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Discussion

I have a question to ask!

I'm just keen to hear about how you guys set up for Ivor-Lewis Oesophagectomies. Where I work there is only one scrub nurse who has to provide instruments to two surgical teams. Now i've done a few of these and have noticed that I'm not the only one who struggles during these cases.

I've heard of other hospitals who have a scrub nurse for the thoracotomy and another scrub nurse for the laparotomy. I think that this is a safer alternative to the way we do them.

I'm seriously thinking of bringing this issue up to try and change this practice. It's not because I don't think I or other nurses in my area are capable, but from a safety point of view there is far more sharps to handle, it's not easy to anticipate two surgical teams, and quite frankly it's mentally draining. And then theres the question....is it fair on the patient to have only one scrub nurse for two seperate procedures?

Anyway what are your thoughts? Do you think it's an acceptable practice or should it be considered dangerous?

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Our cardiothoracic surgeons do both parts, so we only have one team. General surgeons don't get involved. We have one surgeon, a PA, a 2nd assist, and the ST handling instruments. I've never been in the room, so I'm not sure how they handle counts.

Our surgeons do one part at a time, so it's the same scrub nurse for the whole thing.

  • Author
Our surgeons do one part at a time, so it's the same scrub nurse for the whole thing.

Hmmm so do you think you would be comfortable being the only scrub nurse for both parts of the surgery at once?

Hmmm so do you think you would be comfortable being the only scrub nurse for both parts of the surgery at once?

Nope! :)

Working for 2 teams, like you said, causes your attention to be split between the two teams, who are doing different things. It's not like you've got 2 surgeons working on the same hole... it's 2 separate surgeries. I think they should provide nurses for both teams. Good for you for trying to change it. Too often we nurse just suck it up and deal with it... and complain to each other!!

It is NOT easy to manage!

Take a CABG as an example, only one scrub nurse deals with both surgeons, one is doing chest, another for conduit-harvesting. This is not the difficult part, the challenge is when the surgeon is harvesting the conduits from both legs where the scrub nurse stands. In this case, scrub nurse still needs to pass instru to both safely and quickly. Believe me, it can be very annoying as the conduit-harvesting surgeon blocks your space and view. In this situation, some surgeons are still fussy to blame you for not quick enough passing him the instru such and such...

You know what, I sometimes do wish i am born with 3 arms & hands. Does this help us to be more flexible scrub nurses. i hope it does...lol...

Anita

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