jdg0719

If someone is scrubbing to hold retractors, camera or to "assist", but yet they cannot gown and glove themselves and they need someone to do it for them, then they don't need to be touching anything on the field.

This starts at the bottom, which in this case is SPD. 1. Whoever pulls the case should take into consideration regarding any special peel pack instruments that might be needed. 2. When the sets are being put together, SPD is responsible for inventoring the sets, and making sure each and every instrument is accounted for before the set is loaded in the autoclave. 3. If an instrument is missing, SPD should communicate the issue with a supervisor to take corrective measures, such as checking other sets that are "down", make arrangements in borrowing an instrument from different facility, informing the surgeon of any alternative instrument can be used. Never good to be looking for instruments during a case. Not good for the patient. If its not a stat case, everything should be checked before the patient is brought into the OR.

Many places they're are not allowed, unless you are a physician...of course.

If you are one that likes the "hands on work", in-your face involvement during surgery, the CST route is a good setting. CSTs are required to complete an accredited program and hold certification or have completed a military program while enlisted. While an RN does make more money and does have more legal flexibility they can scrub and circulate. The Circulator does "run the show" in the OR since he or she is filling out the OR record which indicates things like "timeout", correct meds, counts, etc is done. Not to mention position, prep, etc. Once again, a CST attends a specialty program where they learn the scrub role. It's not just learning instruments how some may think. It Involves learning to anticipate the needs of the surgeon, studying on why a certain instrument does what it does, learning sterility that will protect the patient from infection, knowing what to do and what to have available if complications arise during the case, making sure that your one step ahead of the surgeon at all times, wound closure, and most of all being an advocate for your patient. While there are nurses that scrub, I have yet to hear of a nursing program that spends 18 months of learning the OR in and out like an ST program does. While some nurses maybe learned to scrub while OJT or some were once CSTs they maybe became RNs and maintained their skills. Decades ago LVNs and RNs fulfilled the scrub role. Things change over time. You might still find some places that utilizes nurses to scrub Working in the OR is fun, but an adrenaline paced environment where I have seen CSTs go back to school for something totally different and RNs transfer to a different setting, Best of Luck

take this as a fact or take this as an insult, however you prefer. many jobs have been created to fill the need in different roles of healthcare. something a few "older" providers can't grasp, and most likely never will. some out there happen to be out of touch these days. healthcare is evolving if you haven't noticed. it's like hearing mds say that crnas and nps shouldn't practice independently or administer drugs, since they didn't go through medical school, intense years and hours of residency and fellowships. or hearing others say, "since it's cheaper to see an np, you're going to get cheap lousy care" your ego seems to get the worst of you. many military and smart techs that i have worked with have some of the best knowledge than a few nurses who scrub that can barely keep their hands above the waist line. techs are not nurses, they never claim to be. they are there to do a job. a job that they went to school for or an mos they learned in the service. some nurses out there will never understand that csts are also "patient advocates" as well. any nurses who were once techs remember, aeger primo ? a tech has their limitations and scope of practice just like a nurse has theirs. nurses should not see techs as a threat, just like an anesthesiologist should not see a crna as a threat to their job, or an obstetrician seeing cnm as one too. or even a family physician seeing a fnp as a "takeover". techs are educated to provide the best care for the patient, just like any other caregiver should. if you are having a hard time excepting this and it hurts your ego, then perhaps you should work in a different health setting that has all rns . and if a hospital really wants to cut costs all they have to do is go by getting rid of staff with decades of seniority, by offering a retirement incentive and hire new grads to take their place.

some will never get it!

No there are several routes to first assist Nursing- CRNFA RNFA Private scrub nurse NP(not to common but there are some who work as first assistant) Non Nursing- PA CFA SA-C Private Scrub Tech CST with first assist experience

Take this as a fact or take this as an insult, however you prefer. Many jobs have been created to fill the need in different roles of healthcare. You seem to be out of touch these days. Healthcare is evolving if you haven’t noticed. It’s like hearing MDs say that CRNAs and NPs shouldn’t practice independently or administer drugs, since they didn’t go through medical school, intense years and hours of residency and fellowships. Or hearing them say, “Since it’s cheaper to see an NP, you’re going to get lousy care” Your ego seems to get the best of you. Many military techs that I have worked with have some of the best knowledge than a few RNs I know that can barely keep their hands above the waist have. Techs are NOT nurses, they never claim to be. They have their limitations and scope of practice just like a nurse has theirs. Nurses should not see techs as a threat, just like an anesthesiologist should not see a CRNA as a threat to their job, or an Obstetrician seeing CNM as one too. Or even a Family Physician seeing a FNP as a “takeover”. Techs are trained to provide the best care for the patient, just like any other caregiver should. If you are having a hard time excepting this and it hurts your ego, then perhaps you should work in a different department like ICU where they have all RNs.

When in doubt, in cases like this, best thing to do is check with anesthesia before you break down

Healthcare has gone a through a long trend of job titles. Get used to it. CRNAs now make up a long majority of Anesthesia Providers than Anesthesiologists compared to 20 years ago. In many states NPs are the Primary Care Providers, Orthopedic surgeons do less foot surgeries due to the growing field of Podiatry. Sorry to break to you folks, new fields and specialties are going to be growing in all areas of healthcare. Who would have ever guessed that “nurses” would be administering anesthetics, writing prescriptions, etc? People that say they would rather have an RN scrub over an ST (who has gone through specialty training and met competency requirements) would be like saying “I don’t want an advanced practice nurse giving me medicines without a doctor’s supervision since she didn’t go to medical school.” Yes, having an ST over an RN is cheaper just like going to an NP over an MD. Why don’t we focus more on the patient and less of our egos?

We use sterile water, since our city has a "hard water" problem. Its so bad its undrinkable

Healthcare has gone a through a long trend of job titles. Get used to it. CRNAs now make up a long majority of Anesthesia Providers than Anesthesiologists compared to 20 years ago. In many states NPs are the Primary Care Providers, Orthopedic surgeons do less foot surgeries due to the growing field of Podiatry. Sorry to break to you folks, new fields and specialties are going to be growing in all areas of healthcare. Who would have ever guessed that “nurses” would be administering anesthetics, writing prescriptions, etc? People that say they would rather have an RN scrub over an ST (who has gone through specialty training and met competency requirements) would be like saying “I don’t want an advanced practice nurse giving me medicines without a doctor’s supervision since she didn’t go to medical school.” Yes, having an ST over an RN is cheaper just like going to an NP over an MD. So are we then going to say, "what you pay for is what your going to get"? Why don’t we focus more on the patient and less of our egos?

How would having more nurses with PHDs tackle the nursing shortage? Wouldn't that take many of the hands on ADNs with yrs of experience off the floor and into a classroom to wind up behind a desk once they get their PHDs? How would you fight a war with nothing but generals and no foot soldiers? Wouldn't that concept apply here as well?

Oh, another thing that works is if you tie wrap the cords to the unit itself. It lessens the chance of cords or cables becoming loose

Also make sure no cables are lose on the connections to the cautery, montitor, light source, etc. Keep an eye out for exposed wires on light cords, scope camera, shaver, harmonic scalpel. Sometimes during cleaning, steam or fluids can damage the exposed fibers. Try dusting the equipment on the video towers once a week. It has a tendency of getting onto the PCBs which can overheat. Don't rely on Biomed since they may only do their PMs twice a year or so. Keep track of how old the equipment is. Sometimes age and wear and tear play a factor on the life span of it. Turn off any equipment when not in use, and if it has a battery, plug it in.