If your attending didn't respond, then why?

 

[ocean11]

I was talking to a nurse about the scrub nurses that we have and she scoffed and said 'they ain't no nurses... they are scrub TECHS'

I suppose there is a hierchy thing among them too.... yikes!

 

[DOAnestMan]

I was talking to a nurse about the scrub nurses that we have and she scoffed and said 'they ain't no nurses... they are scrub TECHS'

I suppose there is a hierchy thing among them too.... yikes!

There are some floor nurses who resent the fact that in most ORs, the nurses have a much lighter call schedule and in general have weekends and holidays off. I say, don't be a hatin'.

 

[EvoDevo]

I've never had a problem with scrub nurses. I just let them know that I *know* I'm the least useful person in the room, and that I'm here to help them when/if they need it. Courtesy and respect go a LONG way towards making life easier in the OR.

Plus, getting yelled at doesn't bother me. After years in the Marine Corps, I've yet to meet a scrub nurse (or attending for that matter) than can make me feel like my boot camp drill instructor. 😉

And like njbmd said, let it roll off your back.

 

[efex101]

I so agree with the above poster. After being in the Army there is *nothing* that can compare to the yelling/belittling that goes on in basic training and beyond. I actually enjoy the OR because there *is* a hierarchy and everyone knows their place and duties.

 

[ocean11]

I so agree with the above poster. After being in the Army there is *nothing* that can compare to the yelling/belittling that goes on in basic training and beyond. I actually enjoy the OR because there *is* a hierarchy and everyone knows their place and duties.

after reading some of these posts I think that it really depends WHERE you do your surgery rotation. I'm at a county hospital, or a hospital that caters to lower socioeconomic population. The facilities are sub-par (for American standards that is) and resources are not plentiful. I'm sure I would not have posted this thread if I was working at some posh private 'hotel-like' hospital that caters to the insured,or rich.

 

[TY06]

wow, i thought only i was disrespected. i hate the damn scrub nurses. they are the biggest aholes!!!

 

[gunit07]

i am at a pretty nice hospital this month, and the other day i got bitched at by this circulating nurse for like 5 minutes. the attending looked at me like "what the hell is HER problem, you're fine." and then he started asking the scrub nurse to quote studies on how what i did (which i actually didnt do, which made it even weirder) was going to adversely affect the patient, and then he started calling her "Miss perfection". it was pretty nice that he supported me.

i think the most frustrating thing is when scrub techs/nurses and circulating nurses treat you like you dont know what you're doing, even if you do. after doing months and months of surgery rotations, i know what sterile technique is. but they always seem to come up with somethign that doesnt make sense... like this one circulating nurse who told me to watch my back so it didnt get contaminated... it made no sense to me since it was contaminated the second she touched it to snap it up and tie it....
and then one circulating nurse to "informed" me that i wasnt allowed to rest my head on the residents forearm. (um, duh?) i know that sounds weird, but i had to reach under my residents arms why he was working so i could hold the spleen up with my hand... essentially i was in the exact position that the attending and resident told me to be in, and i was trying my best not to contaminate anything but still hold the spleen up... thankfully my attending and resident had my back this time too🙂

then again. there are some who are fabulous! one of them always tries his best to make the med students look GOOD in front of the resident/attending. and he'll even answer your pages for you and be liek "dr. xyz is scrubbed in right now, may i take a message" it's like, whoa, i dont deserve THAT much respect!

i guess just like with anyone else, from bank tellers to professors to the guy who works at mcdonald's, it just depends on that particular person.

but i think that when i'm an attending my rule will be that noone can yell at my med students except for someone with an MD/DO after his/her name who is on our team.

 

[Hopefulmeds]

I think introducing yourself to the scrub nurses beforehand goes a loooong way. I have never gotten yelled at when I made smalltalk with the scrub nurse before the case started...of course you don't always have the time to do that...

 

[Paws]

I have been pretty lucky in the nurse department, so I can't complain for the most part. But! there was one asshat on my last rotation who insisted on constantly criticising me for ... oh, just about anything. At first, I took it at face value, I was new, she had been an OR tech for eons, etc. I was happy to learn and would politely thank her for pointing out things I was doing incorrectly. But she never let up and then I began to realize she was just hassling me because she is an a$$hole. One day, she even pushed me with both her hands and then I knew I was dealing with a crazy person.

I actually stopped going into the surgeries if she was going to be on, and other people in the OR kept apologising to me and letting me know they were not trying to hassle me but just wanted me to step aside or whatever. In other words, I think people figured out she was being a jerk since they could see her behavior, and they wanted to let me know that they weren't like that. I never took it personally, altho I didn't like it. Everyone else was super good to me, and so it was sort of sad that a nasty woman like that was allowed to mistreat students - and interns. Why are people like that allowed to continue in employment? Sometimes, during surgeries the attendings would talk about 'miserable and unhappy' scrub nurses who torment students. This, right in front of her! 😛 But I think people who are professionally inappropriate should be confronted on their behavior. It causes alot of extra aggravation for other people.

