RN's scrubbing in on c/s???

LD123 · Jan 25, 2005

The supervisor in my LD dept is trying to get rid of all of our surgical techs and is wanting the RN's to train to scrub in on c-sections? Personally I don't want to, I don't think that is within the nsg scope of practice, what do you think?

Jolie, BSN · Jan 25, 2005

I have no problem with it, as long as the necessary training is provided. But that is costly, time-consuming, and rarely done properly. Our unit scheduled a surgical tech each shift, or an RN capable of scrubbing. (We had a few former OR nurses working LDRP.)

Had each RN on our unit been truly cross-trained to all areas, we would have needed ante-partum, L&D, OR, PACU, post-partum, nursery and NICU experience, as well as ACLS, fetal monitoring, and NRP. Just not feasible.

Jolie, BSN · Jan 25, 2005

I have no problem with it, as long as the necessary training is provided. But that is costly, time-consuming, and rarely done properly. Our unit scheduled a surgical tech each shift, or an RN capable of scrubbing. (We had a few former OR nurses working LDRP.)

Had each RN on our unit been truly cross-trained to all areas, we would have needed ante-partum, L&D, OR, PACU, post-partum, nursery and NICU experience, as well as ACLS, fetal monitoring, and NRP. Just not feasible.

shodobe · Jan 25, 2005

I don't understand what the problem is or percieved. RNs were scrubbing C/S long before Techs existed. I personally have scrubbed literally hundreds of C/S and find no problem with RNs doing them. We don't do them anymore in our OR because to be quite frank with you, we have better things to do. C/S have to be the most boring procedure. If you have done one you have done it all. As for your list of needed experience, why? The reason your super is wanting to do away with Techs is quite simple, money. Techs are one dimensional were as RNs can be used in a variety of jobs. Think about it, if a Tech isn't scrubbing then they are just a CNA. They can't really do much more. To answer your question whether scrubbing is within the scope of RNs, PLEASE!

shodobe · Jan 25, 2005

I don't understand what the problem is or percieved. RNs were scrubbing C/S long before Techs existed. I personally have scrubbed literally hundreds of C/S and find no problem with RNs doing them. We don't do them anymore in our OR because to be quite frank with you, we have better things to do. C/S have to be the most boring procedure. If you have done one you have done it all. As for your list of needed experience, why? The reason your super is wanting to do away with Techs is quite simple, money. Techs are one dimensional were as RNs can be used in a variety of jobs. Think about it, if a Tech isn't scrubbing then they are just a CNA. They can't really do much more. To answer your question whether scrubbing is within the scope of RNs, PLEASE!

lapappey · Jan 25, 2005

Scrubbing on a C/S is absolutely within a RN's scope of practice. Nurses have been scrubbing long before techs were even on the scene. This argument will not work.

However, becoming proficient at scrubbing, especially in an emergency atmosphere, which I would imagine a STAT C/S to be (I haven't even seen one as, L&D and OR are separate at my hospital as I guess they are at yours as well), is not something that happens overnight. That would be in my opinion the best way to frame your objections; would you really be comfortable scrubbing a C/S alone in a truly crazy situation, when at least one, possibly two lives are at stake? I know I wouldn't after a scrub class and scrubbing in on one or two routine C/S. To expect you to do so would be unreasonble and compromise patient safety.

lapappey · Jan 25, 2005

Scrubbing on a C/S is absolutely within a RN's scope of practice. Nurses have been scrubbing long before techs were even on the scene. This argument will not work.

However, becoming proficient at scrubbing, especially in an emergency atmosphere, which I would imagine a STAT C/S to be (I haven't even seen one as, L&D and OR are separate at my hospital as I guess they are at yours as well), is not something that happens overnight. That would be in my opinion the best way to frame your objections; would you really be comfortable scrubbing a C/S alone in a truly crazy situation, when at least one, possibly two lives are at stake? I know I wouldn't after a scrub class and scrubbing in on one or two routine C/S. To expect you to do so would be unreasonble and compromise patient safety.

