How to deal with a difficult scrub tech

[canesdukegirl, BSN, RN]

She is technically a good scrub, and to her credit, she can do just about anything. However, she has no idea what it is like to be a circulator, and thinks that all we do is play on the computer. She actually said to me one time, "When you are done with the whole charting thingie, can you please get me some more 0-Vicryl?" She asked me during intubation to get her another pair of gloves so she could drop scrub. I am just shaking my head.

Have any of you dealt with this before? Any help would be appreciated.

[Argo]

Write Her up. Continue to write her up until she straightens up, quits or gets fired. No need to have a bad seed in the group. I had one like this an suspended her for 3 days, sent her home in the middle of one o her specialty days just to let her realize that she wasn't that special an could be replaced. She needed to know that if She wanted to continue being emloyeed with us she should straighten up. She did an is very different now.

[PetiteOpRN]

Yikes. Yes, I've dealt with these types, but not consistently. There was one who would make me repeat the time out because she hadn't heard the patient's DOB (which is on the time out board). The surgeons I work with are plenty patient when someone has a good attitude, but if you step out of place (as this tech seems to be doing) I get to call in the relief, and you get to find somewhere else to scrub.

In cases like this, I do as much CYA as possible. I make sure someone hears me ask if we have everything, and I try to stay one step ahead, like you seem to be doing. I also keep a real close eye on techs like this because the tend to think they know as much as the RN or new residents, and might just do or suggest something that can compromise patient care.

You might tactfully/anonymously bring this up with the nurse educator or supervisor, if they will handle it appropriately. Explain that certain behaviors negatively impact the surgical team and you fear this may result in negative outcomes.

Other than that, good luck. She is lucky her circulator puts up with her, and doesn't throw her under the bus or egg her on.

[Scrubby]

Thankfully I've never worked with techs, it's all nurses we work under the same standards and so I don't have to dealwith the whole nurse to non nurse politics.

If I had a nurse who carries on like you have described and I am concerned for patient safety I would threaten to scrub in take over. That is if you have been trained to scrub. I have done this when I had an agency nurse and it stopped the behaviour straight away.

[mrsilly]

This is tough. I've worked with other people like her as well. I keep meaning to bring a notebook with me to work and start writing things down that bother me. Doesn't mean I'll use anything written down, but if there's a pattern, whether it be a colleague or problem at work, there's the information you've gathered. If anything, the notebook/diary, may help you vent... maybe you will see a pattern on which cases the tech has more problems with so you can be better prepared.