OR nurses/support staff: what's their problem?

[PostCall]

is it just my experience or does almost every nurse or other support staff that works in or around the OR environment have an attitude problem? whether it be passive-aggressive or outright hostile. directed at med students of course because i guess they know they can get away with it. no matter how nice or u are to them it doesn't matter. what i have noticed is that they're almost all chubby, middle-aged women. which makes me think they realize they are well past their prime and their career revolves around handing instruments to surgeons and/or cleaning up the OR afterwards...which i guess builds up the resentment that they take out on med students.

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[TinyFish]

Oh man. I was tempted to reply to this post, and couldn't resist this. I'm going to preface this that I take each person on an individual basis when I meet them.

...but yes. As a general rule, I have been treated much worse by support staff than I have by residents and attendings, despite the horror stereotypes about med school hazing/pimping/etc. I'm not sure if it's insecurity that motivates certain support staff behavior, or just the fact that they feel they CAN treat us like dirt and thus use us as a way of relieving their frustrations.

I don't mind being called out for not knowing things that I should know or not working hard enough, because I think that I should be pushed to do my best. I do mind being yelled at or ridiculed for not knowing things that I couldn't possibly know in my position, or for things that are completely irrelevant and out of my control. That kind of behavior serves absolutely no educational purpose, nor any other purpose than to make the perpetrator feel superior.

 

[metallo]

I'm on my Surgery rotation right now, and I can definitely attest to the fact that scrub nurses/techs tend to treat med students like crap. They assume we are idiots. I am almost at the end of my rotation, and scrub nurses are still telling me not to get too close to the sterile field when I am standing 5 feet away. I have found that completely ignoring them (i.e. not even reacting to what they say) works best. They eventually figure out that you know what you're doing, based on how the attendings and residents treat you (allowing you to suture and otherwise participate in the case). I have even had a couple of them apologize once they realize that I'm not clueless.

 

[juiceman311]

My resident dropped an instrument and the scrub nurse yelled at me for not catching it. She said, and I quote, "Why don't you try to be useful? You're standing there useless, you should have caught it". I responded, "then you'd yell at me for reaching below the sterile field", she came back at me with something else and my resident said "That's enough, don't talk to my student like that".

They are so low on the medical totem poll that we're pretty much the only people below them, and they just want to take those 4 weeks they have with us and just take advantage. I am nice to them, and ignore them when they're being bitches. And I have a long memory. And am going into surgery.

 

[AnteriorSegment]

Some people are just grouches. Or maybe it's the institution lol!

I've worked with an eye surgeon for 20 years and we luckily
have a great OR staff at the institution he does his cases.
He loves surgery at our home institution, it's a great team.
So we're lucky. Actually, we are lucky all around,
great med school, great residents, nurses, etc
(well, administration you can get rid of). Patients always
ask if I will be in the OR with him and I always tell them
"nope, Im not needed, we have a great team at the hospital".

But....there's always a few cranks...many years ago
when I was a young RN working on my surgical floor
I got a cranky phone call from the OR lol. My preop
patient i had sent up for some eye procedure didnt have
his consent signed. Well, our eye attendings got their own
consents, the ophtho residents did not do that so the
consent was usually in the preop paperwork. This one
attending who was just a great guy, would never have
his consent with the preop paper work, he always brought
it to the OR with him in the am, that was his routine. So of
course, the patient was in the holding area, waiting for his
surgeon and his consent lol. I tell the cranky OR person
(not sure who/what it was lol), "Dr. Eyeguy" either has it
as per his usual or he can get it before he scrubs in,
whatever..." So she says to me "well that is unacceptable,
the patient has received preoperative medications and
cannot sign an informed consent" I said "uh what preoperative medications? he received dilation and antibiotic drops to
one eye, there is no preop sedation, what are you talking
about?" so she says "well those are preop medications, and
he is now dilated and cannot see so he can no longer sign
an informed consent" I said to her "Uh...okay...now how do
our blind patients (which we had many of) sign their consents?"
They are unable to see and are fully able to sign. And besides,
he has ANOTHER eye!!." She just hung up the phone on me, muwhahahaaaaaaa...

