Scrub Techs & OR Stories.

[Faebinder]

I tell you, the OR continues to be an evil playground. So yesterday, we are operating in the OR on a first time case (filming and everything inside the belly). There were a couple of signatures that the PD had to sign... stat... as in within 2 hours. So I personally came down, got the papers and went up to have him put a sterile glove and sign. He of course wanted to talk to the admin that is causing this headache. So i get a hold of someone to get a hold of him and call us back. Meanwhile the scrub tech and the circulator have the music up loud.. so i ask to turn it down cause an important phone call is coming... after it gets turned down the scrub tech goes, "It's not Faebinder's OR, it's my OR, turn it back up." I explained how he cant hear the phone call and all I got are glares.

My PD, who of course is the one who requested the phone call to the disruptor stayed quiet.

Anyone else having some crappy OR/Scrub Tech stories now a days?

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[buckley]

I assisted in a TAHBSO with BSO, PF sampling, resident left me to prepare histopath specimens. Circulating nurse screams "intern on duty--phone!", i tell OR Nurse 1 not to touch specimens as I will label them, pack them, etc. and that I just have to get a phone call. Less than 2 minutes on the phone, went back to my OR, and literally saw the janitor throwing away my peritoneal wash! it was like some slow mo scene from a movie where i literally shouted and dove for that peritoneal fluid. I ask OR Nurse 1 why she did not say anything, she told me something like , "hey you just told me not to touch them. i didn't. it's not my fault the janitor did..." She was standing right there...

 

[Faebinder]

I assisted in a TAHBSO with BSO, PF sampling, resident left me to prepare histopath specimens. Circulating nurse screams "intern on duty--phone!", i tell OR Nurse 1 not to touch specimens as I will label them, pack them, etc. and that I just have to get a phone call. Less than 2 minutes on the phone, went back to my OR, and literally saw the janitor throwing away my peritoneal wash! it was like some slow mo scene from a movie where i literally shouted and dove for that peritoneal fluid. I ask OR Nurse 1 why she did not say anything, she told me something like , "hey you just told me not to touch them. i didn't. it's not my fault the janitor did..." She was standing right there...

Oh wow.

 

[Winged Scapula]

As a new attending, I might as well get out a tape recorder because I have this conversation every day:

Scrub: "Dr. Cox we don't have a preference card for you."

Me: "That's funny, I turned it in X (increasing number) of weeks ago and they seemed to have everything I needed last week."

Scrub: "We just set up everything using your partner's card."

Me: "Well, she and I are different people and we use different things."

Cue to me spending time saying I use Lido without epi mixed with marcaine, I don't like Steri-strips cut for me, no dressing in the axilla, where's my Martin arm retractor, no I don't use methylene blue for a lymph node dissection only for sentinel nodes, has someone checked with Rads to make sure they are staying to image my specimen, etc."

Right now they pretty much kiss my arse but, at one hospital in particular, it is a daily occurence to try and get them to see that my partner and I are not the same person (ie, my patients get admitted to her, my op reports faxed to her [except when them fax them to some random number out of town that I don't recognize - "its what we have in our system." Me: "the system is then broken because neither she or I have ever been at anything close to that number.")].

 

[Chronic Student]

Faebinder, as a former scrub tech and by the power vested in me by the gods of sterility I give you permission to break that scrub techs jaw.

That is completely unacceptable, period.

 

[Top Gun]

I assisted in a TAHBSO with BSO, PF sampling, resident left me to prepare histopath specimens. Circulating nurse screams "intern on duty--phone!", i tell OR Nurse 1 not to touch specimens as I will label them, pack them, etc. and that I just have to get a phone call. Less than 2 minutes on the phone, went back to my OR, and literally saw the janitor throwing away my peritoneal wash! it was like some slow mo scene from a movie where i literally shouted and dove for that peritoneal fluid. I ask OR Nurse 1 why she did not say anything, she told me something like , "hey you just told me not to touch them. i didn't. it's not my fault the janitor did..." She was standing right there...

