Do most OR's use scrub tech's?

[galenanurse]

Hello everyone,

I was wondering if your OR uses scrub tech's, or RN'S scrub and circulate? I just had a phone interview with a large hospital in Chicago, and they said their OR RN's scrub 50% and circulate the other 50%. They say you do one half the day, and switch for the other half of the day so their nurses are always scrubbing and circulating. Are there any nurses out there working this kind of schedule in the OR? Do you also have scrub tech's or only RN's?

Thanks

Jen

[Scrubby]

The same could be said about being a Circulator that doesnt have a CST that is up to snuff. BTW, every scrub tech and nurse in the OR has worked with someone that was lazy and not up to snuff.

No that same can't be said. I've seen both scenarios and it's far worse if you have a bad circulator.

If the scrub person isn't up to scratch then two things will happen. They will either be scrubbed out for someone who can manage or the surgeons will simply help themselves to instruments and pretty much push the scrub person aside. The surgery will still get done, the surgeons will probably get p*ssed off because the scrub nurse is useless but the surgery will go on.

However if the circulator is completely useless then the surgery will still get done eventually but there will be a lot of delays. The scrub nurse can't do anything because they're sterile. The surgeons can't do anything either because they're sterile as well. The circulator is really what keeps that scrub team going and will make or break the case.

[canesdukegirl, BSN, RN]

I am torn on this subject. On the one hand, I believe that ORs should have only RNs scrubbing and circulating. My rationale for this mindset is that only an RN who has scrubbed can understand the challenges a tech faces. On that same note, I have witnessed and experienced how much easier and more prepared the team is when an RN scrubs because they understand and appreciate how important it is to look at the case in an all-emcompassing way...meaning they look at the big picture. I am having trouble getting my words out, so I will give you an example: an RN is scrubbing an ORIF of the femur from a pathological fracture. As an RN, you would know that a pathological break results in some sort of systemic disease-more than likely metastatic cancer. An RN would be more prepared to handle the loads of blood loss resulting in resecting the tumor because you know that cancer can bleed like stink. So an RN would confer with the anesthesia provider to get blood in the room before the patient even gets on the table. The RN would also have meds on the backtable like Gelfoam, Surgicel and Thrombin. I don't know what kind of training an ST gets, but would they automatically put the two together? That's not to say that the circulator would not also be thinking along the same lines and be prepared. I suppose what I am so awkwardly trying to say is that the training and schooling that an RN goes through contributes to the critical thinking skills that is required and demanded for safe patient care, thus I believe that an RN is a better choice for a scrub role.

I read a comment from a previous poster that mentioned the tech saying that the circulator's job is easy. It may LOOK easy to them because we mainly gather and prepare as circulators. We are also thinking forward to the next case, being vigilant of the lab values, cultural values and the needs of the patient in a holistic way. For example, there was a ST that I worked with that thought she knew everything. And I mean EVERYTHING. She would spout off about how much she knew, told the RNs how to do their jobs, and even "suggested" techniques to the surgeons! One day, the surgeon was just sick of it. He told this ST to shut it and let me do my job. She immediately opened her mouth and boldly stated, "Well, her (meaning me) job is not that hard. All she does is get stuff. How hard is that?" Without missing a beat, the surgeon says to her, "Our next patient has an INR of 3. What would you do?" She obviously didn't have a clue what an INR value was and remained silent. The surgeon looked at me over his mask and said, "Wanna prove my point, Fetcher?" Of course, I stifled a laugh while educating the ST that an INR of 3 is high and we would have to delay surgery because the patient would bleed out.

There are benefits to having STs. There are EXCELLENT STs out there. However, when I work in a room where an RN is scrubbing and I am circulating, it ALWAYS goes more smoothly. There exists an understanding of what BOTH roles entail and the teamwork factor comes into play. There is none of the "my job is harder than your job" mentality.

[SC APRN, DNP, APRN, NP]

I'm glad I've been fortunate to work with respectful professionals. As a tech I've always felt like part of the team. We don't have that typical RN vs CST battle. RNs and surgeons teach me something everyday, and sometimes I teach RNs something. All the RNs have been so helpful on my journey to becoming an RN myself.