SmilingBluEyes · Jan 25, 2005

Scrubbing on a C/S is absolutely within a RN's scope of practice. Nurses have been scrubbing long before techs were even on the scene. This argument will not work.
However, becoming proficient at scrubbing, especially in an emergency atmosphere, which I would imagine a STAT C/S to be (I haven't even seen one as, L&D and OR are separate at my hospital as I guess they are at yours as well), is not something that happens overnight. That would be in my opinion the best way to frame your objections; would you really be comfortable scrubbing a C/S alone in a truly crazy situation, when at least one, possibly two lives are at stake? I know I wouldn't after a scrub class and scrubbing in on one or two routine C/S. To expect you to do so would be unreasonble and compromise patient safety.

thank you for the polite expression of a common concern. I am not interested in scrubbing in for csections. I do enough being an L and D , newborn, PP and GYN nurse. I am not interested in adding that to my list of responsibilities. And you are right; it does NOT happen overnight! Better know what you are doing in a STAT situation!

SmilingBluEyes · Jan 25, 2005

Scrubbing on a C/S is absolutely within a RN's scope of practice. Nurses have been scrubbing long before techs were even on the scene. This argument will not work.
However, becoming proficient at scrubbing, especially in an emergency atmosphere, which I would imagine a STAT C/S to be (I haven't even seen one as, L&D and OR are separate at my hospital as I guess they are at yours as well), is not something that happens overnight. That would be in my opinion the best way to frame your objections; would you really be comfortable scrubbing a C/S alone in a truly crazy situation, when at least one, possibly two lives are at stake? I know I wouldn't after a scrub class and scrubbing in on one or two routine C/S. To expect you to do so would be unreasonble and compromise patient safety.

thank you for the polite expression of a common concern. I am not interested in scrubbing in for csections. I do enough being an L and D , newborn, PP and GYN nurse. I am not interested in adding that to my list of responsibilities. And you are right; it does NOT happen overnight! Better know what you are doing in a STAT situation!

BETSRN · Jan 25, 2005

I don't understand what the problem is or percieved. RNs were scrubbing C/S long before Techs existed. I personally have scrubbed literally hundreds of C/S and find no problem with RNs doing them. We don't do them anymore in our OR because to be quite frank with you, we have better things to do. C/S have to be the most boring procedure. If you have done one you have done it all. As for your list of needed experience, why? The reason your super is wanting to do away with Techs is quite simple, money. Techs are one dimensional were as RNs can be used in a variety of jobs. Think about it, if a Tech isn't scrubbing then they are just a CNA. They can't really do much more. To answer your question whether scrubbing is within the scope of RNs, PLEASE!

WE went through this. Our techs are our regular aids that were trained (200 hour course). Thank God for them. We RN's just circulate. I guess in an emergency, we do have to open up and start until a scrub arrives, but personally, I am NOT going to put my license on the line (or risk injury to me or the patient) by being forced to do something I have not been trained properly to do. This is just another sloppy money-saving technique that puts us at risk. We are already an LDRP and are crosstrained in several ways.

You don't see nurses in other areas (like ICU) asked to go to the OR. I am not sure why everyone feels it is okay to train us. We are a critical care area,too.

BETSRN · Jan 25, 2005

I don't understand what the problem is or percieved. RNs were scrubbing C/S long before Techs existed. I personally have scrubbed literally hundreds of C/S and find no problem with RNs doing them. We don't do them anymore in our OR because to be quite frank with you, we have better things to do. C/S have to be the most boring procedure. If you have done one you have done it all. As for your list of needed experience, why? The reason your super is wanting to do away with Techs is quite simple, money. Techs are one dimensional were as RNs can be used in a variety of jobs. Think about it, if a Tech isn't scrubbing then they are just a CNA. They can't really do much more. To answer your question whether scrubbing is within the scope of RNs, PLEASE!

WE went through this. Our techs are our regular aids that were trained (200 hour course). Thank God for them. We RN's just circulate. I guess in an emergency, we do have to open up and start until a scrub arrives, but personally, I am NOT going to put my license on the line (or risk injury to me or the patient) by being forced to do something I have not been trained properly to do. This is just another sloppy money-saving technique that puts us at risk. We are already an LDRP and are crosstrained in several ways.

You don't see nurses in other areas (like ICU) asked to go to the OR. I am not sure why everyone feels it is okay to train us. We are a critical care area,too.