Beyond Language, Cultural Barriers, General Surgeons from Russia, Syria Flourish at Mercy as Surgical Assistants
According to the United States Bureau of Labor Statistics, the demand for surgical assistants is increasing faster than the average growth rate for jobs nationally. Hospitals throughout the U.S. often find it challenging to fill this critical position, responsible for preparing operating rooms, arranging equipment, and helping doctors during surgeries.
According to Judy Melnyk, MSN, RN, CNOR, CSPDT, when traditional recruitment strategies for surgical assistants didn’t yield qualified candidates, Mercy held a job fair, and two general surgeons, Mikhaeil Zahlouk from Syria and Andrey Zhevlakov from Russia, attended. Both had obtained legal immigration status and passed their exams from the American Board of Surgical Assistants (ABSA).
Normally, the training period for a new surgical assistant is three months. However, surgery in the U.S. differs in several significant ways from surgery in Russia and Syria.
Judy says, “I knew a longer training period would be required for Andrey and Mikhaeil, but, having 20 years of experience in overseas medical mission work, I also understood where they were coming from and their work ethic. I believed given the opportunity, they would work hard, succeed, and be committed to Mercy. That would outweigh the extra time it took to train them.”
Andrey and Mikhaeil were both hired on April 14, 2017.
Coming to America with Nothing
Andrey, originally from Siberia, describes his entry into the United States in 2016 as “winning the green card lottery.” He adds, “It’s almost impossible to emigrate from Russia to the U.S., and we arrived with nothing but our suitcases.”
Andrey and his wife left parents behind but were able to bring their adult daughter, who is now 22, and their dog with them. Upon arrival, they lived with a friend of Andrey’s who emigrated from Russia many years ago.
Andrey describes the move as something he had always wanted to try. “Everything was fine in Siberia, but I like to be challenged, to learn new things, and to experience a different kind of life from what I’ve always known,” he says.
For Mikhaeil and his family—Christians from the town of Maharda in Syria, where a civil war has been raging since 2011—life was anything but fine. “When missiles began dropping near places where children went to school and played, we knew it was no longer safe to stay,” he says.
Mikhaeil, his wife, and their two children left everything in Maharda and sought asylum in the U.S. in 2015, receiving temporary protection status, which was renewed earlier this year. Their youngest child was born two years ago in South Carolina where they stayed with Mikhaeil’s brother-in-law before moving to Canton.
“When Mikhaeil came to Ohio, I asked him if he needed time to unload his U-Haul, and he told me, ‘We have nothing,’” says Judy. “Andrey, Mikhaeil, and their families were all sleeping on blow-up mattresses and wearing hand-me-downs initially. My church got involved and helped provide them with household items.”
Mikhaeil stays in touch with family still in Syria by Skype and text as often as possible. He says, “Sometimes they are safe, and sometimes they are not. My wife’s other family members are trying to come to the U.S., but it’s not easy.”
Overcoming the Language Barrier
When Andrey and Mikhaeil arrived for orientation at Mercy, both received a locker and combination lock. Neither had used a combination lock before.
“I realized very quickly how many things are part of our culture, stemming from knowledge and experience we take for granted,” says Judy. “After I spent 90 minutes showing them how to use the locks, they ended up putting them on the lockers backwards. I had to lie down on the bench to remove the locks and put them back on the right way.”
Other cultural differences included labor laws and practices and paycheck processing. “Andrey showed me his first paycheck, curious about the difference between gross and net pay,” Judy says. “I told him, welcome to America. It’s called taxes.”
Not surprisingly, language proved to be one of the biggest issues. Both men had previously learned basic British English in school, but it was of little help with complex medical terminology and the widespread use of American slang. By the second week of training, they were exhausted from the pressure of trying to comprehend and respond.
To improve language skills as quickly as possible, Andrey and Mikhaeil enrolled in English as a Second Language (ESL) classes, and Mikhaeil also hired a tutor for additional work on conversational skills. At Mercy, they were also given special permission to have their cellphones at all times for translation purposes.
Judy also had to coach staff members to rephrase, to speak slowly, and to ask Andrey and Mikhaeil to repeat instructions. “Once that was in place, it was a turning point,” she says. “They started blossoming in their work.”
“Even now, I still feel like a baby when it comes to American English,” Andrey says. “My dog still doesn’t even understand English commands.”
Judy says the language barrier has resulted in many amusing stories. During one operation, a surgeon needed medium-heavy forceps, called Russian Forceps, and said urgently, “I need the Russian!” Andrey replied, “I’m here!”
Differences in the Operating Room
The operating room itself presented additional challenges. Trained as general surgeons, Andrey and Mikhaeil had to learn 14 different specialties as surgical assistants, using new equipment, instrumentation, patient positioning and draping techniques, multiple types of sutures, Foley catheter placement, scrubbing, gloving, and more.
“We appreciate the patience of everyone who helped train us,” says Mikhaeil. “In addition to Judy, there were many others who spent a great deal of time with us.”
Andrey, Mikhaeil, and Judy credit Mercy employees Stacy Eberhart, RNFA, first assistant; Beth Holland, CSA, first assistant—specialist; Andrew Miklos, CSA, surgical assistant; and Dawn Harriman, CFA, first assistant—generalist.
According to Judy, the benefits have been worth all the effort. “Throughout eight months of training and beyond,” Judy says, “you couldn’t ask for better employees. They are competent, kind, hard working, always smiling, and willing to do anything you ask of them. What organization wouldn’t want an employee like that?”