And it never even crossed her mind that they were specimens meant to be sent to pathology so that a diagnosis of the patient could be made???
I have encountered a few nasty scrub techs in med school, but at least they put a certain amount of thought into their job. The scrub tech you mentioned needs to be fired, seeing as how she is a part of the surgical team that operated on the patient. She could at least have warned the janitor that the specimens were meant to be sent to pathology. As a member of the team, she should have known what those specimens were for.

 

[Faebinder]

Faebinder, as a former scrub tech and by the power vested in me by the gods of sterility I give you permission to break that scrub techs jaw.

That is completely unacceptable, period.

Thank you.

I actually defended med students vs her a few times. Kinda funny. Good thing I'm pretty savvy and can do it without inducing anger. I've seen her yell at an anesthesiologist one time as well, after extubation.

 

[buckley]

As a member of the team, she should have known what those specimens were for.

Oh I think she knew them alright, she just didn't CARE. It was my a** on the line not hers, so she was singing happily fixing those instruments of hers. harumph.

 

[DrDawg]

No horror stories, but if I get an excessive amount of attitude toward myself or the student I think its grounds to let the student close all incisions.

 

[buckley]

oh i told her something like, "i hope one day when it's you or your mother or your sister having surgery for ovarian ca, you'd get the treatment you rightfully deserve."

but i guess it's hard to "teach" anyone to care. some are just really callous, and some are just sociopaths

 

[buckley]

oh believe me i looked devastated at my 1/3 filled iv bottle of peritoneal fluid...and you couldn't paint my face as i had to fill out an incident report. i believe that was one of the turning points in my life where I knew I wanted a life outside the OR

 

[fab4fan]

I've often thought about making up medical lies in order to cause feelings of guilt and fear in people like this.

For example, you could have looked devastated, and explained that by throwing away that specimen, you wouldn't be able to determine the histologic subtype, so you wouldn't be able to offer her chemotherapy. Followup shortly thereafter by asking if they have hospice forms you can give the patient in recovery.

I've never had the balls to do this, but I think about it almost every day.

This made me laugh til I cried. I really think you should screw up the courage to say something like that the next time situation presents itself.

 

[smq123]

I've often thought about making up medical lies in order to cause feelings of guilt and fear in people like this.

For example, you could have looked devastated, and explained that by throwing away that specimen, you wouldn't be able to determine the histologic subtype, so you wouldn't be able to offer her chemotherapy. Followup shortly thereafter by asking if they have hospice forms you can give the patient in recovery.

I've never had the balls to do this, but I think about it almost every day.

No - it would be even better if you turn to the med student in the room, and say, "Come on. We need to go call the family...and tell the patient's daughter that it looks like mom won't be able to see the birth of her first grandchild after all...."

If that doesn't make the scrub tech feel guilty, then nothing will!

 

[Kubed]

On my ortho rotation we spent one day a week at a private surgical center and it was there I encountered my first (and thus far, only) truly evil OR nurse. She did some petty stuff like take and use for herself the XXL gown I got out (I'm 6'2" 280, she's 5'5" and 120) and she did some not so petty stuff like "accidentally" bump into me with her back (then shouted "stop! the student's contaminated!). However, hands down worst thing she did was always "lose/forget" the lunch order for the students. The center picked up lunch from someplace nice for the Dr's and students, and it was a bummer when I saw she was the one taking orders knowing that mine would somehow get "lost."

 

[velo]

I actually defended med students vs her a few times.

Oh I loved it 3rd year when residents or fellows would have the balls to stand up to a Scrub Tech or circulator who had decided they were going to make it their mission to ride my a$$ all day. Its so hard for a med student in the OR-- aside from the basic rules of sterile technique, each one of those Scrub Techs makes up their own additional set of arbitrary (often contradicting) rules and then sets out to make you feel ******ed if you don't know what they are...

 

[diosa428]

Oh I loved it 3rd year when residents or fellows would have the balls to stand up to a Scrub Tech or circulator who had decided they were going to make it their mission to ride my a$$ all day. Its so hard for a med student in the OR-- aside from the basic rules of sterile technique, each one of those Scrub Techs makes up their own additional set of arbitrary (often contradicting) rules and then sets out to make you feel ******ed if you don't know what they are...