 

[Richie Truxillo]

I am on surgery service right now and I've had a handful of scrub nurses be brusque with me at first. However, a couple jokes later and a few conversations outside of the OR, things are cool. 🙂 Some scrub nurses don't like unfamiliarity, others just want to see students stick up for themselves. Being a scrub nurse has it's own stress I am sure. Overall, I believe everyone, med student, resident, scrub nurse, etc....just wants a little bit of acknowledgement and respect.

So I don't hate scrub nurses in the least bit now. I'll just be thick skinned and try to be part of the team. 🙂

Now onto my next problem...I suck at suturing and I really enjoy surgery...
Practice practice practice

-Richie

 

[driedcaribou]

There is a heirarchy in the OR that I did not know about when I did my first surgery rotation. It is always good manners to introduce yourself to the nurse and tech, write your name and year on the board, and help out before and after the surgery. If you are not needed by your attending or your resident, you should not excuse yourself from the OR or break scrub until the scrub nurse no longer needs your help.

There are some nurses who will never like you, but if you show them these courtesies, you'd be amazed at how fast some of them turn around.

Definitely some really good advice. 👍

The scrub nurses have to be hawks of the sterile field- it's their job. I've never been a scrub nurse but I assume they have to put up with a lot of crap for a lot of them to act the way they do.

As a student, you're in the way unless you are quite experienced.
It's also just courtesy to introduce yourself to them and help them out where you can. They all have a job to do and it's a privilege to be in the OR.

There will always be a few of those who you'll never get through too and they'll be rude to you no matter what- just take comfort in the fact that their life is miserable....

 

[toehammer]

lol

 

[Mr. McDuck]

I just got out of the or, was bored so came to the library, made me laugh to read this topic....

so i scrubbed up was putting my gown on...and from across the room i hear..."WHAT DID YOU DOOOOOO!!!!'...I looked behind me, i had no idea what the hell was going on...he dashes through the sterile fields and tears my gown off..."you pulled your sleeve with your unsterile hand!!!!"....i say...no...I had my arm still inside the sleeve and pulled the other sleeve down....

after the surgery is over the surgeon goes to the scrub nurse..."by the way...you're a loser, leave my medical students alone...."

funniest thing ive heard in 3rd year.

I hate it when people do that. Or when you come into the OR and the nurse goes "wow, that was an awfully quick scrub!" 🙄 They can say whatever they want, though. I'll just ask for a ridiculous amount of **** that I know they have to run for, and then say nevermind when they get back.

 

[MR1]

I got tagged teamed by the circulator and the scrub tech. I preface this by saying this was my one and only problem with OR nurses all third year. On the second case of the day as we are waiting for the patient to come in and I am just casually talking to the attending and resident, the circulator all of a sudden goes "oh you forgot to put on your shoe covers, here I'll show you were to get some". Now of course I know where they are, I just was in a hurry and didn't put any on. No one ever wears these things at our hospital, usually I am the only one that does. So I say "oh I know where they are" and then the scrub nurse goes on the attack "you knew where they are and just didn't put them on". My attending and resident just shook their heads as I went to get them. And by the way, the attending, resident, anesthesia, along with the circulator and scrub tech were NOT wearing shoe covers. I never figured out what their problem was with me but everytime I was with them they always made passive aggressive comments to me. Again I never had this problem with any other OR nurse.

 

[Mr. McDuck]

Maybe their shoes were shoes they left in the OR. Apparently, if you keep them there at all times, you don't have to wear shoe covers. Or, they might just have been a couple of douche bags. Either way, it's annoying.

The other day I walked back to the room without a hat on because they were out in the men's locker room. Whenever I do this, WITHOUT FAIL, someone goes, "hey, where's your hat?!?!" I want to punch them in the neck when I hear this.

Well, fast forward to today, and the same person that said that last time was standing in the hallway of the OR putting her hair in a bun. Where was her hat? On the table next to her.

I've also seen people eat water ice and apples and all kinds of crap back there, but I bring a tootsie roll of a small cup of water, and you'd think I spit in an open wound with a mesh. Jesus.

 

[fab4fan]

I have been pretty lucky in the nurse department, so I can't complain for the most part. But! there was one asshat on my last rotation who insisted on constantly criticising me for ... oh, just about anything. At first, I took it at face value, I was new, she had been an OR tech for eons, etc. I was happy to learn and would politely thank her for pointing out things I was doing incorrectly. But she never let up and then I began to realize she was just hassling me because she is an a$$hole. One day, she even pushed me with both her hands and then I knew I was dealing with a crazy person.

I actually stopped going into the surgeries if she was going to be on, and other people in the OR kept apologising to me and letting me know they were not trying to hassle me but just wanted me to step aside or whatever. In other words, I think people figured out she was being a jerk since they could see her behavior, and they wanted to let me know that they weren't like that. I never took it personally, altho I didn't like it. Everyone else was super good to me, and so it was sort of sad that a nasty woman like that was allowed to mistreat students - and interns. Why are people like that allowed to continue in employment? Sometimes, during surgeries the attendings would talk about 'miserable and unhappy' scrub nurses who torment students. This, right in front of her! 😛 But I think people who are professionally inappropriate should be confronted on their behavior. It causes alot of extra aggravation for other people.