 

[MSmentor018]

I just have to post....I was an ER/ICU RN dabbled as an admin the last yr before I left for med school so I've had some insider insight

yeah that's how a bunch of them are. first i have to say it's not all of them, some are absolutely fantastic, do their job diligently, and helpful as can be but that's the minority. I think it's a big fish/little pond type syndrome. they have a very detailed skill set, in a very specific area, with a relatively low stress/responsibility job, that doesn't really translate into other fields of nursing. unless you consider counting and quoting regs a skill set. if they ever leave, all will require re training in basic nursing 101, and working their way back up the clinical ladder. that's a demoralizing reality.
if that was my life I'd be oscar the grouch too.

as a med student I never really had any problems with them. I bit my tongue and let them quote regs on how you wore your scrubs in from the outside, dropped an instrument, or touched something you weren't, or god forbid if you have OR skills and dress yourself! just let it go, keep a evil grin, you'll leave shortly and move on to bigger and better things.....enjoy it my med school friends

 

[cpants]

I'm gonna stick up for the OR nurses here. I've mainly worked in a hospital where the nursing in general is extremely poor. I've seen mistreatment of students by nursing staff. However, almost any problem can be avoided (and this goes for problems with floor nurses, ICU nurses, any nurses really) by introducing yourself, explaining what you're doing there and asking if you can help them. When you go into the OR introduce yourself, tell them you are scrubbing in on the case, ask if you can get your gloves and gown and if they need anything else dropped into the sterile field. Show them respect, and you'll get it back. Show them that you know your way around an OR, and they will treat you like you do. Come in already scrubbed and demand your size 7.5 gloves, and you will be a huge target. And you can't really blame them for it.

 

[Jolie South]

I'm gonna stick up for the OR nurses here. I've mainly worked in a hospital where the nursing in general is extremely poor. I've seen mistreatment of students by nursing staff. However, almost any problem can be avoided (and this goes for problems with floor nurses, ICU nurses, any nurses really) by introducing yourself, explaining what you're doing there and asking if you can help them. When you go into the OR introduce yourself, tell them you are scrubbing in on the case, ask if you can get your gloves and gown and if they need anything else dropped into the sterile field. Show them respect, and you'll get it back. Show them that you know your way around an OR, and they will treat you like you do. Come in already scrubbed and demand your size 7.5 gloves, and you will be a huge target. And you can't really blame them for it.

That's completely reasonable. I've had the misfortune of working with some scrub nurses that were rude regardless of what I did to help or how polite I was.

Karma usually comes back to these folks though when the attending yells at them for not getting the right tools or sutures ahead of time.

 

[ACSurgeon]

I'm gonna stick up for the OR nurses here. I've mainly worked in a hospital where the nursing in general is extremely poor. I've seen mistreatment of students by nursing staff. However, almost any problem can be avoided (and this goes for problems with floor nurses, ICU nurses, any nurses really) by introducing yourself, explaining what you're doing there and asking if you can help them. When you go into the OR introduce yourself, tell them you are scrubbing in on the case, ask if you can get your gloves and gown and if they need anything else dropped into the sterile field. Show them respect, and you'll get it back. Show them that you know your way around an OR, and they will treat you like you do. Come in already scrubbed and demand your size 7.5 gloves, and you will be a huge target. And you can't really blame them for it.

While I agree with a lot of this, there is really a whole lot of what others are describing, too. I had a circulating nurse yell at me for asking the scrub tech for an instrument (after my resident asked me to ask for it). She was sitting at the end of the OR and walked right up to me and asked "what did you just say" and I named the instrument differently (thinking I mispronounced it) and she goes of on her rant about how I'm only there to learn and not supposed to ask for anything. My resident and attending ignored the situation.

Mind you, this scrub tech was a very laid back guy who I had worked with many times previously, and we got along pretty well (he taught me to self gown/glove and we often joked with each other). He actually stood up for me a little.

Just smile, and scuff it off. I think we all know better than to get on anybody's bad side at this point of our training.

 

[cpants]

I agree that sometimes you will just encounter jerky people in medicine, and scrub nurses are no exception. I do think a lot of students are preoccupied, nervous, or just not thinking about it, and end up coming off poorly even though they think they are being completely courteous. It's something of which you have to be conscious.

Shrugging off any slights is great advice. If you say nothing or sorry, only the scrub nurse looks like an ass. If you get into a discussion about what you should have done, you both end up looking poorly. And, if there is any window to take the nurse's side, the attending and/or resident will do it. They have to work with this person day after day for years, and they don't really care about you.

One more tip. Learn the scrub nurse/tech's name at the beginning of every case and use it. "Lap pad on the floor, Carol." It's polite, and also people are less likely to give you a hard time if you know and are using their name. Maybe it's an accountability thing.

