"Circulating is so easy"

[ORSmurf]

I'm sick to death of hearing how easy it is to circulate. The surgery center where I work is having a difficult time recruiting circulators and we are miserably understaffed right now. One of the tech's made the comment, "I don't know why they can't find anyone - I mean, it's the easiest nursing job there is - you get to sit around all the time" :angryfire I guess when you're a good circulator, you make it look easy. Has anyone else heard comments like this? What do you say? I end up feeling so angry that I just bite my tongue for fear I'll say something I'll regret (I have a bit of a temper, so it's best for me to keep quiet).

[RN Zeke]

Surgical techs know the pay scale when they start school, it is no surprise.HELLO!! I have been in rooms that the surg. tech. is the only one that knows what is going on, step 1, step 2, and so forth. I have assisted in training circulators while being scrubbed in and it isn't the best learning environment to do both jobs at the same time. It sounds to me that there is some resentement here from the RN's that don't scrub and want to do that job too! Just maybe an RN is causing tension due to jealousy. Pay has nothing to do with it. I am on both sides of the fence and feel I can make these statements. Those that haven't just may not have that knowledge base.

[TallBlondie]

I dealt with this topic in my OR by posting a cartoon that I developed on the fridge in the locker room. The first frame has a nurse filling out paperwork looking at the scrub and thinking to herself "Gosh, I wish I were a scrub. All you do is stand around and pass instruments!"

In the second frame is the scrub holding retractors and thinking "Gosh, I wish I were a circulator. All you do is stand around and fill out papers!" I hear all the time from both parties saying "I am so glad you posted this! We have to realize that we all have a difficult job to do however, when that respect is gone I will usually hop on my broomstick and snap "You don't do my job, and you will NEVER DO my job!" It goes both ways regardless if you are scrubbed or circulating. Those that have done both are the only ones who can honestly say which job they think is more difficult.

[ewattsjt]

please read all this post carefully so there is no misconception in what i am trying to say!

my thing is what difference does it make? didn’t anyone here have a psychology class or at least an interpersonal communications class? yes i know you did but let's remember some things learned in it.

what is said really means nothing unless it is perceived to mean something. the vietnam war was extended 6 extra months because of table seating in the treaty. some were offended at where they would be seated so they would not negotiate. how many lives were lost because of this absurd perception?

let it roll off your shoulders, techs and nurses alike. perceive it as who is making the comment. is it a jealous person who we should feel compassion for because of their personal inadequacies? is it someone who is enraged because they receive no bonuses and there are no clinical ladder programs for extra money and they feel gypped by the hospital and the person is envious of your job?

we are here to serve the patient as a team to give them the best possible outcome of their operation. surgery is a very serious matter. we shouldn’t be acting like high school kids and say my job is better than yours and you do nothing.

this thread should end here and those with hurt feelings or the ones who have become bitter should think about this whole heartily.

tall blondie is right in her cartoon of the grass is greener on the other side of the fence, but just remember that someone’s life rides on the center of that fence!

[lenjoy03, RN]

I'm just new in this forum and already read all your comments. Here in the Philippines, we dont have surg. techs. OR nurse do all the scrubbing, circulating, passing of instruments. I'm a newly grad by the way. You know what I learned from my OR duties? Its not always who gets the better job and the highest pay! Ok, the pay does matter! But then, you should also consider that RNs are not higher than the surg. techs and vise versa. About the backstabbing thing, we can't just judge the surg. tech as general. Same with the RNs. There are always rotten eggs in every group! Now its up to you how to deal with it. You can try to snob them, do your job and act in professional way or you can be like them. Whoever do the backstabbing thing have lots of insecurities and issues. Just try to ignore! If you can't bear it anymore, you can always talk to that person. I know its really hard to do, but its worth to try! Because the issue is not who are the elite or highest pay, its how you work together as a "TEAM" to save lives.

[boriquarn]

In the end, we cannot be concerned with what others think about our jobs. It is really not about us, it is more about their jealousy and pettiness. Regardless of how someone feels about what I love (Circulating) I will continue to hold my head up high and enjoy what I do! Trust me- a smile is the best revenge :)

[haras regnurps]

Working in the OR is one of the most exciting jobs you can have in nursing. Nothing is more irriating to a seasoned RN than to have a green scrub tech say something like " circulating is sooooo easy all you have to do is sit there". Besides irriating; it just displays the techs ignorance. There are many observers in the OR that have been overheard saying the same thing----- circulating is easy.

