Know it all scrub techs

Specialties Operating Room

Published

Hi-

I have been a circulator in the OR at a major level 1 trauma center for 2 years. I work at night, so I do all services, mainly traumas and transplant. I have learned how to work well under pressure and my sense of humor and flexibility have really increased since doing this job. I love it.

However, I am wondering if I can get some advice on how to deal with a couple of scrub techs who feel they know EVERYTHING. They have been there for years, and they will correct me on how I hook up suction, correct the doctor on how he stitches, etc etc. I have appreciated the things they have taught me, because I need their knowledge and it is very helpful for the most part. I don't mind being corrected on things pertaining to their job that they know, but it really upsets me that they think they can do my job and that I am irrelevant in the picture. I had one instance where the pt was prepped and ready and the attending was still not in the room. The tech starts yelling at the resident that he can start. I said no you can't start w/o the attending. Even the resident said no, I can't start. It is my responsibility to watch those things. So the tech gets all upset with me, that I'm not listening to her and I should be. WHY?? That is not a tech responsibility-it is a nursing responsibility.

A few have commented how our job shouldn't take a nurse, and that they are the ones doing the most in the room and getting paid the least. My response to that is-take your butt to nursing school!! I don't want to become the raunchy nurse, and a couple of times, I have said something. I appreciate you have been there for so long and you know so much, but please don't discount what I DO know and understand that every once in awhile, I might actually know something you don't!! How on earth do I handle this?? I really love my job and the majority I work with, but it is a common complaint amongst the nurses who don't scrub. I am also learning to scrub and there are a few who aren't happy about that. Why? If anything, it would make your job easier because I could relieve you for lunch!! I don't understand it. Any thoughts would be helpful.

rbs105

Well.. it certainly can be a problem and seems to be universal. I've worked in (2) different OR's and you have your good techs and your bad (smart alek know it all's) which doesn't mean that the smart aleks don't know what they are doing. I've seen exactly what you are describing at the hospital I work at now. We have (7) CST's. (3) of them are absolutely wonderful to work with, are team players, simply want to come to work and set up the case, perform the operation, break down the case, and go home. The other (4) want to come to work, stir up a bees nest, want everyone else to do their work and think they know how to do the RN's job and the MD's job better. Plain and simple.. it stinks working with them every single day. Any little thing that they don't want to do or think they know how to do better they feel that they have the right to do. They don't want to come into the room before the operation and count, yadda yadda. It's an aboslute nightmare for me some days. Just as a petty example, I came from a hospital where you counted the little FRED sponge on a lap chole. It was up on the sterile field, was small enough where it really could end up in a trochar hole. I would ask to count that and the (4) smart alek techs refused to count it and all told me that "we don't do that here" The other (3) nice techs would just count it simply because I asked, wouldn't think a thing about it. I certainly feel for you because I go through this each and every day. The end result is that I've talked with the lead RN co-ordinator and it went nowhere. Right now I'm looking for a different job and have my resume out there. Another funny story is that one of my best friends from nursing school got a job at another OR in a town about 45 minutes from me about 4 months ago. At first he absolutely loved it. This past weekend we went to a show and out to lunch. Guess what... the whole time he cried to me about the same thing we are discussing here. The techs are eating him alive. Asking him for silly stuff that doesn't need to be during the procedure. Amazingly.. telling him that he's got the suction, etc. "hooked up wrong" etc. He's already looking to transfer out of the OR after only 4 months because of this exact same thing. I hear about OR's where it sounds absolutely lovely to work at, however at the 2 places I've been to it hasn't been the most fun. One saving grace after being an OR nurse for almost 3 1/2 years is that it looks great on a resume when you are applying for a job somewhere. I've picked up skills that other RN's have no idea how to perform because they weren't shown any of what we know in school.....