You should have written her up if she shoved you. Hostile work environment, much? There is no way you should have had to tolerate that.

 

[beansandchips]

Pathetic. Dude, grow some [testicles and act like a mature male adult]

Kind of why I don't like posting comments. Talk about 'pathetic' - How about insulting someone over a forum...real brave, real mature.

I just like to pick my battles, that is all. One against a scrub nurse/in an OR/in front of my residents and attendings/as a 3rd year medical student is one that I could never win. Also, it is not like I said all of the things that I posted at one time - but I did admit defeat before I began, swallowed my pride, killed them with kindness and made the most of it. I guess my ego can take it. Oh, and my surgery rotation went completely friction-free. Out.

 

[baysider]

Preventing surgical site infection in the operating room is the primary goal of the surgical team, and the main function of the circulating nurse. This is what s(he) gets paid for.

In New York, the circulator nurse is paid at least 63-90K to perform this task. No, it isn't a lot of money, and the surgeon may makes double or triple that, but who cares. It's all about patient advocacy and safety. If my daughter or wife was to have surgery. I would of course want to best surgeon and also the best circulating nurse, who I know cares about the patient and acts as their advocate and who isn't afraid to tell the surgical team, STOP.

We are a freaking team first, it isn't about what you make, your titles behind your name or your education. It is about team work. The circulating nurse must supervise the Operating room because state and city laws mandate it. Believe me, if hospital administrators wasn't mandated to have a supervisor in the OR, than it wouldn't have to pay over 60K/year for it. One person must be able to ensure sterility, safety, position, and/or right site, while also concerning themselves about sponge count, etc.

As a circulating Nurse, I am really shocked by some of the responses by some of the med students, residents and attending here. It's all about the patient and not breaking sterility. I have known doctors and registered nurses (circulator) sued because a surgical team member didn't take sterility seriously and the circulating nurse was too weak to say a thing to prevent what she saw and knew was wrong. I am not going to have my licenses questioned because of someone's arrogance. Please remember, It isn't about you, your degree, how much you make or how little you make it is about the patient.

We are hired by the hospital to ensure control over the OR. The circulating nurse is the advocate for the patient, and when s(he) see potential breaks of sterility and or potential issue (s)he MUST by law attempt to rectify it or face lawsuits or her license revolked. You can't tell a judge, well the surgeon or the attended told me not to worry about it. Of course, he or she must do this with respect and dignity of the surgical team. I hate people with bad attitudes!

Imagine your wife, family member or love one having surgery and s(he) gets a secondary infection such as Mrsa, Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium thermoresistibile, Peptostreptococcus micros, E. coli or Campylobacter, because the medical team didn't take the rules of the OR seriously. Grow up! Again, it isn't about you or your feelings or being hurt or being under stress. I don't care! Read about or the hospital policy about being in the Operating Room.

There have been many lawsuits surrounding heart, plastics and knee surgeries secondary to infections due to breaks of sterility in the OR. The circulating nurse job duties is to ensure the Scrub nurse (tech), surgeon, students give the patient the best chance to have zero complications.

Everyone in this life has a job to do. Even restaurants must have rules and regulations with food handling and cleanness. If a nurse or a tech is telling another team member in the OR that an act is potentially risky, why on earth must you take it to the hear. Again, it isn't about you.

Circulating nurses and scrub techs, must deal with many different surgeons, and medical team, the OR doesn't revolved around your skills, but that you do them right and don't make mistakes. THERE has to be order. Just because you are a M.D, doesn't mean you have the right ignore policy and potential patient safety, even if you don't get it. THis really isn't what you are hired to do. You are hired to perform your surgery and not do harm, isn't this your oath?

The role of the nurse, no matter how low you may see it to be, this is their function. Deal with it! We are there for you as a third eye. Nothing more, nothing less. Not there to be your friend, or make you feel uncomfortable or to give you common sense. I never yell at anyone in the OR, unless, the potential of risk is severe. I have two other circulating nurses that prevented wrong site surgeries because the attending was either too tired or couldn't get his anatomy correct in a prone position.

Wrong-site surgery continues to occur regularly, even with formal site verification. Many errors occur before the time-out; some persist despite the verification protocol. Patients and nurses are the surgeons’ best allies. According to studies, retention of surgical sponges and instruments after surgery may occur as often as once in 100 procedures or as infrequently as once in 5,000 procedures. (1) The American College of Surgeons has stated that one incidence of a retained item after surgery occurs at least once a year in any hospital at which 8,000 to 18,000 major procedures are performed annually.

