Bill - Cut the Mustard

Bill -







I became a surgical assistant after a long journey from hospital housekeeper, to orderly, to surgical technologist, to nursing school and a RN, and then to surgical assistant training. It's a satisfying position; I feel that I do a good job, and the people I work with confirm that.

When I wake up in the morning, I don't dread going to work--on the contrary. When I'm busy at work, time becomes irrelevant, because I'm not watching the clock. I'm focused on what I'm doing and I'm concentrating on the work. It wasn't like that when I started out. After the first day as a surgical assistant, my whole body was tense and sore. But I told myself things would get better, because I knew skills take time to develop. As I began to relax, I enjoyed myself more, had more confidence, and my body loosened up.

I found out that surgeons are not bashful. They're not afraid to tell you you've done it wrong. But after awhile, as my skills developed, they actually became complimentary, and told me they enjoyed working with me. Eventually, I would be greeted with "Thank God you're the one that's on call tonight." Which is a big ego boost. And so different from the early unskilled jobs I had, where I was the outsider looking in. I'm glad I put time and effort into getting training to improve my skills.

I once had the experience of working with a surgeon who was impossible to please, for me anyway. At one point I felt I couldn't tolerate his treatment of me, so I spoke up. We talked privately, and I refrained from telling him off. I just said, "Obviously, we're not doing well together. What is it I need to do so things will be better between us?" After that we understood each other better and things were smooth.

One of the things that's frustrating about being an RN is the necessity for having a written or verbal order for so many things we do, even simple, obvious things. Some physicians don't seem to understand that, because I hear them complaining, "Those nurses can't even do this without calling me." They don't seem to understand that this is a legal requirement.

This creates a power issue, but not all physicians buy into that. I remember someone calling one of the physicians "the boss," but he didn't want that title. He said, "I've been to school longer than you have, but we're all here together. We're all working for the patient." He didn't think of himself in a hierarchical role. As it happens, he is part of a cooperative, and they seem to be more laid back, or more realistic – more cooperative.

The higher the academic degree, the farther up in the hierarchy you go. I'm an associate degree nurse, but I also have a bachelor's degree in another subject, English literature."I say what needs to be said, and usually people are so glad they're not getting screamed at, they say "Ok. Cool. No problem." I have an issue with the whole system of degrees in nursing. The nurses who graduate with a two-year degree have already earned at least 65 credits before they enter the program, including courses in all the basic sciences and liberal arts. After two years in the nursing program, they usually have from 150 to 165 credits, and a lot of patient skills. The four-year degree people start with zero credits and graduate with 180 credits and a BSN. There's no acknowledgement of what it takes to get a two-year degree. If I were a young man without a family, starting from the beginning, I'd become a nurse practitioner.

I've always felt that the profession of nursing as a whole has an inferiority complex. Maybe it's because it's been a predominantly female field, and they felt overpowered. There's no denying that. On the other hand, I've worked with female docs who seem to feel that I, as a male, could do nothing right. Of course there are more male surgeons than women, so what you see more often is women being put down. But I'd say the gender issues work both ways.

Conflict isn't only gender-based; it is not unusual to see it between nurses and doctors. Some docs are very ego driven, and they don't want to be told there's another way of doing things. "By God, this is my way and this is how we're gonna do it, and that's all there is to it."

I don't have trouble asserting myself, maybe because I don't feel threatened. If someone doesn't do something quite right, I don't feel like they're stepping on my turf. It's not personal. I can say "This isn't quite right," because I believe I know what's right for the patient. I say what needs to be said, and usually people are so glad they're not getting screamed at, they say "Ok. Cool. No problem."

But in any case, what's missing in the profession, in my opinion, is a lack of identity as a group, and a valuing of the nursing field. We're very fragmented. For instance, I'm an RN, but I seldom think of myself as an RN. I think of myself as a surgical nurse and a first assistant. I'm in a class with myself, and nursing is not my identity. My identity comes from the work I do in the operating room.

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