Any good advice for learning to scrub?
- 0Oct 22, '07 by hotdog19dI'm going to start my second day of scrubbing tomorrow, any words of advice? Today I started with the basics, gowning, gloving, passing instruments, and cutting suture.
- 6Oct 22, '07 by mikethernSafety first. Wear biogel gloves as inner gloves to help prevent getting a latex allergy. Wear ortho gloves as outer gloves to decrease the odds of needle stick. Always pay attention to where the sharps are on the field. Surgeons will often put needles back on your mayo without saying "needle back" like they should.
When you put used needles into your needle book, put it in so the sharp tip is inside the foam. I've seen people put in the needles with the sharp tips stick out just waiting to stick someone.
Label ALL medications on the field. All basins and syringes should be labeled.
If someone scrubs in during the middle of a case and wants a towel to dry his hands, don't touch the towel with your bloody gloves. Use a clean clamp to give the towel to him.
Here's a tip for gowning and gloving. Open the gloves packet so that the fingers of the gloves are pointing to you instead of pointing away from you. Then put your right hand over the right glove (which is on your left now.) Then you can lift it up and it will already be in the right position to glove.
If you use the masks with the built-in plastic visor, bend the visor down the middle before you put it on so it won't touch your face as much which leads to fogging. Tie the upper straps tight, but tie the lower straps very loose so your breath will come out the bottom instead of fogging your visor.
If you sweat a lot, wear a headband under your hairnet.
If your back table is totally set up before the patient comes in, help your circulator when the patient comes in and then scrub at the last second. Your circulator will appreciate it.
When setting up your back table, offer to count as soon as possible so your circulator will have one less thing to worry about.
When you need something from your circulator, say please. It's just common courtesy.
If your circulator wants to give you medication out of a glass ampule, ask for a filter needle. After you draw up the medication, remove the filter needle and put a regular needle on the syringe.
When a circulator gives you heparin, make sure he shows you the vial that the heparin came from. Heparin comes in many different concentrations so you want to make sure you are not giving an overdose. Patients have died this way.
Another pet peeve of mine. Do not gown off of the back table. Gown off a mayo stand or other table. Lots of scrub people gown off the back table which is incorrect because you are not supposed to reach over the back table with bare hands especially if they are wet.Last edit by mikethern on Oct 22, '07
- 3Oct 24, '07 by RezidenturaScrubbing is in my opinion a total OTJ experience. The more you do it the more you learn etc...
Let me tell you what not to do:
Don't try and tell your experienced Scrub tech how to do their job (Even if you know their wrong) Make friends with them and you'll learn loads
Don't try to invade someone else's space. Some Scrub Tech/Nurses are very territorial and will withold knowledge if they feel you'll get attention from their Surgeons.
Don't be afraid to join a service early on. I know it's frowned upon but once you become expert at a particular service picking up on others is a breeze.
Don't shy away from difficult situations. Difficult surgeons will never change, but the more you are around them the less they affect you.
Developing a thick skin is a must. The more you avoid these situations the harder they are to deal with.
What to do:
Be punctual. If you get in the room early and help open up etc... You demonstate a willingess to learn and will foster teaching from others
Be conservative with questions especially intraoperative. The less you talk the more you will be able to hear and experience. Save the chat for after the case and times when stress levels are low
Be careful!!!!! Move deliberately, know your sterile field and as was mentioned your sharps. If you get nervous and jittery it's time to breath and do your best to relax. There's nothing like dropping a custom made Implant to ruin your experience.
If your not familiar with a case, do some afterwork homework on the net and read about it or watch a video.
Get on Pubmed and read some abstracts. This alone can give you some insight you won't get from some AORN magazine or Educators handout
- 0Oct 28, '07 by Marie_LPN, RNIf you happen to be with a doc who you know loves to teach, ask them questions if you think they won't mind, and tell them why you're asking. Several docs i've worked with say they like that because it shows the willingness to learn. Plus it'll reinforce to you why things are done the way they are done.
- 0Oct 30, '07 by ewattsjtgreat advice from everyone!!!
i would also like to add that when counting whether on the initial or closing, do it at an appropriate time. the circulator can be busy with something important, like giving meds, positioning a body part to prevent nerve damage, etc… i know in closing you are supposed to on layers but patient safety overrides that.
as marie said, some docs love to teach. ask the questions at appropriate times, if you see them struggling to do something or getting annoyed, of course don’t ask.
alexander’s, “care of the patient in surgery,” is a great resource to look up procedures the day or night before.