Police and order are the utmost of importance and this is the role of the circulating nurse. The problems associated with surgical counts are varied. Initial counts performed by a surgical team may be inaccurate for a number of reasons. For example, the count may be hurried or the sponges may not be separated when opened, so the actual number on the field may not be correct. Counts occur at inopportune times for the surgical team, including shift changes when new staff members replace original staff members and at the end of the operative procedure. A procedure generally does not stop for the count, so the circulating nurse and scrub person continue to perform many tasks while they are counting. Large surgical teams make many requests that distract from the count. For example, the anesthesia care provider may ask the circulating nurse for supplies or assistance at the end of the procedure. So, please lets all remember that we are a team first. Forget the salaries, titles behind the name, male female, student or professional. We are here for the patient first.

Remember the Circulating Nurse is the supervisor of the OR, state laws requires this. Here is the breakdown because many of you here don't know the hierarchy of the Operating Room. Of course, we are all here for the Patient and the Surgeon, but please remember that we a first a team.
-------------------------------

* an LPN or surgical technologist may serve as a scrub person only under the direct supervision of an RN; a scrub nurse can be a tech (non licensed) or an LPN.
* an RN who is experienced in surgical procedures must supervise the OR;
* only an RN may function as the circulating nurse in the OR;
* the OR must be supervised by an experienced RN or a physician of medicine or osteopathy; and
* circulating duties must be performed by a qualified RN, who shall not perform circulating duties in more than one OR at one time.
The eight states (ie, Alabama, Indiana, Iowa, Massachusetts, Montana, North Dakota, New York, Texas) that explicitly follow HCFA's rule governing surgical services also mandate that LPNs and surgical technologists may assist in circulatory duties under the direct supervision of a qualified RN, who is immediately available to respond to emergencies.
👍 by the way outside of the OR, I make $50-60/hour walking for agencies and take home at least 160K/year working 6 day weeks, not bad for a BS in biology and a nursing degree and with no student loans. So, I wouldn't say nurses are losers. The average nurse in New York is middle class, and doing okay. just FYI.

 

[smq123]

As a circulating Nurse, I am really shocked by some of the responses by some of the med students, residents and attending here. It's all about the patient and not breaking sterility. I have known doctors and registered nurses (circulator) sued because a surgical team member didn't take sterility seriously and the circulating nurse was too weak to say a thing to prevent what she saw and knew was wrong. I am not going to have my licenses questioned because of someone's arrogance. Please remember, It isn't about you, your degree, how much you make or how little you make it is about the patient.

😕😕😕

Any particular reason why you decided to resurrect a 2 year old thread?

In any case, pull your nerve endings in from above your skin. 🙄

I wish that some circulating nurses and scrub nurses could stand in the shoes of med students and interns. Maybe you're nice to the students and interns....but not everyone is.

Some of the OR nurses are so rude and condescending, they give their fellow nurses a horrible reputation.

I understand that it is the scrub/circulating nurse's job to protect sterility. But do they have to scream, yell, and physically push students out of the way? It is the surgeon's job to take care of the patient, and all of the surgeons that I have worked with do NOT scream, yell, or push.

The job that the nurses do is very important. But many of them unfortunately decide to go on big power-trips, and make the others in the room absolutely miserable.

I hate people with bad attitudes!

So, please lets all remember that we are a team first. Forget the salaries, titles behind the name, male female, student or professional. We are here for the patient first.

EXACTLY. So, you want to tell some of your colleagues this? Why some of them need to be so rude and patronizing, and totally forget their manners, is beyond me.

Plus, many of the circulating nurses seem to forget the titles behind the name. They're so incredibly mean to the students and the interns, but can't brown-nose hard enough to the attendings. 🙄

Perhaps you think I'm exaggerating. I'm definitely not. I'm sure all of the med students and surgery residents can tell you stories that would amaze you. At my hospital, there is a circulating nurse who was famous for her poor treatment of students (which, in some cases, involved physically and inappropriately pushing med students out of her way....and not during an emergency). Her behavior was SO unprofessional that she was reprimanded by the surgeon in charge of the rotation. Trust me, there are plenty like her.

Wrong-site surgery continues to occur regularly, even with formal site verification. Many errors occur before the time-out; some persist despite the verification protocol.

Many studies have shown that the things that the circs and the scrubs are supposed to in order to "ensure patient safety" have actually not made any difference at all.... Just pointing that out.

 

[JeffLebowski]

Preventing surgical site infection in the operating room is....blah blah blah ridiculously long post...

What the hell? Lighten-up, it's a medical student forum with medical students airing their frustrations. Say all you want about "patient care", acting unprofessionally to colleagues (whether you're a doctor, med student, nurse, or tech) is totally unnecessary and inappropriate. Yes yes yes, we're all on board with the buzzwords (being a team, patient care, patient safety, etc. etc. etc.), you're no more committed to it than we are, get off your high horse. No one's complaining about nurses being alert, they're complaining about nurses (in isolated incidents) being unprofessional in working with med students.