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Specializes in CST in general surgery, LDRs, & podiatry.

i've been in that position myself - as the "target" of know-it-all techs who think it's ok to "throw their coworkers under the bus" and i'm a cst too! i have been hassled by an ojt tech who is stuck where she is because she was trained "in-house" and has nowhere else to go because she's not certified, or eligible to take the test, so she takes her misery out on the rest of the world. one day, i was opening my case, and she came in the room behind me and started picking up the glove wrappers off my table with her bare hands and dumping the gloves out on the table. i was flabbergasted, and asked her what the hell she thought she was doing with my sterile field??? her only reply was that "i do it that way all the time." i told her to get her dirty hands off my setup, and get the hell out of my room, and started tearing it down to redo it because as far as i was concerned, she had contaminated the whole thing when she started rumaging around on my table. she just smirked and walked away. i took it up with the or supervisor later on, and it seems that this person has everyone there "cowed" but me. i got my setup redone for that case, and kept my eye out for her from then on. i went in her room on another day to look for an item, and she was scrubbed in and set up, waiting on the patient and the rn. she asked me to get her a pair of mayos and forceps with teeth, because she had forgotten them. i said ok, and went to fetch them out of the instrument bins. i brought them back and started to open the peelpacks, and she says "oh - no, i asked for metz and russians." i said "oh no you didn't - this is what you asked for and it's what your getting." i threw them on the field and walked out. it wasn't the last time we would tangle, but she didn't seem quite so anxious to take me on as she had before.

on my first job out of school, i had a coworker "set me up" on a case by telling me i wouldn't need some of the things i thought were obvious and that i would need other things instead. so, being new and not knowing any better, i got what he recommended, and it turns out of course, i was right and had been 'thrown under the bus' by someone who was supposed to be helping me. he got his later on though, when mr know it all got caught by me after he had run a video colonoscope through the steris processor without the cap on the video connection, which completely ruined it. i left it where it was, and went and got the or supervisor - as i should have done - to leave her to deal with it. his name was in the log book as having been the one to run it, so it was all on him. i never said a word to him about it, but from then on, he left me alone.

it's a sad state of affairs when the people you are supposed to be working with do everything in their power to make your life hell. they are bullies - just like the ones in school - it's no different, except they are adults and are supposed to know better. lateral violence is a recognized phenomenon in the health care field, and it should never be tolerated. there's just no point to it - it takes so much effort to make your coworkers miserable - and that effort could be spent so much better on making life more pleasant. it's distressing to me to hear about such people also, because they make the rest of us look bad, and it sure makes life harder for those of us who do know our place and try to do our jobs well. there are good and bad examples of every profession though - plumbers, mechanics, policemen, techs, rn's, doctors, housekeepers, cna's - you name it - it's got its share of bad apples. gotta pick though the bad ones to find the better examples sometimes.......and hope for the best!

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Specializes in NICU- now learning OR!.
and I've done plenty to help my circulator...help prep, put foleys in, positioning.

Wow! There is not one tech where I work that would do any of those things! Even the nicest, most helpful scrub does nothing to help position, prep, generally speaking, nothing. Of course many times they are sterile so they can't...but some cases they have actually stood there and watched me run around trying to do everything without moving their butt off of a chair

Jenny

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Originally Posted by ORTech2RN viewpost.gif

and I've done plenty to help my circulator...help prep, put foleys in, positioning.

Wow! There is not one tech where I work that would do any of those things! Even the nicest, most helpful scrub does nothing to help position, prep, generally speaking, nothing. Of course many times they are sterile so they can't...but some cases they have actually stood there and watched me run around trying to do everything without moving their butt off of a chair

I am sorry that you work in such a teamwork unfriendly environment. At my facility, nurses and techs are assigned to assist the surgeon during the procedure and scrub in with the doc. The assistant, regardless of title will help with all of the above things. And, if assigned to the case where the doc brings a PA or such, the "assistant" helps the circulating nurse in any way allowed. I am a CST, and have spent an entire case on hustle mode to help my team mate the circulating RN. I do not claim to be able to do their job as effectively as they do, but help is help. It requires a team to make an operation a success, and to expect or allow any less is bad for our patient. I understand the scope of my knowledge and training, and to provide any less is unjust to those who trust me with their care.

It is sad that you are expected to provide all that you can without support.

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Specializes in Operating Room.
Wow! There is not one tech where I work that would do any of those things! Even the nicest, most helpful scrub does nothing to help position, prep, generally speaking, nothing. Of course many times they are sterile so they can't...but some cases they have actually stood there and watched me run around trying to do everything without moving their butt off of a chair

Jenny

In some states, like mine, the tech cannot put foleys in, or prep. There are quite a few things that they cannot take over for us. All I ask of the tech is that they set up in a timely fashion, count in a timely fashion, that they are well prepared so I'm not running for every little thing and that they are professional. Most techs are very helpful and nice to work with, but there are always the few bad apples. But, this goes for nurses too.