Yeah this happened to me all the time. I also looooved getting yelled at whenever I came within 10 feet of the sterile table (which I never once contaminated). I realize that sometimes med students don't know or are careless, but really, I'm 25 years old, I have a college degree and a graduate degree and I'm in the process of getting a doctorate. I am capable of understanding and implementing rules after being told once.

 

[velo]

Yeah this happened to me all the time. I also looooved getting yelled at whenever I came within 10 feet of the sterile table (which I never once contaminated). I realize that sometimes med students don't know or are careless, but really, I'm 25 years old, I have a college degree and a graduate degree and I'm in the process of getting a doctorate. I am capable of understanding and implementing rules after being told once.

No kidding. I totally understand that there are things in the OR that I don't know and that it's stressful for them to have a new face in the OR every 2wks-1month who could potentially screw something up-- but that doesn't excuse their routine practice of "teaching" us these things with heaping helpings of condescension. Honestly, none of the rules that go into not contaminating one's self are complicated concepts. Tell me once, calmly and politely, and I'll remember--I've mastered more challenging concepts than "the back isn't sterile."

Your post reminded me of another wonderful time I was on the receiving end of a scrub tech power trip. We were doing an ovarian ca case that had seeded all over the abdomen. With the debulking we were working everywhere from the pelvis to the diaphram and due to some technical problems were doing it with only two working lights. I'm very tall and can easily reach light handles and had gotten pretty adept at maneuvering them around so I had taken it upon myself to follow them with the light because they were moving around the abdomen a lot. I could feel the tech's annoyance growing each time I reached up and finally she said, "Look, just pick a place for the light and leave it there, you're going to contaminate yourself." I mustered all the courage I had and shot back, "Are you sure, I think the light handle is sterile." She started to lay into me about how I would certainly touch something on my way up to the light (even though I hadn't come close to doing that yet) when the fellow cut her off with an, "actually he is helping a lot." Shut her right up. It was beautiful, and that fellow was awesome.

 

[crazylegs]

I take things directly off their Mayo stand just to annoy them.

Haha, yeah. I loved doing that ... especially when the surgeon gave me permission to do so and the scrub tech couldn't tell me no. She just stood there silent and red-faced, boiling over with anger.

One of the few moments I actually enjoyed in surgery...

 

[DOctorJay]

we have a scrub tech who purposely hands everyone the left glove first, no matter what, just to be difficult

 

[core0]

we have a scrub tech who purposely hands everyone the left glove first, no matter what, just to be difficult

Probably trained at Mayo.

I make little animals out of the bone wax when it gets slow. That really annoy one of the techs. As a former OR tech I really hate hazing.

David Carpenter, PA-C

 

[Blade28]

I make little animals out of the bone wax when it gets slow.

Ha ha that's awesome!

 

[core0]

Ha ha that's awesome!

When it gets really slow I make up dialog for the animals:
Rabbit: What do you think of this hospital.
Turtle: Its pretty nice and they had donuts in the lounge
Rabbit: Sure wish we could take this liver out and go home though
Turtle: And that heart isn't getting any fresher.

Even the CV surgeon was laughing over that one.

David Carpenter, PA-C

 

[Drawing Dead]

Have to agree with giving the med student crap, especially about coming within 10 feet of a sterile table. During an optho case, where I was on an anesthesia rotation, I had to go around the room to get to the phone and page the attending to start the intubation. I walk around the perimiter of the room, staring at the table to make sure I didn't touch it, didn't come within 5 feet of it, and still got the tongue lashing from the circulating nurse. Then, the optho resident says to her, "Why do you give the students such a hard time?" to which she responded, "Well, I have to yell at somebody!"

Oh, you do? Go yell at yourself for going to nursing school, slowly transitioning from a gorgeous, tight bodied 20 something y.o. to a crotchety, fat, gossipy beeotch. (You ever notice how like 90% of female nursing students are attractive, but 90% of nurses are, to say the least, unattractive? And they go from nice, sweet and shy to master of the domain. What's up with that?)

Also had a tech who was kinda new, and was confused about the instruments. So, I starting taking things off the Mayo tray to speed things up, and got yelled at. Yeah, so I was wrong for not asking, but I also didn't want to be in the OR an extra 2 hours because she didn't know the difference between an addson and smooth pickup.