 

[SoCuteMD]

One of my favorite posts regarding nursing duties in the OR: http://forums.studentdoctor.net/showpost.php?p=7245902&postcount=1

 

[baysider]

What the hell? Lighten-up, it's a medical student forum with medical students airing their frustrations. Say all you want about "patient care", acting unprofessionally to colleagues (whether you're a doctor, med student, nurse, or tech) is totally unnecessary and inappropriate. Yes yes yes, we're all on board with the buzzwords (being a team, patient care, patient safety, etc. etc. etc.), you're no more committed to it than we are, get off your high horse. No one's complaining about nurses being alert, they're complaining about nurses (in isolated incidents) being unprofessional in working with med students.

Is that an order, No I don't have to lighten up. Don't you get it? You say it a forum for med students to air their frustrations. So, I am airing my frustrations at them. How the hell do you know if I am no more committed to it then you are. You don't even get the point. WE ARE A TEAM. There are no "we" or "you." I take Patient advocacy with respect, and seriously, and it is the function of the circulating nurse. When I am outside of the OR, I lighten up, have a beer, some Jack and Coke and watch sports. But in the OR, this isn't about being nice, it is about getting your job done and doing it right! If you don't like it too bad, there is nothing you can do about. I won't lower my standards to protect your feelings or jeopardize my license because you wanna do things your way. No, it doesn't work that way, sorry. If you want it your way.. go to McDonald's!

 

[baysider]

😕😕😕

Any particular reason why you decided to resurrect a 2 year old thread?

In any case, pull your nerve endings in from above your skin. 🙄

I wish that some circulating nurses and scrub nurses could stand in the shoes of med students and interns. Maybe you're nice to the students and interns....but not everyone is.

Some of the OR nurses are so rude and condescending, they give their fellow nurses a horrible reputation.

I understand that it is the scrub/circulating nurse's job to protect sterility. But do they have to scream, yell, and physically push students out of the way? It is the surgeon's job to take care of the patient, and all of the surgeons that I have worked with do NOT scream, yell, or push.

The job that the nurses do is very important. But many of them unfortunately decide to go on big power-trips, and make the others in the room absolutely miserable.



EXACTLY. So, you want to tell some of your colleagues this? Why some of them need to be so rude and patronizing, and totally forget their manners, is beyond me.

Plus, many of the circulating nurses seem to forget the titles behind the name. They're so incredibly mean to the students and the interns, but can't brown-nose hard enough to the attendings. 🙄

Perhaps you think I'm exaggerating. I'm definitely not. I'm sure all of the med students and surgery residents can tell you stories that would amaze you. At my hospital, there is a circulating nurse who was famous for her poor treatment of students (which, in some cases, involved physically and inappropriately pushing med students out of her way....and not during an emergency). Her behavior was SO unprofessional that she was reprimanded by the surgeon in charge of the rotation. Trust me, there are plenty like her.



Many studies have shown that the things that the circs and the scrubs are supposed to in order to "ensure patient safety" have actually not made any difference at all.... Just pointing that out.

please cite your reference, I would like to read.... So, what does that mean. You can do whatever you want because you want to. The OR is an ordered-structured environment and it functions best that way. Because it is still searchable via google, which is how I found it. C'mon you and I know there are jerks in every profession. Surgeons are known to be the biggest arrogant jerks in medicine. So, this is the first time hearing about circulating nurses and Scrub techs. But, in every professional there are rude and disgusting people. The OR is a heated place, with one objective is to fix the patient, keep him or her alive and don't do any further damage, especially secondary to infection, nerve damage due to positioning and or wrong site. So, they invented Circulating nurses to attempt to lessen malpractices suits related to these incidents. We all have bosses and hospital have policies and people, just need to do what they are supposed to and do their job.

 

[baysider]

One of my favorite posts regarding nursing duties in the OR: http://forums.studentdoctor.net/showpost.php?p=7245902&postcount=1

that nurse needs to get a grip and learn how to prioritize. Some nurses, aides, doctors, even parents forget about prioritize what is most important. This however is very different than a med student playing with her hair because she is nervous and wants to touch things and rolls her eyes when you tell her what are you doing?

 

[diphenyl]

Is that an order, No I don't have to lighten up. Don't you get it? You say it a forum for med students to air their frustrations. So, I am airing my frustrations at them. How the hell do you know if I am no more committed to it then you are. You don't even get the point. WE ARE A TEAM. There are no "we" or "you." I take Patient advocacy with respect, and seriously, and it is the function of the circulating nurse. When I am outside of the OR, I lighten up, have a beer, some Jack and Coke and watch sports. But in the OR, this isn't about being nice, it is about getting your job done and doing it right! If you don't like it too bad, there is nothing you can do about. I won't lower my standards to protect your feelings or jeopardize my license because you wanna do things your way. No, it doesn't work that way, sorry. If you want it your way.. go to McDonald's!

There's a difference between addressing an issue professionally and screaming unnecessarily a a medical student who may not know better. Remember the Med student is their to LEARN from the surgeon. Nurses are their to AID the surgeon whether they be an attending or resident. Yes their is a team but their is a pecking order.