 

[PostCall]

One more tip. Learn the scrub nurse/tech's name at the beginning of every case and use it. "Lap pad on the floor, Carol." It's polite, and also people are less likely to give you a hard time if you know and are using their name. Maybe it's an accountability thing.

umm...why? why should we have to go through this song and dance of learning their names and doing things to appease them? screw that. i don't go around making sure i know everybody else's first name in the hospital so i can feign sincerity by using it in such a phony way. what next, bring them donuts too? the bottom line is the miserable ones take their misery out on us students cuz they can. they even make stuff up ("you just touched something, go rescrub" when i clearly didn't but they get their little power trip doing it). let's see them pull the crap they pull on us to an attending. oh that's right they know they can't cuz the attending wud tell her (it's almost always a she) to shut up if not ignore her like she doesn't exist.

 

[cpants]

umm...why? why should we have to go through this song and dance of learning their names and doing things to appease them? screw that. i don't go around making sure i know everybody else's first name in the hospital so i can feign sincerity by using it in such a phony way. what next, bring them donuts too? the bottom line is the miserable ones take their misery out on us students cuz they can. they even make stuff up ("you just touched something, go rescrub" when i clearly didn't but they get their little power trip doing it). let's see them pull the crap they pull on us to an attending. oh that's right they know they can't cuz the attending wud tell her (it's almost always a she) to shut up if not ignore her like she doesn't exist.

Well, if you are doing it to feign sincerity I don't recommend it. What I was kind of implying is that you would actually be sincere to people, not feign it.

 

[IM Substance P]

I'm gonna stick up for the OR nurses here. I've mainly worked in a hospital where the nursing in general is extremely poor. I've seen mistreatment of students by nursing staff. However, almost any problem can be avoided (and this goes for problems with floor nurses, ICU nurses, any nurses really) by introducing yourself, explaining what you're doing there and asking if you can help them. When you go into the OR introduce yourself, tell them you are scrubbing in on the case, ask if you can get your gloves and gown and if they need anything else dropped into the sterile field. Show them respect, and you'll get it back. Show them that you know your way around an OR, and they will treat you like you do. Come in already scrubbed and demand your size 7.5 gloves, and you will be a huge target. And you can't really blame them for it.

These are good points.

But I agree with the other posters that you just can't win with some of the OR techs and nurses. A few of them are definitely on a power trip or maybe just jealous. Either way, they're unnecessarily petulant for the sake of pissing off students.

 

[MSmentor018]

These are good points.

But I agree with the other posters that you just can't win with some of the OR techs and nurses. A few of them are definitely on a power trip or maybe just jealous. Either way, they're unnecessarily petulant for the sake of pissing off students.

true,female med students and residents tell me they have the most diff time with them

 

[Jolie South]

These are good points.

But I agree with the other posters that you just can't win with some of the OR techs and nurses. A few of them are definitely on a power trip or maybe just jealous. Either way, they're unnecessarily petulant for the sake of pissing off students.

I would say that the majority are nice, but there were a few that I couldn't win over despite knowing their names, always getting my gown and gloves, helping with patient prep stuff pre and post-op, etc.

 

[dilated]

I had a circulating nurse yell at me for asking the scrub tech for an instrument (after my resident asked me to ask for it). She was sitting at the end of the OR and walked right up to me and asked "what did you just say" and I named the instrument differently (thinking I mispronounced it) and she goes of on her rant about how I'm only there to learn and not supposed to ask for anything.

Haha, yeah. On the very last day of my last surgery AI I asked the tech for a retractor so I could hold something back that kept flopping in the attending's way. She just pretended like I didn't exist. I just rolled my eyes and took some pleasure in the fact that that was the very last time she'd ever be able to do that to me. Being a medical student suck(ed).

 

[Substance]

I think that these ******ed fat and sassy OR techs and nurses need to be put in their place hard.

Medical students are a real sycophantic bunch. What they tend to forget is that they are paying hundreds of thousands of dollars for an education. Most of the time during clerkship they are not getting this. To add insult to injury, they take guff from the ANCILLARY STAFF(LOL!). We should demand, and command, respect! I know when I was in medical school and a nurse or ancillary peon gave me guff, I'd give it right back to them. I wouldn't throw insults. I would just let them know their place in relation to patient care. Putting everything in the context of patient care makes their petty Napoleon-trips looks stupid.

I can tell you that any medical student knows more about human health than the best OR tech and nurse. Sure the nurses have the muscle-memory gained from experience to know the protocols, but that is monkeywork that anyone without MR will pick up by habit.

 

[NAGNAM]

not to generalize or be mean, but i seriously hate scrub nurses.

 

[Colbert]

I think that these ******ed fat and sassy OR techs and nurses need to be put in their place hard.

Medical students are a real sycophantic bunch. What they tend to forget is that they are paying hundreds of thousands of dollars for an education. Most of the time during clerkship they are not getting this. To add insult to injury, they take guff from the ANCILLARY STAFF(LOL!). We should demand, and command, respect! I know when I was in medical school and a nurse or ancillary peon gave me guff, I'd give it right back to them. I wouldn't throw insults. I would just let them know their place in relation to patient care. Putting everything in the context of patient care makes their petty Napoleon-trips looks stupid.

