From Bullied to Buoyant: Surviving My First Years as a Perioperative Nurse

I knew I wanted to be a perioperative nurse more than 20 years ago when I was in nursing school and went through my clinical rotation in the OR. I applied for perioperative nurse residency programs and was so excited to begin my new journey. I am fortunate to work at an institution with a zero-tolerance policy for bullying and incivility now, but I was not so fortunate at the first institution where I worked. 

Bullying 

Nurse bullying was alive and well back when I started my career. The seasoned staff nurses who precepted my fellow nurse residents and me made comments to us like, “I didn’t want to precept—they’re making me do it,” “When I was your age, I didn’t need anyone to hold my hand,” and “They just don’t make nurses like they used to.” Some of those preceptors mocked us, withheld information to make us look foolish in front of surgeons, and often threw us under the bus. To make matters worse, OR administration either turned a blind eye or dismissed the issues altogether. I heard my friends from other hospitals were encountering similar treatment. 

I didn’t expect to be intimidated; I wasn’t in school or in general, and my residency program was overwhelming to say the least. I was a good student, but now I had to learn all new skills and start at the bottom again, which was frustrating. I was a slow learner in this environment, which surprised me. Learning to prioritize with so much information being thrown at me by nurses who “ate their young” certainly didn’t help. 

I often felt wrong for choosing the OR as my specialty, as if I would never do well in my unit. To make it worse, three months into my new career, my nurse manager suggested that I go back to school and try something else, because I just wasn’t going to be a very good nurse. I was no quitter, though! 

Weathering the Storm 

I tried not to let any of this get to me. I knew I was smart and I was a good student in school; I just needed to learn some skills to help me. I would have to learn prioritization (Sidebar 1). I bought a small notebook and kept it in my pocket. I would write things down in it to jog my memory when second-guessing myself. I reviewed it throughout the day, writing down anything that might help the next time I performed that task or circulated or scrubbed a particular type of case. I also invested in a copy of Alexander’s Care of the Patient in Surgery and looked up my cases for the next day each night before I went to bed. 

Sidebar 1. Prioritization Tips 

• Be prepared ahead of time. Check the schedule the day before if you can, arrive on time (or early if you’re allowed), and be sure you have all of the necessary supplies and equipment available. Delegate when necessary.
• Once the patient has entered the room, assisting your anesthesia provider takes precedence over other tasks. Make sure there’s an airway established and the patient has been induced and intubated before you worry about anything else.
• The chart is the last priority. Don’t sit down until everything is plugged in and working, and everyone else has what they need. 

Eventually, I transferred to a different area of the OR where the nurse preceptors were kind, patient, and welcoming to new nurses. Some of them even became mentors. From them, I learned that I had to be kind to and patient with myself, as they had been with me. 

Career Growth 

I looked for growth opportunities. I volunteered to do some cases to strengthen my skills to help future patients undergoing complex procedures. I offered to take nursing students with me for the day, and rather than keep them in the corner, I was happy to teach them what I had learned about patient care in the OR. I was eventually asked to be a preceptor for new nurses, and I was honored. 

Five years after beginning my career in the OR, I got my CNOR. About 10 years after that, I became a perioperative nurse educator and taught new nurses using some of the skills my mentors used: patience, perseverance, and kindness. Five years later, I even dabbled in nurse management for a few years. I found my ultimate calling was education, however, and I returned to my role as an educator recently, which I enjoy immensely.  

Lessons Learned 

If you find yourself overwhelmed or frustrated, be patient with yourself. Buy yourself a notebook for notes and a copy of Alexander’s to review and prove to others, as well as yourself, that you will be a great perioperative nurse. If you are being bullied, as I was, I have some tips for dealing with it. First remind yourself that you are intelligent. You’ve already survived nursing school, and you can get through this as well. Next, speak to your educator about switching preceptors. If needed, you also can talk to your manager or someone from human resources (Sidebar 2). Finally, stand up for yourself. You don’t deserve to be treated rudely. Be polite, be professional, and do it privately (Sidebar 3). 

Sidebar 2. Tips for Addressing Bullying 

• If you’ve tried speaking up to the bully directly (see Sidebar 3), but it’s not working, you can take the following additional steps:
  • Tell your educator that the preceptor/orientee relationship you’re in doesn’t seem to be working well for both parties. If you feel comfortable discussing specifics, they may be able to help navigate this with your manager, and at the very least, help with a new preceptor, if necessary. Not everyone was meant to teach, and orientees learn differently and at different speeds.
  • Be honest with your manager. They are your leader, and they need and want to know that this is happening in your department. 
  • If all else fails, go to human resources. A good human resources representative can help navigate the waters of workplace incivility. Be prepared with notes, including dates, times, and details of each situation. 

Sidebar 3. Example Phrases to Use When Speaking Up to a Bully 

• It might be helpful to speak to the person in front of someone else. The following are examples of phrases you can use:
  • “I’m trying to learn about new _____, and the way you are speaking to me isn’t helping much. I’m sure we both want a good outcome today. Let’s take a minute to discuss this privately.”
  • “I know we both want what’s safest for our patient. Speaking to me in that way is not going to produce a safe outcome for them. I need your help with this task.”
  • “I’d love to hear your honest feedback, but let’s be professional about it.”
  • “The way you are speaking to me is unacceptable and unprofessional. I’m happy to discuss this in a calm, polite manner.” 

Be sure to look for opportunities to enhance your career, like choosing a service or niche that interests you or volunteering for a committee or to be a preceptor. I have found that getting more involved in the workplace not only enhanced my career but helped me feel recognized, heard, and valued. Finally, keep in mind why you came to the OR in the first place. Have faith in yourself, and you can become a great perioperative nurse! 

AORN Resources

Open access:

AANA, AORN, ASPAN Position Statement on Workplace Civility

AORN members can access:

Back to Basics: Preventing Workplace Bullying - AORN Journal

Addressing Workplace Incivility Among Perioperative Nursing Team Members - AORN Journal

Preventing and addressing incivility in nursing - AORN Journal