 

[Blade28]

When it gets really slow I make up dialog for the animals:
Rabbit: What do you think of this hospital.
Turtle: Its pretty nice and they had donuts in the lounge
Rabbit: Sure wish we could take this liver out and go home though
Turtle: And that heart isn't getting any fresher.

 

[smq123]

Then, the optho resident says to her, "Why do you give the students such a hard time?" to which she responded, "Well, I have to yell at somebody!"

Oh, that makes me so angry.

That is not your fault that she has an inferiority complex. Or that she's having a bad day.

And you're right - it's amazing how well I can get along with the nursing students (who are all really fun girls to hang out with), but how the nurses can make me want to start throwing stuff at the wall.

Also had a tech who was kinda new, and was confused about the instruments. So, I starting taking things off the Mayo tray to speed things up, and got yelled at.

That happened to me too. Actually, she smacked my hand.

But hey, no problem - I did exactly what she wanted me to do. I stood by with my arms folded, and didn't lift a finger to help her get herself organized, or help her work faster.

So when the attending started to get angry and frustrated, because the scrub tech was taking so long to get things handed to him, I still didn't lift a finger. I stood there, with my arms folded, watching the attending get angrier at her and start to yell, and watching her get more and more flustered to the point where she looked like she might cry.

She didn't want my help, so no worries - she didn't get it. Call me a vindictive b****, but I'm tired of power-trippy scrub techs. All of us are, probably.

 

[fuzzyerin]

So far, my favorite putting a scrub tech in her place story was about a month ago:

I was the senior resident on L&D. It wasn't too busy, so when we called the section, I scrubbed with my intern and took her through the case. My attending didn't scrub, he merely wandered around the room (and then out of the room once the baby was out). It was early in the rotation for the med students, so when it came to us repairing the uterus, I was explaining how we did it - Liz did her stitch, I pulled the suture through, and then the student wiped with the lap so Liz could throw her next stitch. I said that when it went like this, we could do it quickly and it ran smoothly. Liz through her next stitch and before I could even pull it through, the SCRUB TECH took the student's hand and wiped the uterus with the lap. I said "what are you doing?" and she responded "I'm teaching the med student what to do because he's not doing his job." I replied "I am the most senior physician at this table right now and I just explained to the student how I want it done and we do it MY WAY."

Needless to say, she was quiet and just did her job for the rest of the case.

 

[AlternateSome1]

That happened to me too. Actually, she smacked my hand.

Smacking someone's hand is so completely inappropriate and unprofessional that I would have gone up the channels over that one. Maybe I am vindictive, but no one is going to touch me, let alone smack me, without my consent.

Edit: My school actually held a seminar prior to starting 3rd year to list completely inappropriate actions that could be perpetrated against medical students and that was one of them.

 

[GoodMonkey]

Probably trained at Mayo.

or michigan.

 

[fab4fan]

Smacking someone's hand is so completely inappropriate and unprofessional that I would have gone up the channels over that one. Maybe I am vindictive, but no one is going to touch me, let alone smack me, without my consent.

Edit: My school actually held a seminar prior to starting 3rd year to list completely inappropriate actions that could be perpetrated against medical students and that was one of them.

In some facilities, it's a terminable offense. I can tell you no one would smack me and get away with it.

 

[smq123]

Smacking someone's hand is so completely inappropriate and unprofessional that I would have gone up the channels over that one.

In some facilities, it's a terminable offense. I can tell you no one would smack me and get away with it.

I think she meant to do it the way you smack a small child's hand when they're reaching for a cookie. Not that it's any less condescending, seeing as how I'm in my mid-20s, but, well....

In any case, she got so flustered through the case (she was not accustomed to the attending's quick pace, and it was a fairly complicated operation) that the attending got very frustrated. So frustrated, that he kicked the wall. And then, she accidentally threw away a suture needle, so the counts were incorrect at the end of the case, which made the attending even angrier. So I figured that karma had bitten her enough for one day.

 

[fab4fan]

I think she meant to do it the way you smack a small child's hand when they're reaching for a cookie. Not that it's any less condescending, seeing as how I'm in my mid-20s, but, well....