I can tell you that any medical student knows more about human health than the best OR tech and nurse. Sure the nurses have the muscle-memory gained from experience to know the protocols, but that is monkeywork that anyone without MR will pick up by habit.

I had a beef with the midwife on my OBGYN rotation the other day about this. After I did the entire intake and physical for a woman admitted for labor, she went on to tell me it was up to her to decide if I could go in for the delivery b/c at this hospital the midwives deliver all non-private nsvd's from the hospital clinic. Since this was now her patient, in her view, she had all say over who is in the room. She said she had a big problem that our school signed a new contract with this hospital to send students there and never asked for her permission for students to shadow/observe/complete deliveries. She went on to yell at me about how she doesn't get paid any more to deal with us. I simply and respectfully told her that if she has a problem with us being there and how it relates to her pay then to talk to the head of the department b/c we were instructed to go in on every delivery as part of the L&D team. I then told her since this is a teaching hospital and I am a student it's my responsibility to try to learn and listen first to my preceptors. There is no reason why I should have to get yelled at by a midwife for basically doing all her paperwork for her. I realize that I'm "lower on the totem pole" than her, but her ego does not dictate my education to me, especially when what she says is in direct contrast to the head of the department.

 

[Substance]

I had a beef with the midwife on my OBGYN rotation the other day about this. After I did the entire intake and physical for a woman admitted for labor, she went on to tell me it was up to her to decide if I could go in for the delivery b/c at this hospital the midwives deliver all non-private nsvd's from the hospital clinic. Since this was now her patient, in her view, she had all say over who is in the room. She said she had a big problem that our school signed a new contract with this hospital to send students there and never asked for her permission for students to shadow/observe/complete deliveries. She went on to yell at me about how she doesn't get paid any more to deal with us. I simply and respectfully told her that if she has a problem with us being there and how it relates to her pay then to talk to the head of the department b/c we were instructed to go in on every delivery as part of the L&D team. I then told her since this is a teaching hospital and I am a student it's my responsibility to try to learn and listen first to my preceptors. There is no reason why I should have to get yelled at by a midwife for basically doing all her paperwork for her. I realize that I'm "lower on the totem pole" than her, but her ego does not dictate my education to me, especially when what she says is in direct contrast to the head of the department.

...thing is, you're not. She's a MIDWIFE - a vestigial profession from the days before allopathic medicine took hold and is only still around because of hippy-dippy ***** moms who think that MEDISIN = TEH EVEL

 

[thehoosier]

I once had a circulating OR nurse tell me I wasn't allowed to scrub on a case because there were already two residents scrubbing and any more people would be too much potential contamination for the patient. Worse, when she told me this, she claimed that the attending was the one who made this decision. This was my first rotation of MS3, and maybe my 3rd or 4th surgery ever, so I didn't talk back and left the OR.

Half an hour later I get paged - "You can come back to the OR now". The attending on this case was a bigshot who I had worked with in clinic a couple days earlier, who knew I was interested in his field. My residents later told me that the attending walked in, got ready to start the case, then looked across the table and asked "where's the student?". The nurse who told me to leave had to explain why she did so, then had to go page me and tell me I was allowed to come back.

Sometimes people get what they deserve.

 

[MSmentor018]

Half an hour later I get paged - "You can come back to the OR now". The attending on this case was a bigshot who I had worked with in clinic a couple days earlier, who knew I was interested in his field. My residents later told me that the attending walked in, got ready to start the case, then looked across the table and asked "where's the student?". The nurse who told me to leave had to explain why she did so, then had to go page me and tell me I was allowed to come back.

Sometimes people get what they deserve.

similar thing happened to me, feels good don't it?

 

[angiogenesis]

I agree that there are some out there- particularly the older ones that are so jaded that they treat the med students like crap for the sake of it.

 

[PathMD2010]

I think that sums it up. While some med students can be rude/ not considerate enough of other personnel, and most med students end up getting in the way, there is no reason for some of the treatment that we get. And after reading that post, I think that sums it up. The older, fatter, and shorter female scrub techs/ circulation nurses are the meanest.

I dare a horror story from a scrub tech/ circulating nurse who is younger, tall, thin, and male. They have always been very nice, as have younger scrub techs. But I've met very few nice, old, obese scrub techs.

I agree with earlier posts that they are just taking out their anger/ frustration on those who will take it.