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my facility operates the same way that zerby's does. the hospital employee who will be assisting the surgeon, be it cst, rn, cfa or lpn or whatever, will "second circulate".

they are not allowed to “take over”, they assist the primary circulator as the duties are delegated. the idea is that we work together as a team to provide the best outcome for the patient.

yes there are some states that limit the scope of practice for the tech but there are some that see that techs who have met certain educational requirements can lend assistance the nurse and make their jobs easier, affording the time for them to give quality assessments rather than have someone standing around watching as the nurse struggles.

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I totally agree!!!

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Specializes in Operating Room.
my facility operates the same way that zerby's does. the hospital employee who will be assisting the surgeon, be it cst, rn, cfa or lpn or whatever, will "second circulate".

they are not allowed to "take over", they assist the primary circulator as the duties are delegated. the idea is that we work together as a team to provide the best outcome for the patient.

yes there are some states that limit the scope of practice for the tech but there are some that see that techs who have met certain educational requirements can lend assistance the nurse and make their jobs easier, affording the time for them to give quality assessments rather than have someone standing around watching as the nurse struggles.

i love the helpful scrub techs. my point was that by my state's law, certain tasks cannot under any circumstances be delegated, such as foleys, preps, giving meds,counts, assessment. scrub techs can certainly run for things and other tasks such as that.

we do not do "second circulator" where i'm from as a rule-usually when we do, it's a new nurse in training. i think my personal preference is to have everyone performing the job they were hired for-too many hands in the soup can confuse matters. i'd rather have the scrub sterile and ready to go, personally. sadly, i've been exposed to some that wait until the last possible minute to scrub and count. i suppose to some of them it's a weird badge of honor but to the rest of us it's just plain aggravating.:banghead:

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I have been a certified surgical technologist for four years. I also just passed the NCLEX and hope to land a nursing job in the OR.

There are many know it all surgical technologists in the OR (including myself). During my 2nd year as a scrub, I questioned the positioning of a new resident for a case that I have scrubbed many times. The nurse pulled me aside and said to me firmly that I should never do that again. She didn't start a fight with me nor did she use her power as the circulator to tell me off. I forgot what words she used but she was very professional. Since then, I only offer my suggestion when I was asked. I continue to work well with this circulator.

Now it is my turn to learn how to work with know it all scrubs.

I'm sorry to hear that you refuse to be an advocate for the patient when you see something that is questionable. It is everyone's job in the OR, not just the nurse's, to be an advocate for the patient. If anyone sees something that may be against policy or may jeopardize the patient in any way, you MUST speak up. There is a professional way to do so. But you cannot be content with "not speaking unless spoken to" just because you are "only" a scrub tech. EVERYONE in the OR is important and everyone should be willing to advocate for the patient.

I'm sorry, but I believe that the circulator had no business pulling you aside and telling you to firmly keep you mouth shut. She should instead be thanking you for speaking up for the patient.

Let's not forget the reason we do our jobs :)

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Specializes in OR, community nursing.

Kimbalips,

Regarding the particular case that I mentioned in my message, the patient was not at risk. It was just the physician's preference that I pointed out to the nurse. Anyhow, if I do see that the patient is at risk, I would definitely speak up.

However, we all do things differently which may or may not have an impact on the patient's final outcome. I was trying to point that out in my message especially I was not a nurse at that time and I was not the surgical resident. I was not in position to tell them how to do their jobs.

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Specializes in Med Surg, Case Management, OR.

I left the OR because I couldn't stand being micromanaged by techs. I know I'm a darn good nurse and I take my job seriously. But it's the little things that made me burn out. I also wanted to learn to scrub but had the educator tell me that they were only taking "good nurses" to start teaching RNs to scrub and I'd have to keep circulating for now. And this was in front of other nurses and techs. The day I left the OR, I had surgeons who came up to me and hugged me and told me they were going to miss me. I had one that got teary eyed but said he understood the dynamics I've had to work with.

It was a good professional experience overall as it helps me understand the procedures that my homecare patients go through and how to help them recover.

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