In any case, she got so flustered through the case (she was not accustomed to the attending's quick pace, and it was a fairly complicated operation) that the attending got very frustrated. So frustrated, that he kicked the wall. And then, she accidentally threw away a suture needle, so the counts were incorrect at the end of the case, which made the attending even angrier. So I figured that karma had bitten her enough for one day.

I can understand someone getting frustrated. But no one gets to smack anyone, period. I don't care what's happening, who did what to whom, no one gets to hit. Hitting is indefensible.

 

[AlternateSome1]

I think she meant to do it the way you smack a small child's hand when they're reaching for a cookie. Not that it's any less condescending, seeing as how I'm in my mid-20s, but, well....

The implications behind this action are just ghastly. Basically she is saying that you are so worthless that she can hit you without fear of recourse. That is something pretty unheard of in other professional sectors, so why allow it in an operating room?

 

[Anka]

SMQ is picking her battles. It's a good thing, otherwise you are at war all the time, and your enemies outnumber your friends pretty rapidly. There's also the issue of proportionality, i.e. there is no proportional response open to SMQ. SMQ appears to think that this was a relatively minor incident and that the intent wasn't entirely malign. Unfortunately there is no minor response. If she writes the tech up, she could get the tech into way more trouble than she thinks the tech deserves (fired, suspended).

However, if the resident or attending were aware of it, there is something very proportionate available to them -- they could just say something to the tech.

Anka

 

[fab4fan]

SMQ is picking her battles. It's a good thing, otherwise you are at war all the time, and your enemies outnumber your friends pretty rapidly. There's also the issue of proportionality, i.e. there is no proportional response open to SMQ. SMQ appears to think that this was a relatively minor incident and that the intent wasn't entirely malign. Unfortunately there is no minor response. If she writes the tech up, she could get the tech into way more trouble than she thinks the tech deserves (fired, suspended).

However, if the resident or attending were aware of it, there is something very proportionate available to them -- they could just say something to the tech.

Anka

The tech deserved to be fired, not only for hitting the student, but then for retaliating with abusive language. You don't think that's a problem? People like that don't deserve a job.

 

[Blade28]

The tech deserved to be fired, not only for hitting the student, but then for retaliating with abusive language. You don't think that's a problem? People like that don't deserve a job.

It's tough. As med students or residents, "writing someone up" is not commonplace and there's always the fear of being labelled a whistleblower.

 

[smq123]

The tech deserved to be fired, not only for hitting the student, but then for retaliating with abusive language. You don't think that's a problem? People like that don't deserve a job.

There wasn't any abusive language - just a "Don't touch the Bovie!!" after the hand slap. (Because that's all that I was doing - putting the Bovie back in its holder so that it wasn't out on the field where someone might accidentally lean on it and turn it on. I wasn't even really touching the Mayo.)

It was a little annoying, to be honest, but Anka is right, and saying anything would just make things worse. If anything HAD been said to the scrub tech, then what probably would have happened is that the scrub techs would make numerous sarcastic comments about "Ooohhh...now we need to treat the precious med students with kid gloves! Because their feelings might be hurt. Poor little babies." It wouldn't have done any good.

Yeah, it would have been nice for all residents to speak up in defense - but, sadly, those scrub techs can really make fun of the residents too.

My chief resident defended me and the intern in front of the CRNA. In retaliation, the CRNA nitpicked, and made fun of, everything that the chief did after that. Because, you know, that's the "mature" thing to do.

Whatever. It'll be something for me to keep in mind as an attending.

 

[Anka]

The tech deserved to be fired, not only for hitting the student, but then for retaliating with abusive language. You don't think that's a problem? People like that don't deserve a job.

It's real easy for all of us to stand here on an anonymous message board telling SMQ what she should have done. She's the one who was actually there, and I think she deserves that we respect her decision on how to handle the situation. I can imagine that response was conditioned on one or both of the two reasons I outlined in my post.


Anka

 

[fab4fan]

There wasn't any abusive language - just a "Don't touch the Bovie!!" after the hand slap. (Because that's all that I was doing - putting the Bovie back in its holder so that it wasn't out on the field where someone might accidentally lean on it and turn it on. I wasn't even really touching the Mayo.)