 

[JeffLebowski]

Is that an order, No I don't have to lighten up. Don't you get it? You say it a forum for med students to air their frustrations. So, I am airing my frustrations at them. How the hell do you know if I am no more committed to it then you are. You don't even get the point. WE ARE A TEAM. There are no "we" or "you." I take Patient advocacy with respect, and seriously, and it is the function of the circulating nurse. When I am outside of the OR, I lighten up, have a beer, some Jack and Coke and watch sports. But in the OR, this isn't about being nice, it is about getting your job done and doing it right! If you don't like it too bad, there is nothing you can do about. I won't lower my standards to protect your feelings or jeopardize my license because you wanna do things your way. No, it doesn't work that way, sorry. If you want it your way.. go to McDonald's!

You're a very insecure person. Good luck with that.

 

[Water011]

No, it doesn't work that way, sorry. If you want it your way.. go to McDonald's!

You mean Burger King.

 

[DOCTORSAIB]

 

[bananamed]

WE ARE A TEAM. There are no "we" or "you."

I hope you don't go into work this drunk.

 

[PeepshowJohnny]

If it's all about patient care, then why are minor infractions (or imaginary) infractions by students scolded while attendings who make much worse ones are brown nosed? Why does the number of breaks in sterile technique I'm cited for drop way down way down after I've offered to help move the patient to recovery in the first case? Why is the treatment for female and non-white students so much worse than for the guys who are considered "cute"?

Look, feel free to play petty tyrant of the OR, it's your right. But don't hide behind "We do it all for the patient!" It's bull and you know it.

 

[taurus70]

Is that an order, No I don't have to lighten up. Don't you get it? You say it a forum for med students to air their frustrations. So, I am airing my frustrations at them. How the hell do you know if I am no more committed to it then you are. You don't even get the point. WE ARE A TEAM. There are no "we" or "you." I take Patient advocacy with respect, and seriously, and it is the function of the circulating nurse. When I am outside of the OR, I lighten up, have a beer, some Jack and Coke and watch sports. But in the OR, this isn't about being nice, it is about getting your job done and doing it right! If you don't like it too bad, there is nothing you can do about. I won't lower my standards to protect your feelings or jeopardize my license because you wanna do things your way. No, it doesn't work that way, sorry. If you want it your way.. go to McDonald's!

I smell a lurking troll here!

 

[JeffLebowski]

If it's all about patient care, then why are minor infractions (or imaginary) infractions by students scolded while attendings who make much worse ones are brown nosed? Why does the number of breaks in sterile technique I'm cited for drop way down way down after I've offered to help move the patient to recovery in the first case? Why is the treatment for female and non-white students so much worse than for the guys who are considered "cute"?

Look, feel free to play petty tyrant of the OR, it's your right. But don't hide behind "We do it all for the patient!" It's bull and you know it.

My point is that professionalism doesn't ever need to take a backseat to patient care or your role on a team. I don't care who you are: surgeon, IM doctor, nurse, scrub tech, janitor, med student, if you're good at your job, you're professional when you deal with coworkers. There's a difference between being strict in your adherence to safety measures and being unprofessional in your conduct towards people who you're concerned have the potential to compromise it (at worst). A professional student knows that getting a sharp warning from a scrub nurse about the sterile field isn't personal, and a scrub nurse should know the difference between a professional warning and an unprofessional one. The physicians I look up to are professional and respectful to nurses and patients. The same goes for everyone else on the team.

 

[deleted109597]

I won't lower my standards to protect your feelings or jeopardize my license because you wanna do things your way.

I am not going to have my licenses questioned because of someone's arrogance.

Ah, the coup d'etat of the nursing field. Anyone outranks them and asks them to do something, they start complaining about losing their licenses. Just how often do nurses lose their licenses anyway? I've seen it happen twice, both times for, oh, stealing narcotics. Never for following MD orders such as "push lasix" or "morphine 10mg", although I have been refused these orders under this heavy "license" problem that all nurses go through.
Are you all taught that on the first day of nursing school or what? Because every nurse knows that by heart.

We are hired by the hospital to ensure control over the OR. The circulating nurse is the advocate for the patient, and when s(he) see potential breaks of sterility and or potential issue (s)he MUST by law attempt to rectify it or face lawsuits or her license revolked[sic].

Laughable. So tell me why I get yelled at for not having shoe covers under my sterile gown, or for not changing my scrubs between cases, but your Dora the Explorer scrubs are allowable? Are they antibiotic impregnated or something?

Imagine your wife, family member or love one having surgery and s(he) gets a secondary infection such as Mrsa, Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium thermoresistibile, Peptostreptococcus micros, E. coli or Campylobacter, because the medical team didn't take the rules of the OR seriously.

