What's up with RNs who refuse to scrub? - page 5

This trend, at least in the Western states, is starting to irritate me more and more, the more I see it. I have been an OR nurse for over 20 years; scrub and circulate all areas; have done all kinds... Read More

  1. by   mother/babyRN
    How about the OR nurses learning how to "birth" a baby or do any one of a number of other nursing specialties on their down time...That works for me....Same deal in my opinion. Of course it isn't the same, but it is simply another skill, albeit a good one. I have no problem learning as much as I can and need to as long as the teaching is good and the teachers are realistic....If I wanted to be in the OR, I would have applied there. That said, if hospitals were better to their staff, in our case, delivery, and less tolerant of the attitudes that we see run rampant in the OR, more of us would be much happier to take some of our not so free time.. I applaud OR people. It isn't something which has ever interested me in the least, which is kind of ironic considering I have to deal with surgery, BUT, respect has to go both ways. In these days of going to the trouble of actually counting peri pads and forcing patients to bring their own diapers and formula, it doesn't seem as though many facilities are willing or able to prioritize the scrub program for ancillary areas such as us..I have no interest in working with rude people, period and, when they give us adequate staff or have the staff in the OR who might be available care for our patients while we learn to better ourselves at scrubbing, I will certainly be the first in line to volunteer....I am going to a 2 hour scrub class today and if the people who have been in the OR for multiple years expect us to learn everything they have learned in their time there in the midst of an emergency or baby going bad, then how about we switch places and really learn what we need to know...I imagine that won't go over too well in either area......
  2. by   carcha
    i agree with mother/baby. the trend today seems to be that nurses should be jacks of all trades. i cant tell u how many times i have had a quiet time in the or and have been asked to go to the units to "help out". i always refuse as my code of conduct allow me to but feel bad. I wonder how many times a nurse on the unit is asked to go to the or to scrub for an AAA. let me answer NEVER
  3. by   RN2007
    First of all, I am not a nurse, so can someone give me a good definition of what "scrubbing" means to begin with? I would appreciate it.
  4. by   shodobe
    I agree with carcha,and a little with mother/baby but I think the difficulty of scrubbing a case vs circulating is lost. I take a lot of pride in knowing that I have the skill to assist a surgeon on almost any procedure and the most "boring" aspect of the OR is circulating. I have said time and time again, you can teach anyone to be an "adequate" circulator, but it takes a special individual to be able to change roles case after case. The only ones who will understand this are the ones, especially the RNs, who have scrubbed and circulated for many years. Like I said in one of my previous post we taught the OB department how to scrub the sections and tubals, but when it comes to learning the emergency procedures they might encounter such as hysters and such, they don't want to learn. We bail them out too many times. On the other point, I am an OR nurse, not a pediatric nurse, not a L&D nurse, not a Med/Surg nurse. No I won't float anywhere, anytime for anybody in the hospital. I have done that before and yes I could if I wanted to but they won't come to me if I need help so why should I go to them. I feel if you like one aspect of nursing stick with it and get good, very good at it and your market value goes sky high. Just my two cents worth as unimportant as it might be. Mike
    As for scrubbing, this entails setting up instruments for the case and passing them during the case to the surgeon. You have to be very versatile in knowing the procedure so you know what the surgeon is trying to accomplish. You have to know all the names of the instruments so you can pass them in order. You have to anticipate the surgeon so you know what they will need next without them asking for it. No you don't need to be a mind reader, but it helps because they think you are one! It is a tough job to do but once you have mastered it, it can be very rewarding.This is just a quick synopsis of the job and I know I have left some things out, but it gives you a good idea.
  5. by   carcha
    i have to disagree with shodobe, (love the dogs by the way). I feel having been in situations where my primary role was to scrub, and in situations where i mainly circulated, scrubbing while not easy in the slightest, is by far the easier task in the or. as a scrub nurse once u understand the procedure, u can anticipate, troubleshoot, and plan your actions and nursing care, even before u start the case, the circulating nurse however, has to deal with a multitude of queries, problems, situations, ect, ect. so. i also feel that total patient care for the or patient falls to the circulating nurse who has to assess and evaluate the enviornment continually and be confident enough to tackle the medical team if she/he is not happy
  6. by   shodobe
    Not that I disagree with carcha but after 25 years of OR I just find circulating boring and not much of a challenge anymore. I also think in hospitals where RNs tend to only circ then you must get very good at this and become the best you can be. Where the surgeon is the "captain" of the ship, a well seasoned circ is the "field marshall" of the OR. It can be a tough, demanding job that requires a strong backbone and and a multitude of skills. I can circ with the best but as I said have found scrubbing more interesting, especially Ortho. Mike
    PS, where in England? My wife was born in Cambridge.
  7. by   mother/babyRN
    Here is another little tidbit that bugs me. Those of you who can "refuse" to go help out on other units because something might happen at any minute really get to those of us who work in an equally "something could happen at any minute" and have to go anyway. There is no refusing. THAT is unfair....The OR and the ER should have to go help out if every other acute area has to..Depends upon the facility, I imagine...
  8. by   mother/babyRN