It was a little annoying, to be honest, but Anka is right, and saying anything would just make things worse. If anything HAD been said to the scrub tech, then what probably would have happened is that the scrub techs would make numerous sarcastic comments about "Ooohhh...now we need to treat the precious med students with kid gloves! Because their feelings might be hurt. Poor little babies." It wouldn't have done any good.

Yeah, it would have been nice for all residents to speak up in defense - but, sadly, those scrub techs can really make fun of the residents too.

My chief resident defended me and the intern in front of the CRNA. In retaliation, the CRNA nitpicked, and made fun of, everything that the chief did after that. Because, you know, that's the "mature" thing to do.

Whatever. It'll be something for me to keep in mind as an attending.

Didn't you say she called you a vindicitive bitch? Don't you think that's abusive speech? You sure wouldn't get away with that here.

You know, I see these threads where meds students/interns/resdents complain about "ancillary" staff mistrating them, but when someone says "This isn't right, it shouldn't happen, period" it seems most of you turn around and downplay it. I don't get it. There's something really wrong about a system that allows a staff member to strike another member of the team--I don't care who it is. That old-school attitude has to be changed.

 

[fab4fan]

It's real easy for all of us to stand here on an anonymous message board telling SMQ what she should have done. She's the one who was actually there, and I think she deserves that we respect her decision on how to handle the situation. I can imagine that response was conditioned on one or both of the two reasons I outlined in my post.


Anka

True, but I've also BTDT.

 

[smq123]

Didn't you say she called you a vindicitive bitch? Don't you think that's abusive speech? You sure wouldn't get away with that here.

Oh no! No, I was just saying that you could say that I was a vindictive bitch, because I just sat back and let her get in trouble. She was clearly falling behind, having trouble keeping up with the pace of the operation, and I didn't do anything to try to help her. In fact, I got a *tiny* bit of enjoyment out of watching her get flustered and yelled at.

(Well, maybe a LITTLE bit more than *tiny*....)

She didn't call me any names. If she had called me anything, then I would have complained. I complained enough on the end-of-rotation eval as it was.

You know, I see these threads where meds students/interns/resdents complain about "ancillary" staff mistrating them, but when someone says "This isn't right, it shouldn't happen, period" it seems most of you turn around and downplay it. I don't get it. There's something really wrong about a system that allows a staff member to strike another member of the team--I don't care who it is. That old-school attitude has to be changed.

Aww...you're so nice. I wish you worked here!

It shouldn't happen - you're right. But trying to come up with methods to make sure that it doesn't happen again feels counterintuitive. It isn't because the RULES aren't in place. The rules that demand courteous treatment for everyone ARE there. But getting people to follow those rules gracefully, or to follow them AT ALL...that depends on people's attitudes. And you can't change attitudes very easily, as I'm sure you're well aware!

I mean, for instance, there was one circulating nurse who really yelled at med students for EVERYTHING. She yelled at a med student for standing next to the trash can - because he might "contaminate something that is sterile." (The TRASH CAN, remember. ) She was reprimanded for her behavior towards med students.

So....she just turned around, and started treating the INTERNS the way that she had previously treated the med students. Some people just have crappy attitudes, and not much will change.

P.S. How come your computer didn't censor "b****" for you? Mine always does.

 

[elwademd]

Didn't you say she called you a vindicitive bitch? Don't you think that's abusive speech? You sure wouldn't get away with that here.

You know, I see these threads where meds students/interns/resdents complain about "ancillary" staff mistrating them, but when someone says "This isn't right, it shouldn't happen, period" it seems most of you turn around and downplay it. I don't get it. There's something really wrong about a system that allows a staff member to strike another member of the team--I don't care who it is. That old-school attitude has to be changed.

We complain about it because it is damaging and demeaning. We downplay it because we are told to downplay it.

Back in the day, attendings abused residents and students, and that sucked, but at least it was within the field and could be written off as part of the "hazing" ritual. Now everyone in the hospital takes shots at residents and students, and our attendings tell us to "let it go" and "work with the team" and "don't make waves". It's total ****.