Someone found Google today.
Haven't ever seen P. micros, M. thermo, or Campylobacter from surgical wounds. I have seen MRSA, S. epidermidis, and E. coli, but these aren't related to sterile technique, but from wound contamination afterwards, except for one case where the circulator didn't get the pre-op antibiotics and then didn't tell them to stop the case. CRNA didn't mention it either, and the surgeon wasn't one of those that would yell at them. They just blissfully ignored it, thinking it was a minor case, and the breast implant had to be removed and replaced later. Note, nobody lost their license that day.

 

[MSHell]

please cite your reference, I would like to read.... So, what does that mean. You can do whatever you want because you want to. The OR is an ordered-structured environment and it functions best that way. Because it is still searchable via google, which is how I found it. C'mon you and I know there are jerks in every profession. Surgeons are known to be the biggest arrogant jerks in medicine. So, this is the first time hearing about circulating nurses and Scrub techs. But, in every professional there are rude and disgusting people. The OR is a heated place, with one objective is to fix the patient, keep him or her alive and don't do any further damage, especially secondary to infection, nerve damage due to positioning and or wrong site. So, they invented Circulating nurses to attempt to lessen malpractices suits related to these incidents. We all have bosses and hospital have policies and people, just need to do what they are supposed to and do their job.

It sure seems you do!

I find it completely inexcusable to be physically shoved out of the way by the circulating nurse if I am merely approaching anything sterile (didn't touch it), and then have her lie to my attending telling him that I was all over the sterile field like **** on a blanket.

 

[tkim]

Laughable. So tell me why I get yelled at for not having shoe covers under my sterile gown, or for not changing my scrubs between cases, but your Dora the Explorer scrubs are allowable? Are they antibiotic impregnated or something?

It's a dude. Dora the Explorer scrubs I doubt. The inner power struggle stems from the M to the RN.

 

[Green Chimneys]

Yes it's all a matter of patient safety and patient advocacy, right?

I'm currently on anesthesia and had a humorous encounter with a circulator the other day. As I preoxygenated and mask ventilated a patient through induction, the almighty circ nurse stood cross-armed, eyes directed towards me like lasers as if she was going to swoop in and save the day if I couldn't get an airway. As I began to insert the blade in to the patients mouth to intubate, the circulator decides it's the best time to shout at me "Medical student! Where is your ID card! You're not wearing it!" I looked up at her, and then back down at what I was doing without a response. "I'm TALKING to you. You need to wear an ID card in this hospital!" I completed the intubation, checked placement, and switched the patient over to the ventilator, at which time I turned around to see this nurse directly in my face. She proceeded to chew me out not only for not wearing my ID card, but also for the disrespect of ignoring her when she pointed it out at the most critical moment of airway management.

Sure, I should have been wearing my ID, but perhaps you could have chosen a better time to point it out? My favorite thing she said was, "It's a matter of security and safety that everyone wear their ID badge at all times in the hospital." I felt like replying, "No ****. It's also a matter of safety and security that this paralyzed and apneic patient get a tube in his trachea in a relatively timely manner!"

 

[SoCuteMD]

It's a dude. Dora the Explorer scrubs I doubt. The inner power struggle stems from the M to the RN.

My favorite nurse moment:
We're about to start cyclophosphamide on a kid. The nurse is freaking out b/c we need a 2nd peripheral IV (good call on her part, that's not teh funny). No prob, kid's very cooperative. I pop in a 20g in the AC. Nurse to me, "Thanks. I mean, this is his liver we're talking about here."

Or, um, his kidneys, but whatev.

 

[Tired]

Ah, the coup d'etat of the nursing field. Anyone outranks them and asks them to do something, they start complaining about losing their licenses. Just how often do nurses lose their licenses anyway?

Not nearly often enough, but that's because we don't complain to their licensing boards.

I plan to rectify that when I get back to residency.

I've seen it happen twice, both times for, oh, stealing narcotics. .

Then you must be talking about repeat offenders, because nurses who divert (like physicians) rarely lose their license after a first offence.

 

[Ashers]

I got yelled at by the scrub tech after moving a pair of sharp scissors which the surgeon had tossed, directly onto my hands.

Apparently, I was supposed to stand there with the sharps just sitting on my hands. The scrub tech didn't even notice where they were until my hands had moved in an attempt to close the scissors and hand them back.

 

[eforest]

I guess I've been lucky in my interactions with nurses in the OR setting. I get snapped at but usually because I'm bumbling around too close to the sterile table or whatever, but nothing inappropriate.

 

[bananamed]

Yes it's all a matter of patient safety and patient advocacy, right?

I'm currently on anesthesia and had a humorous encounter with a circulator the other day. As I preoxygenated and mask ventilated a patient through induction, the almighty circ nurse stood cross-armed, eyes directed towards me like lasers as if she was going to swoop in and save the day if I couldn't get an airway. As I began to insert the blade in to the patients mouth to intubate, the circulator decides it's the best time to shout at me "Medical student! Where is your ID card! You're not wearing it!" I looked up at her, and then back down at what I was doing without a response. "I'm TALKING to you. You need to wear an ID card in this hospital!" I completed the intubation, checked placement, and switched the patient over to the ventilator, at which time I turned around to see this nurse directly in my face. She proceeded to chew me out not only for not wearing my ID card, but also for the disrespect of ignoring her when she pointed it out at the most critical moment of airway management.

