What's up with RNs who refuse to scrub?

yoga crna · May 5, 2003

An RN who can both scrub and circulate is more marketable and in the long run that could be an advantage. Even though I am a CRNA, I am also the manager of an office surgery center. I will only hire RNs (no techs), because I want someone who can scrub, circulate and recover. The surgeon taught the ones who didn't know how, to scrub. They can get work any where and to a person is thankful that they can scrub.

More knowledge and skills is always an advantage.

YogaCRNA

mother/babyRN, RN · May 5, 2003

I work in a community hospital with a skeleton staff. I work in OB...There are not enough of us to scrub. And, if we had the staff, I would expect the hospital to pay for me to go to an accredited scrub tech program to do it....I am not against it, but one person cannot scrub, circulate, catch a baby, hope it is ok, intervene if it isn't, recover the section AND take care of labor people , post partum people and babies. Period....But, that is just my opinion. If one works in the OR, I thought one had to scrub and circulate. Just goes to show you how uniformed I have been...

I wouldn't personally think scrubbing is fun because I hate to gown up and be behind a mask...And kudos and admiration to you for doing it for hours and daily. That is not something I personally would enjoy, but I think that it is great that you do..To each his or her own I guess...:)

KarenHalse · May 5, 2003

Yoga crna, I appreciate your view point but that is very typical of Out patient surgery. I have worked both and I do prefer a general OR. From the circulator viewpoint, the main negative to a regular OR is the call. On the other hand, in outpatient setting, the circulator work is much harder. Circulatating is the same, just many more surgeries, much more paperwork in a lesser amount of time. It would be better to be a scrub in the outpatient setting. This of course has been my own experience. Not to mention the pay is pretty poor in Outpatient settings.

There is not a question that scrubbing and circulating would be easier to sell but scrubbing is definitely not as interesting to me. I would feel once you see a surgery then I would be ready to do something else. With circulating, there is always a challenge. I seldom sit on the job...I do like to keep my OR room cleaned up, have my paperwork complete as much as possible, while keeping an ear to the field. Always thinking about the next one coming into my room...I like to be as prepared as much as possible. Just differences of opinion.

carcha · Jun 10, 2003

very interesting this discussion!. having worked in north america and europe i too see this trend of some rns not scrubbing, however mostly head nurses who " manage" the room while the rns scrub and circulate. where i work the rns scrub, circulate, and assist in preparing the anaesthetic equipment for the anaesthetist, and personally i find having skills in all these areas very challanging indeed. if i may just point out i remember years ago when the rns were left circulating all the time while the head nurses scrubbed for all the major cases. i found this annoying as i felt my professional needs were neglected. so im all for this new arrangment. however can i ask, can an rn refuse legally to scrub and do their contract allow them to do so?. love this site.

mother/babyRN, RN · Jun 10, 2003

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......

carcha · Jun 10, 2003

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

RN2007 · Jun 11, 2003

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.

shodobe · Jun 11, 2003

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.

carcha · Jun 11, 2003

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

shodobe · Jun 12, 2003

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.

mother/babyRN, RN · Jun 12, 2003

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...

mother/babyRN, RN · Jun 12, 2003

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 lady partslly. 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! :)