Who is responsible for getting supplies to the team ( including anesth. in many institutions. ) Who. if doing their job makes the whole team look good by making sure that supplies are there when needed, charting done, charges done, and most importantly that the patient is "cared" for?

Always put your patient first and you can't go wrong, but; please do not let techs and other or personel say things like circulating is sooooo easy. It simply is not!!!

Who else besides an OR-RN can be a nurse, a social worker, an engineer, a chemist, an IV therapist, maid, massage therapist, electrician, JCAHO and OHSA supervisor, politician, manager, pastor, and the best joke teller on the planet all at the same time.

What do you think the pay should be for all of that, not to mention making sure that the surgeon knows what he/she is doing just as a side bar.

You are your patients' advocate when no one else may be. OR nurses need to stand their ground in a positive manner. Sometimes that means gulping our pride and being a team player when some members of the team want all the glory,( those darn glory hounds).

Really sounds like your surgery center is in need of some techs that have to go back to having "green" OR nurses for a few days. If your manager is aware of the problem , see if they can arrange this and the scwabbling about circulating being soooooo easy may cease. Those techs just might appreciate the good nurses that are willing to work with them on a daily basis......................haras regnurps.

[brewerpaul]

I'm still an OR newbie (about 6 weeks, and loving it!) but I have one or two observations/suggestions.

On a long case, once you're up to date on your documenting and the techs have everything they need, it can indeed look like you're doing nothing. I've seen one or two circulators use that time to check personal e-mail etc, which I think is really bad form. I like to use those times to learn as much as I can about the surgery taking place. I get as close as I safely can without compromising the sterile field and watch everything-- exactly how are all of those instruments used? What is that anatomical structure I'm seeing? What will the surgeon be doing next?(and therefore, what are they likely to ask me for?). I like to ask questions-- intelligent ones, I hope. Reps from medical suppliers are great sources of information if any are in the room (implants, pacemakers, etc). RNFA's are really helpful too.

Most surgeons I've worked with thus far seem to appreciate the fact that you're interested in what they're doing and are eager to share their knowledge. Maybe even show off a bit . We all hear horror stories about Docs reaming out nurses, and I think that developing a positive relationship with the surgeon is a great way to prevent or at least minimize this. If all they see is a lump of a circulator who sits on the side at the computer and takes no interest in what's going on, they may not hold back their anger when things are not exactly to their liking . However, if they know and like the circulator and respect the nurse's intellectual interest in their work, I believe that they'll treat that nurse more positively. I'm not talking about simply "brown nosing" here, sucking up for the sake of preferental treatment .If you ACT like a working member of the surgical team, you'll be treated that way by the techs and surgeons.

[Online660534]

Can someone explain to me what the difference is between a scrub nurse, an OR nurse and a circulator is? I'm getting ready to start nursing school and I think I would like to work in the OR but I'm curious about these other positions that you all speak of.

Thank you so much!

This also intrigues me. In South Africa, you have to be a RN (registered nurse with the nursing council - old term was Sister - now Professional nurse) in order to do a year diploma in Theatre Operating Nursing Science - and only after all that do you qualify as a scrub nurse. We do not have scrub tech's. Our enrolled nurses do the circulating and assist the anaesthetist. God forbid, that a RN is asked to circulate.:angryfire To us that is degrading! Our standards are very high and not just anyone is allowed to work in the OR. You have to do the training.

[shodobe]

I'm still an OR newbie (about 6 weeks, and loving it!) but I have one or two observations/suggestions.

On a long case, once you're up to date on your documenting and the techs have everything they need, it can indeed look like you're doing nothing. I've seen one or two circulators use that time to check personal e-mail etc, which I think is really bad form. I like to use those times to learn as much as I can about the surgery taking place. I get as close as I safely can without compromising the sterile field and watch everything-- exactly how are all of those instruments used? What is that anatomical structure I'm seeing? What will the surgeon be doing next?(and therefore, what are they likely to ask me for?). I like to ask questions-- intelligent ones, I hope. Reps from medical suppliers are great sources of information if any are in the room (implants, pacemakers, etc). RNFA's are really helpful too.