Sure, I should have been wearing my ID, but perhaps you could have chosen a better time to point it out? My favorite thing she said was, "It's a matter of security and safety that everyone wear their ID badge at all times in the hospital." I felt like replying, "No ****. It's also a matter of safety and security that this paralyzed and apneic patient get a tube in his trachea in a relatively timely manner!"

Where do you go to school? The exact same thing happened to me and my anesthesia attending snapped back, "STFU. We're intubating."

God I loved that rotation.

I nominated that attending for educator-of-the-year.

 

[anon-y-mouse]

Too true. And some of them will ride you even if you are doing absolutely nothing wrong. I could be five feet from the nearest table and there's always a nurse yelling at me, "DON'T DRIP ON THE TABLE!"

CRNA's can be a piece of work too. One time the CRNA was letting the pt brady down to 40-something pulse and BP 70/25ish while she just sat there and did paperwork. So when I finally said something, she used the Evil Eye on me for a good couple of minutes while she got around to pushing eppy.

Disclaimer: There are a lot of nice scrub nurses too. But human nature being what it is, we only talk about the bad ones 😳

Had great experiences with the techs and nurses, although I was yelled at for grabbing something from the mayo. I don't mind when someone tells me I'm not sterile (which happened a couple of times at the beginning of my rotation), and I quickly learned.

CRNA's, on the other hand, ugh ugh... during one of my cases, I overheard a couple of them whispering about how they had pushed 20mg lasix because of low urine output. While I might not know too much about medicine yet, I got really suspicious and said loudly "lasix??" just so both my attending and CRNA's could hear me simultaneously, and my attending got so pissed and was like "does this patient look wet? what is his cvp? what the hell made you give lasix to this guy? maybe his pre-existing RENAL FAILURE explains his oliguria" and scrubbed out to grab the anesthesiology attending. the CRNA's then gave me the evil eye, proceeded to talk about how i had the 'nerve' as a student to question their 'judgment'. i was then like, 'why don't you guys stop talking about me and start giving this patient some albumin?'.

gah, god damn. and then there was the time where they missed the developing arrhythmias, till i told my attending...

wtf are the anesthesiologists doing when they leave the room after intubation?? why is it that they only return when we're about to extubate??

 

[Blade28]

CRNA's, on the other hand, ugh ugh... during one of my cases, I overheard a couple of them whispering about how they had pushed 20mg lasix because of low urine output. While I might not know too much about medicine yet, I got really suspicious and said loudly "lasix??" just so both my attending and CRNA's could hear me simultaneously, and my attending got so pissed and was like "does this patient look wet? what is his cvp? what the hell made you give lasix to this guy? maybe his pre-existing RENAL FAILURE explains his oliguria" and scrubbed out to grab the anesthesiology attending.

Ah, the age ol' battle between Surgery and Medicine...

Medicine: "Low urine output? Let's give him a touch of Lasix and see if his kidneys respond."
Surgery: "Low urine output? Let's give him some more volume."

Disclaimer: obviously lots more volume is not always indicated in patients with one of the so-called "H/L/L/K" comorbidities - poor heart, lung, liver or kidney function

 

[SoCuteMD]

Ah, the age ol' battle between Surgery and Medicine...

Medicine: "Low urine output? Let's give him a touch of Lasix and see if his kidneys respond."
Surgery: "Low urine output? Let's give him some more volume."

Disclaimer: obviously lots more volume is not always indicated in patients with one of the so-called "H/L/L/K" comorbidities - poor heart, lung, liver or kidney function

I always noticed this. I'm a "fluid bolus challenge" person. Give 'em 500 (250 if INCREDIBLY frail), listen to lungs, check vitals and go from there.

 

[78222]

I guess I've just been lucky, but most scrub nurses have been really helpful to me. I've had one or two that have been mildly rude (mainly when I first started the service) but for the most part they've been pretty great. More than a few would even hand me scissors before I needed them so I would look preparded to cut a knot.

One thing that was a minor annoyance was that after drying my hands, half of them would say "oh, just drop that on the floor don't worry about trying to find a bin, you might touch something" whereas others would be like "what's wrong with you, just throwing a towel on my floor!?"

 

[THP]

In New York, the circulator nurse is paid at least 63-90K to perform this task.

That seems like a ridiculously high amount of money for a circulator. Sit in a chair with the blanket draped over you, chart some stuff, go get stuff from sterile holding, make sure all the rules are followed. I always thought the scrub nurses were higher ranking than the circulators! Doh!

 

[Blade28]

I'm a "fluid bolus challenge" person. Give 'em 500 (250 if INCREDIBLY frail), listen to lungs, check vitals and go from there.

👍

500-1000 mL NS/LR boluses for me.

(Ah, which reminds me of another age-old debate...NS vs. LR...to be continued another day!)