Mike, none of us are questioning sponge and needle counts. Well, of course, there will always be people who want to do sponge counts on cases where they truly are not indicated, like finger lacerations, minimal incision surgeries like lap choles, and on eye cases--even on I&Ds of infected wounds, where no suturing is done, and the wound is packed open--EVEN ON CADAVER ORGAN HARVESTING CASES, for God's sake-- on that last, don't get me started. That subject, alone, could be the issue of another thread.
They, again, are just being very "by the book" and not using the common sense God gave them. We are allowed to write "Count Not Indicated--Minimal Incision" or the like on cases like those, but some RNs (again, usually the ones who don't scrub) want a full count on EVERY CASE, no matter how minimal the incision, or whether the patient is dead, as I just described--including instruments.
I, too, have seen the blue towel left in the belly. Most ORs write "Blue towel x 1 in Pelvis" or something similar so that the team does not forget to remove and account for it when they close.
I think a good rule of thumb is, and I was taught this, is, if anyone in the room requests a count, at any time, of any item, JUST DO IT, without argument (even if, like me, you might sometimes be wondering the rationale for the count.) You can always discuss it later, and may even be able to open up a group discussion that might effect some changes in some old "sacred cow" policies and procedures, or at least in peoples' perceptions of why they do things.