 

[basupran]

This thread really brings back some memories of my rotations. There were some outright nasty scrub techs out there- some of them snapped for no good reason. I figure that a lot of it is a form of displacement.

On a sidenote, not to bring race into this, but the Asian/Russian/Bosnian/Polish scrub techs have been the nice ones.

 

[Acabee]

granted, a few scrub techs have been rough on me, as have a few nurses/residents/attendings, etc... but I have more than once worked with scrub techs who whispered to me the answers to pimp questions I got asked or quietly told me what instruments to ask for so I could appear to "anticipate" the next step in the case. I have to say, overall, I've been really grateful to the techs I've worked with. I don't think it's entirely institution specific, as I had a similar experience on my away rotations. I think it helps that I always get my gloves, help set up, say please and thank you, etc.

 

[veenut]

I lived it too when I was a med student. Don't take it too personally, your time to enjoy the glory of internship earning some cash, free lodging, 3 hot meals a day and paid vacations will come. Oh, and a free dental plan. I'm SOO taking advantage of this one in my social service year now that I recovered my ISEM health insurance!

When I was an intern, the very same nurse that was horribly rude to the med students was all polite to me even if I make a mistake and they are just quietly there not bothering anyone.

I did know a nurse on the weekend shift in my old hospital that was the complete opposite to the stereotype. Instead of being rude and nasty to the students, she felt she was awesome because she was able to teach them things inside of her knowledge that we took for granted and/or were too busy doing our jobs operating on the patient to be able to educate. She'd explain stuff like the the uses of the different OR tables, the names of the instruments, the jobs of each member of the OR and what each person did, the steps that an instrumentalist has to do while the surgeons scrub up and the duties of the circulating nurse. They students learned a LOT that day and were awed at how awesome she was for knowing things that aren't exactly easy to teach in a classroom setting. I on the other hand kind of had to learn all of that the hard way. She even taught them how she filled out the nurse sheet of the operation which is something I never got to learn.

Maybe some nurses should see the perspective from this one nice nurse and see that maybe they don't know all of the intricate details of disease, but they too know things that doctors sometimes are too busy to teach personally.

Free lodging? Not for interns in the US...

 

[Rombula540]

My resident dropped an instrument and the scrub nurse yelled at me for not catching it. She said, and I quote, "Why don't you try to be useful? You're standing there useless, you should have caught it". I responded, "then you'd yell at me for reaching below the sterile field", she came back at me with something else and my resident said "That's enough, don't talk to my student like that".

They are so low on the medical totem poll that we're pretty much the only people below them, and they just want to take those 4 weeks they have with us and just take advantage. I am nice to them, and ignore them when they're being bitches. And I have a long memory. And am going into surgery.

The OR is not for sensitive souls. OK you are partially right in that they see a surgeon they work with every day mentor a student, I think they get jealous! (weird I know)...the thing about OR staff you have to realize is that they are usually in a TOTALY different world...they work 8hrs 5days a week and the culture is about speed, efficiency, and routine. They usually don't care about why certain instruments are used over others, or what makes a better pre-op antibiotic; they just make it happen. They see students as someone they have to babysit, I've felt similar on occasion during complicated cases. The ones who have been doing it for years are not interested in the awesomeness of surgery, and are just wanting to get home to their family and cook dinner (or knit or whatever). I see it from both sides (obviously I love students since I am one). I pity those people honestly, their misery should not be taken as a personal afront. A lot of the veteran nurses are hateful- not just to students. As far as being "low on the totem pole", keep in mind these people could be caring for your mother, and like or not, their competency directly affects the ease or difficulty of a case.

 

[juiceman311]

The OR is not for sensitive souls. OK you are partially right in that they see a surgeon they work with every day mentor a student, I think they get jealous! (weird I know)...the thing about OR staff you have to realize is that they are usually in a TOTALY different world...they work 8hrs 5days a week and the culture is about speed, efficiency, and routine. They usually don't care about why certain instruments are used over others, or what makes a better pre-op antibiotic; they just make it happen. They see students as someone they have to babysit, I've felt similar on occasion during complicated cases. The ones who have been doing it for years are not interested in the awesomeness of surgery, and are just wanting to get home to their family and cook dinner (or knit or whatever). I see it from both sides (obviously I love students since I am one). I pity those people honestly, their misery should not be taken as a personal afront. A lot of the veteran nurses are hateful- not just to students. As far as being "low on the totem pole", keep in mind these people could be caring for your mother, and like or not, their competency directly affects the ease or difficulty of a case.

Meh, you missed the point. I am the least sensitive person you'll meet. Ask my fiance. Caring for my mother? She'll be handing a suture to the person caring for my mother, but good point.