    I didn't say I haven't had to scrub.. A dying baby waits for no one BUT it will not be to the expertise or up to par of the OR people who should be there, in the hospital because that is their job....I just had a labor patient that thankfully delivered vaginally. She developed some fetal distress, bled and had some massive intervention. I had the ONE labor patient....There were 5 in labor with 4 nurses and one PCa....Thank God there were no sections as the OR in my facility would have given us grief because they had to come in and "Bail us out." Other patients on the floor included a HELLP patient, borderline critical ( icu material), a pretermer on Mag AND a symptomatic 32 week pulmonary embolus with the resultant labs and things that go with it. I negated to mention the hyperemetic 16 weeker that wouldn't have been a problem and actually wasn't despite the fact that she had a central line and TPN...That is a normal night. There is no bailing us out when you arrive...We NEED you!
  9. by   shodobe
    From reading your post I can see you appreciate the OR helping you out. Where I work there is really no appreciation but expectation. I think if they were to say thank you once in awhile our staff wouldn't gripe so much. Also I spent to many years and sleepless nights going to other departments to help them out and believe me it was "bailing" them out. Most of the time it was pure incompetence and poor staff training on very basic nursing functions, a-line setups, cvp,etc. I will not refuse in extreme emergencies because I stay at the hospital when I am down south and the house supervisors know this. We now have cluster float areas and L&D is our only one. ER and ICU/CCU interchange. Mike
  10. by   angelzeyez
    OK...all you OR nurses out there. Personally, i think it is wonderful for an RN to have the opportunity to scrub. I work as a certified surgical technologist in a level one trauma center here in the Northeast. We have more RN's than scrub techs and our RN's do have the opportunity to scrub...not all the time, but they do get to scrub. We have a few who refuse because they have done it for 20+ years and are just tired of standing in one spot all day ( can you blame them?) We also have new graduates from our OR program for RN's who are just too afraid to "step up to the plate" and play. From a surgical tech standpoint, I would much rather have a circulator who scrubs than someone who does not. It makes for a smoother case because he/she can anticipate my needs as well as my surgeons' needs. It truly does make you more well rounded in the operating room. I hope to someday complete my RN training and I also hope than when I do I will still have the opportunity to scrub, because I love it!
    As far as why there are so many surg techs out there compared to OR nurses? It has nothing to do with CST's being cheaper...it has everything to do with the younger generations seeing that they can make a better profit doing less work in areas other than the medical field. Hospitals need to pay medical staff more appropiately and have a good retention plan for those already employed. Just something I have personlaly noticed in my area.
  11. by   JasonGreen
    Originally posted by angelzeyez
    From a surgical tech standpoint, I would much rather have a circulator who scrubs than someone who does not. It makes for a smoother case because he/she can anticipate my needs as well as my surgeons' needs. It truly does make you more well rounded in the operating room.
    I agree with this statement 100%
  12. by   jude11142
    I am an LPN, enrolled in RN program. For 12 yrs, I worked as a scrub tech. I have to say something positive about techs........most do know the difference between a hip retractor and a weitlander. I have worked with many excellent techs who could bounce from a simple hernia repair and jump right into a transplant or crani etc.............I was not and the techs I worked with were not mindless people who could let their mind drift off. You have to be on the ball.........you must anticipate what the surgeon needs/wants before they even know. When things go bad, you are right there, and must be able to keep up. I think that being a circulator vs scrubbing is a choice.......but believe that all circulators learn how to scrub........obviousely techs cannot circulate, but I have on occasions set up cases, flipped sutures/sponges etc........made sure the right instruments were pulled etc........it is much easier to teach on to circulate than it is to teach one to scrub.
    I don't believe that anyone meant to "put down" a scrub techs role, but I felt that as a one-time tech.......who hopes to get back into OR as an RN and scrub......it is important to realize that techs not only go through a rigorous program that teaches much more than how to pass instruments. The tech is a vital part of the surgical team and usually here in CT, our surgeons respect us and love teaching us about surgeries, what they are doing and why and so on.
    Over the yrs, I have taught many new circulators how to scrub and they in turn taught me things.

    This has been my experience.

  13. by   jude11142
    Originally posted by stevierae
    Where the he** do you live, meandragonbrett? And why do you allow yourself to get stuck in a situation where you have so little autonomy? Why not speak up and ASK to learn to scrub, rather than getting stuck in such a rut? To say that RNs who CAN scrub and RNs who CAN'T are equally well-rounded is simply nonsense. Ask any of your scrub techs who THEY would rather have as their circulator, given a choice!! If you don't scrub, you really cannot empathize with your scrub, you cannot really anticipate needs (other than what is clearly visible like laps and needles,) you can't suggest instrumentation that might work in a pinch if the commonly used instumentation is "out for repair" in use in another room or BREAKS while you are using it. If the surgeon nicks some major vessel and the patient starts bleeding out and your scrub yells out "Gimme a vascular stitch," you will have to waste critical time asking, "What kind, what size, on what type of needle" because you, having never scrubbed that type of case, won't be knowledgable of what most likely just happened (that is, what vessel was most likely nicked, and what the consequenses might be.). You CAN'T put yourselves in the shoes of the scrub, because YOU HAVE NEVER BEEN THERE. I firmly believe every OR RN needs to function in both roles; if not, you are only doing half your job.
    Stevierae.........good post............I agree totally.