Most surgeons I've worked with thus far seem to appreciate the fact that you're interested in what they're doing and are eager to share their knowledge. Maybe even show off a bit . We all hear horror stories about Docs reaming out nurses, and I think that developing a positive relationship with the surgeon is a great way to prevent or at least minimize this. If all they see is a lump of a circulator who sits on the side at the computer and takes no interest in what's going on, they may not hold back their anger when things are not exactly to their liking . However, if they know and like the circulator and respect the nurse's intellectual interest in their work, I believe that they'll treat that nurse more positively. I'm not talking about simply "brown nosing" here, sucking up for the sake of preferental treatment .If you ACT like a working member of the surgical team, you'll be treated that way by the techs and surgeons.

Are the nurses checking stuff very experienced? They really shouldn't be checking e-mail during a case, but with many years of experience you don't have to be right up on the field stroking the surgeon's ego. I can sit with my back to the field and still hear and know what's going on. Years of know how will teach you these tricks, but for you ,YES you should be up close to the field asking questions. There sre some surgeons who love to teach as opposed to those who like to show off. Big difference! Hopefully those nurses are teaching you everything you need to know and not just letting you float around in a fog. Good luck though!

[sandlewood_nurse]

I am a Canadian OR Nurse. Here we are always running around and have a lot to do. If a surgery runes longer than an hour and a half we might get some time to sit, but usually someone will come relieve us for break and when we get back its time to pack up stuff. I was told while doing my training that IT IS THE NURSE'S JOB to always be aware of whats going on in the room and in the surgery to anticipate anything that might be needed (such as prosthesis, another instrumetn etc,) and to ALWAYS be checking the integrity of sterility. We as circulators have to always be on the job. Usually we are notice its time to do another count becasue they are closing another cavity. Yes some nurses will just sit there with a book, but it is very rare and frowned upon.

Here we alternate scrubbing and circulating and although both jobs can be stressful (Surgeons being very particular and wnating even green nurses to know exactly what they need as surgery goes on instead of putting in effort to teach the new nurses), I would say the scrubbing is the easier job.

As a circulator here we rush to get the room set up, scrub nurse set up, patient checked in, help with anesthesia, prep, count all instruments required to be counted with scrub nurse, hoook up all equipment, do charting, etc etc. I heard in the states there's a lot more help in between cases getting them started, and nurses don't necessarily responsible for trying to do everything on their own. We also check carts and run to get anything that is missing for the surgery, and we pick some of our own stuff.

The scrub nurse is just responisble for setting up, maintaning sterile technique and at times assisting the surgeon. I love scrubbing .. but I've begun to appreciate the experience I get as a circulator. Techs should never underestimate Circulating Nurses, and take them for granted. We have Surgeons and Management to do that job already .

Are the nurses checking stuff very experienced? They really shouldn't be checking e-mail during a case, but with many years of experience you don't have to be right up on the field stroking the surgeon's ego. I can sit with my back to the field and still hear and know what's going on. Years of know how will teach you these tricks, but for you ,YES you should be up close to the field asking questions. There sre some surgeons who love to teach as opposed to those who like to show off. Big difference! Hopefully those nurses are teaching you everything you need to know and not just letting you float around in a fog. Good luck though!

[shodobe]

sandlewood nurse, sounds you do pretty much what most of the OR nurses I know here in the states do already. You really don't do anymore than usual. But being able to do alot is benefical because it expands your knowledge and doesn't make you one dimensional. The hospital where I work ALL of the RNs scrub and circ because that is the only way you can work here. We have NO scrub techs. Been that way for the 31 years I have worked here. This doesn't mean it will stay that way. we are having more and more trouble finding RNs that want to be trained to go both ways. Strange because it seems that most people who post want to learn to scrub, just not in my area.

[sandlewood_nurse]

I guess every hospital is different. I heard from some recruiters and a friend whose working in the states now at a bigger hospital that RNs mostly circulate.

Here in Canada we have techs at the bigger hospitals too. I prefer to scrub .. if I had to choose to stick with one it would be scrubbing, and thats why I went into the OR. I don't mind circulating anymore so much, and you're right if we were to only do one job we would be limited in our knowledge. I do however think that hospitals use scrub techs to get someone they can pay less than an RN to do the same job.

sandlewood nurse, sounds you do pretty much what most of the OR nurses I know here in the states do already. You really don't do anymore than usual. But being able to do alot is benefical because it expands your knowledge and doesn't make you one dimensional. The hospital where I work ALL of the RNs scrub and circ because that is the only way you can work here. We have NO scrub techs. Been that way for the 31 years I have worked here. This doesn't mean it will stay that way. we are having more and more trouble finding RNs that want to be trained to go both ways. Strange because it seems that most people who post want to learn to scrub, just not in my area.