Last week I watched a phlebotomist yell at a cardiology fellow for trying to take the echo machine into a patient's room. "I have a stat order for a blood draw! Get out of my way until I'm finished!" He just took it.

I read allnurses, and listen to folks in the hospital. A resident looks at a nurse funny, and they are labeled a "giant a$$hole" for all time. But a scrub tech hits a student and they become some kind of folk hero, standing up to "the man". Of course, "the man" is some kid who works triple the hours of the scrub tech and takes home 2/3 their salary. And what does our staff say about this? Let it go, don't make waves. Thanks for protecting your juniors, tool.

These experiences don't just go away. They stick with you. I remember every indignity, every slap, every public humiliation. I will still remember them when I am an attending.

when push comes to shove, i'd imagine that many attendings and/or program directors don't want to hear about it because they don't want to deal with it. it's easier to sweep it under the rug and tell a resident to "deal with it" or "don't make waves", than it is to confront the situation and try to make some change.

add to that, nurses and other staff have both the time and desire to make an incident report, talk to the charge nurse and/or floor manager about it, and follow up. contrast that with an intern or resident who has seemingly a million and one things to do, decisions to make, follow up, etc. ... the last thing on most interns and residents minds is filing some sort of report.

personally, i had a situation a few weeks ago in the icu where a nurse for my patient shared concern regarding informed consent for a patient (sad case where a 41 year old guy had a massive stroke, had midline shift and edema, and became brain dead. only "family" was a girlfriend). myself, my intern were in the report room, and she was in the hallway. we discussed it, she (the nurse) said she wanted to get the social worker for clarification. an hour later, i'm asked by my program director why i was yelling at a nurse on the floor. turns out the nurse went to the charge nurse and the icu manager and told them that i yelled at her in the hallway about the situation. i had to have a meeting with the icu manager, with my intern there as a witness that the nurse was lying.

i was pissed off that the nurse would even lie, but even more that the program director had to hear about it. i imagine it's something more to be placed in the file.

i suppose i could retaliate by trying to write the nurse up regarding that sitaution or any other, but to me, it's not worth it. i'm worried about the patient care, not whether or not a nurse made me mad, or talked to me a certain way, or looked at me a certain way. i don't care about your attitude towards me, as long as the patient gets the care he/she deserves.

in many ways as a physician, it seems like a no win situation. for the phlebotomist yelling at the cards fellow, the cards fellow either takes it (like he did), or he "puts the phlebotomist in his/her place" which likely just results in people thinking he (the cards fellow) is an *** who shoulddn't talk to people like that, who mistreats those "under" him, etc. etc.

 

[smq123]

These experiences don't just go away. They stick with you. I remember every indignity, every slap, every public humiliation. I will still remember them when I am an attending.

Exactly. I sometimes wonder if scrub and circulating techs know what they're doing when they beat down on med students. They're not putting me in my "place", they're not teaching me the "correct attitude" - they're just making sure that I'll never feel comfortable around circs and scrubs ever again.

Each time I met a new circ or a new scrub, I'd get really tense until I found out whether or not this one was nice. And some of them WERE nice...but I had a hard time trusting any of them.

I don't think that they realize that humiliating the resident or the intern in front of the med student (or vice versa) does NOT make them look cool or powerful or witty - they just look like sad, loser-ish people who have nothing better to do than beat down on overworked, exhausted residents/students.

 

[fab4fan]

Oh no! No, I was just saying that you could say that I was a vindictive b****, because I just sat back and let her get in trouble. She was clearly falling behind, having trouble keeping up with the pace of the operation, and I didn't do anything to try to help her. In fact, I got a *tiny* bit of enjoyment out of watching her get flustered and yelled at.

(Well, maybe a LITTLE bit more than *tiny*....)

She didn't call me any names. If she had called me anything, then I would have complained. I complained enough on the end-of-rotation eval as it was.



Aww...you're so nice. I wish you worked here!

It shouldn't happen - you're right. But trying to come up with methods to make sure that it doesn't happen again feels counterintuitive. It isn't because the RULES aren't in place. The rules that demand courteous treatment for everyone ARE there. But getting people to follow those rules gracefully, or to follow them AT ALL...that depends on people's attitudes. And you can't change attitudes very easily, as I'm sure you're well aware!

