[carcha]

one of my new, inexperienced colleagues is irritating me no end. She wants to scrub for everything, but then as soon as the patient is draped wants a stool. for some of our cases, eyes ect when the surgeon is sitting it makes more sense. However she begged and begged to do a case this week. the drapes were barely on when the fimiliar "STOOL PLEASE" was called for. The case was a LAPAROTOMY. I refused and explained why ect , she wasent happy. was I wrong?, do u sit for such cases

[shodobe]

You can sit for certain cases such as eyes or AV fistulas and maybe ortho hand cases. Sitting for a lap? She better be about to pass out or something or she will get ignored. Disrespectful towards the surgeon also. Mike

[carcha]

thanks mike now I dont feel like such a ***** for refusing

[chartleypj]

How on earth can a scrubbed person hand instruments and see what a surgeon is doing perched on a stool? How does she think she will maintain a sterile field sitting? I agree, it is disrespectful.
Is she out of her mind? Please do her a favor and direct her to AORN's Standards and Recommended Practices, 2003. Tell her she can SIT to read this.

Paula

[kathyann]

AORN recommendations state that it is proper to sit when scrubbed only if you will be sitting for the entire case ( IE: eye cases, AV fistulas...) So, you were not wrong.

That said, we do have a scrub tech with a bad knee that also sometimes sits on a stool if we are stuck waiting for longer than expected for the Dr. to arrive. The best solution is to scrub in and set up, then break scrub until the Dr. gets there if you are uncomfortable standing for that period of time.

[witzend]

We had this discussion several months ago when the surgeon was delayed and a scrub was caught sitting down waiting. The rule of 'sterile' levels was involked and we were all forbidden to sit when scrubbed. Naturally all sorts of hackles bristled and qualifications listed re A-V fistulae etc, etc... Perhaps there's a reason she needs to sit down - perhaps she needs support stockings, cardiovascular assessment, fitness training or someone's said something to her early on re the perils of long hours on her feet? A mystery to be solved! We had a nurse who wanted to scrub for everything too. Two years later he's one of our mainstays and an oasis in a desert of disinterested scout. If all else fails, remove the chair from the room!

[squeek]

In oz we too sit for the odd hand case, facial plastics etc however wouldnt dream of sitting for anything else.....

the most enthusiastic scrubbers tend to stay in OT the longest...

[BarbPick]

OK, lemme give this a try.....If this is a Nurse scrub, she is in violation of the state nurse practice act. If your are the RN Circulator, if you allow it, you are in violation of the state nurse practice act. I took the Medical Legal Consultant Course, have practiced on the side and am ready to take the certification exam (yay)!

As a medical nurse for the past 28 years, I still remember Nursing 101.
I remember during my rotation in the OR, in-between passing out from all the blood, (j/k) that you can only be sterile if your hands are near your chest, high above the waist. They have to be in complete view of the circulator. The RN Circulator is the state's Legal witness of the proceedings.
Now I render my formal opinion (gimme a break, OK)?
The scrub person is wrong, and you are legally responsible. At the least, say no, at the most, kick her out of the case.
Barbara

[shodobe]

Barbpick, I think this is a little too picky. I have been doing this for 25 years and I will sit down whenever I can to save my legs and back. This is far more important than some obscure legal issue and besides where are you going to see any legal action based on whether a scrub sits down or not? I am comfortable in knowing if I have contaminated myself or not and do not have a problem, when I circ telling the scrub if they are getting close to contamination. I think we can as OR nurses be a little anal on certain stuff and I know you will say that you are only quoting your states NPA rules. I do agree however that a person can't sit for the type of procedure that was mentioned above and only should sit when the whole scrub team sits, but when I am scrubbed in and waiting for the surgeon to appear, I sit. Mike

[carcha]

thanks u all, I really wondered if I'd been around too long and lost touch with the real world , nice to know some things havent changed and common sense is alive and well.