Been on assignment for quite some time at this facility, it is pretty much staffed with travelers, maybe 10 staff member’s total. Which to me usually means management is poorly managed. People need jobs, and if they feel valued at the workplace they typically stay. This assignment does not have very difficult surgeries either, so that really shows me there is a critical failure in management chain. They asked me if I could pick up one weekend, they were short staffed to be in charge, I looked at the incentive pay and agreed.
I arrive on Saturday to the desk and am surprised to see the weekday charge nurse there as well. I asked Rudolph what he is doing here, and he said that they also asked me to pick up. I assume that means I am just an extra nurse, which I don’t mind doing cases instead of sitting at the desk anyway. Looks like the only case coming in is an exploratory laparotomy for bowel perforation, and it’s with a doctor I like. I go into the room and begin to prepare for my case. I notice that the transplant hall has both rooms going and seems chaotic down there. Transplant rooms have their own travel staff, and we typically never cross paths.
I finished my ex-lap, with no issues. I begin to clean my room up, when Rudolph approaches, he is offering to help clean up my room which I find strange because there are no other cases, I wonder what he is up to. He nervously approaches me with a question, “ummm do you mind relieving in 12?”, I asked him isn’t that transplant? He states its “just a nephrectomy”. In that moment I wonder if he truly believes that because he is so green, or he thinks I am dumb enough to believe him. I weigh my options, I can technically say no, as I know this is a transplant case and I am not on those teams, or I can oblige and offer to help and learn something new. I decided to agree, not mentioning to him that I knew it was a transplant, and not a nephrectomy.
Arriving in the room I am greeted with a huge smile by the transplant manager who is currently circulating the room. She says how much she appreciates me coming into the room, as she has another case also running in the children’s hospital connected to them. I tell her no problem, just tell me what I need to know that is different, so I don’t mess anything up. She instructs me to write down off ice time, clamp time, unclamp time, and starting a clock on the wall for the surgeon to see. I tell her I will, and I will holler if I have any questions.
I approach the field just assessing the mood, the two surgeons communicating, and the scrub Dana seems frantically struggling to assist them in their requests. I sit in a stool close to the field so I can watch and not miss the times I am supposed to write down. I see the kidney laying in a bowl of ice, and I watch the scrub hand the kidney to him, I ask “is this off ice time?”. The surgeon snaps at me “No, I will tell you when off ice time is!”, with such a hateful tone, I can tell this surgeon is not pleasant. I watch this surgeon continue to give Dana a hard time, asking her berating questions about her skill level as she desperately tries to appease these two surgeons. I try to encourage her when I can, as I can tell she is completely over it. After listening to him snap and me and her, I decided I was no longer going to act engaged in this case and started charting and figured he would tell me when he is off ice.
About ten minutes go by and I hear transplant surgeon yelling “what is my time”, I turn around from charting and ask him to repeat the question. He states, “ I guess that means you don’t have off ice time either then?”. I told him I didn’t hear him state any of those time over his loud music, and asked if I verbalized or acknowledged his statements at all? He ignored me. I walk down to the timeclock and started it, and he looks at me ready to re-engage in the fight, asking me the point of starting the clock? I told him I figured it was a mental thing for him to see if moving, and he says “well that’s pointless”.
At this point I am completely over his behavior, as I pondered the last week of training in the HR from the facility about standing up for yourself and not accepting bad behavior. In that moment I tell the surgeon, Hey this hospital has been empowering me to stand up for myself and I do not appreciate the way you are talking to me right now, belittling me. He doesn’t acknowledge me, just speaks to the other surgeon and ask’s him “have I talked down to her?”, which the fellow surgeon say’s “oh no, she hasn’t seen being talked down to.” I firmly state loudly in the room, I don’t care how you guys want to treat each other, but I personally will not accept your rude and obnoxious comments.
The scrub tech makes eye contact with me, as in shock. Both surgeons stopped talking about it. The case is beginning to wrap up and I find out that the tech had actually also picked up this shift to help, and I state to her “ how much this patient appreciates her coming in on her weekend to get a new kidney.” As the surgeon breaks scrub he tells the tech she did a great job. At that point she was so exhausted and just spent the time cleaning up the room laughing at my comments to him as I guess he is one of the most difficult transplant doctors there. Instead of appreciating me and Dana being there for his case to be done, he tried to use his nervous or hateful energy to put us down, and I was not going to tolerate it.
Healthcare is ruthless and dealing with surgeons I have learned that you must teach them your boundaries and clearly communicate what you will and will not accept. It is survival of the fittest in these rooms. Leaving that day with Rudolph’s legs kicked up at the desk, not once did he offer to come in the “Nephrectomy”, In my mind I think of what a poor leader he is. I am just a visitor here, and my shift is over.