At the moment we're having a huge issue at my work with scrubbing in for a case, when the instrument nurse needs to scrub out due to fatigue, hunger, been there too long etc.
Our current practice is that a count is done between the existing scrub and the scrub taking over, and this must be done in the presence of the charge nurse.
The issues we're having is that some bright spark in management has decided we shouldn't be scrubbing in because ACORN policy doesn't recommend this and that having a changeover in the middle of the case can increase the chance of retained items.
When we questioned this theory on retained items, we asked if there was any evidence that this has occurred. We received a vague answer of 'historically it has'.
We were also told that it may annoy the surgeons because doing the count in the middle of the case can cause a delay. :icon_roll
Personally i think that the chances of errors occuring during a case would be increased by an overly fatigued scrub nurse who has stood there for ten hours without relief.
What are you thoughts, HCF policies on this?