I mean, for instance, there was one circulating nurse who really yelled at med students for EVERYTHING. She yelled at a med student for standing next to the trash can - because he might "contaminate something that is sterile." (The TRASH CAN, remember. ) She was reprimanded for her behavior towards med students.

So....she just turned around, and started treating the INTERNS the way that she had previously treated the med students. Some people just have crappy attitudes, and not much will change.

P.S. How come your computer didn't censor "b****" for you? Mine always does.

Oh, OK. Because between the hand slap and thinking she called you a bitch, I thought, "Now wait a minute...!"

I don't know how I got away with it. That's interesting.

 

[fab4fan]

We complain about it because it is damaging and demeaning. We downplay it because we are told to downplay it.

Back in the day, attendings abused residents and students, and that sucked, but at least it was within the field and could be written off as part of the "hazing" ritual. Now everyone in the hospital takes shots at residents and students, and our attendings tell us to "let it go" and "work with the team" and "don't make waves". It's total ****.

Last week I watched a phlebotomist yell at a cardiology fellow for trying to take the echo machine into a patient's room. "I have a stat order for a blood draw! Get out of my way until I'm finished!" He just took it.

I read allnurses, and listen to folks in the hospital. A resident looks at a nurse funny, and they are labeled a "giant a$$hole" for all time. But a scrub tech hits a student and they become some kind of folk hero, standing up to "the man". Of course, "the man" is some kid who works triple the hours of the scrub tech and takes home 2/3 their salary. And what does our staff say about this? Let it go, don't make waves. Thanks for protecting your juniors, tool.

These experiences don't just go away. They stick with you. I remember every indignity, every slap, every public humiliation. I will still remember them when I am an attending.

That's the problem. You come out scarred. All that stuff doesn't help make you a better doctor. The scrub who hits is no hero to me. The nurse who yells at an intern is no inspiration to me. That's the stuff that winds up making the workplace harder for everyone and compromises patient care. Why can't people see that?

I'd be willing to bet the attendings respond as they do not because they don't want to make waves, but because there's a certain degree of laziness/apathy involved. It doesn't really affect their lives anymore, so why should they get in a tangle over it? Just deal.

 

[Apollyon]

This is probably an older scrub tech. Back in the day (so I'm told) surgeons routinely smacked the hands of the residents during cases when they made errors.

Dude, you can appreciate this. Way back in 2001, when I was a third year, I was rotating on surgery. A buddy of mine was doing 2 weeks of ortho, and was in the OR with some case that had a lot of dust or whatever and they're wearing face shields. The attending took the mallet out of the resident's hand and hit the resident on the mask with it - right over his forehead.

 

[Apollyon]

What d***head. So not only did he demean his resident, and potentially injure him if he swung too hard, but (even worse) he made the instrument nonsterile. Jackass.

Right on all points.

 

[Blade28]

That's the problem. You come out scarred. All that stuff doesn't help make you a better doctor. The scrub who hits is no hero to me. The nurse who yells at an intern is no inspiration to me. That's the stuff that winds up making the workplace harder for everyone and compromises patient care. Why can't people see that?

Exactly.

I may not say anything at the time, but I remember every single scrub tech who's ever abused me (from med school on) and you can be sure there's no love lost between me and those people.

They'll get theirs. I believe in karma.

 

[Bring It On]

"Do all of you get along in here?" "Will there be any bickering back and forth...are you comfortable with each other...anyone here trying to out do the other"? nerve racking just reading this mess.....and yes, I have rotated thru the OR....

 

[Faebinder]

Exactly.

I may not say anything at the time, but I remember every single scrub tech who's ever abused me (from med school on) and you can be sure there's no love lost between me and those people.
They'll get theirs. I believe in karma.

Me too.

 

[Winged Scapula]

Although I considered it to possibly be a nursing conspiracy where fab4fan was able to type bitch and the poor medical student (smq123) could not, we had discussed removing it from the filter (its still a TOS violation if you use it to insult someone), and it is now gone.

Seems like IT chose a random time to remove it and it appeared between posts. So don't worry smq, you can type bitch all you want (sort of).