Realizing there are many OR units, and each has their particular idiosyncrasies; yet my current OR is run, if not managed, by scrubs and not nurses. Disclosure: I am a nurse. While the scrubs do very good work in this particular OR, the nurses definitely have little if any input regarding daily assignments, duties, scheduling, etc.. Instead the scrubs oversee this OR. Not the first time I have encountered this power arrangement. Always leaves me wondering, Why even bother having a nurse in the OR? Being a nurse for many years in the OR, I have enjoyed the OR, but the re-occurring power struggle nurse vs. scrub is always ever-present. Sometimes I think nurses should abandon the OR, and many a scrub I have encountered has argued as much in the past. I know there are nurses who may read this and take exception to this proposal of relinquishing OR duties (scrubbing, if some nurses still do, and circulating) to scrub techs. I applaud your defiance to what I have seen as being a trend to a no-nurse OR, in which the nurse is merely a figurehead, secretary, and/or gopher. I've heard of all-nurse ORs, but not in this neck of the woods. I hate leaving the OR. I enjoy the OR. But seeing, and being part of, such a diminished role leaves such an empty feeling at the end of the day. Maybe it's time to go into another area of nursing? Or maybe I should hang up being a nurse, and join the tech ranks? Either which way, it's just sad to see nurses take such a backseat in this "specialty" of nursing.
Been gone from here for a very long time. Just retired after almost 40 years in the OR. I run my room NOT some Tech. Simple for those out there who allows this to happen.
Go work in another OR. In most, the OR is run by nursing. Scrubs have a say, sure. But, the OR should be run by nurses. In the OR I am in now, some of the scrubs graduated from a program that is only a few months in duration. The scrub's focus is the surgical field, we all know there is more to a patient's well being in surgery than that.
I am not bashing surgical techs, by the way. I was one for many years. I still scrub on occasion. We all have a place in the OR and should be working together, not against each other.
I've never seen an OR run the way you describe in 23 years and 20 years of hospital hopping as a traveler. That is point number one.
Point number 2 is that friction I've witnessed between scrub and circulate is personality based. The goal is teamwork and harmony.
Point 3 is that techs circulating is legal in many states but I've not seen it. It works well in the military. My suspicion is that it will be difficult at best to prove that outcomes will be better with RN circulators. This seems analogous to to CRNA outcomes versus MDA. My belief is that my background as an RN means my cases will be shorter and have better outcomes than a pure tech. But MDAs feel the same way about their care versus CRNAs and there is not a shred of proof.
Just as an interesting aside, I've worked in England. The higher trained staff (usually nurses) scrubbed and the lower trained staff (usually techs) circulated. In this country, I have effectively managed several emergency open heart cases while scrubbed directing a relatively inexperienced circulator. But that is not ideal or optimal in our system. All participants have to be (should be) proficient at their part.
In most or if not all hospitals, there's always somebody that you can't get along with especially in the OR, you will be dealing with a lot of people with different attitudes and different upbringing. In my experience, surgical techs who had long years (20-30) of experience tend to be dominant than the OR nurse with a 1 year of experience. That's okay as long as that surgical tech doesn't give you an attitude and belittle you instead of helping you out especially with cases that you're not familiar with and working as a team. Im not bashing surgical techs but from what I have observed some are really bossy and bullies the OR nurse with less experience. I just dont get that. Don't tell me they already know everything when they started working as a tech. Some are know it all some are humble. It just gets down to this question, and you can ask this question to techs that gives you an attitude, "Who is licensed here?". We as OR nurses are responsible for our scrub techs and it would be nice if we all work together as a team. Being able to scrub and circulate, I still have a sense of humility and I dont brag about anything. Never thought of that, as long as I can keep my patients safe, I am happy. Just remember, we are the angels in the sickroom. Everybody in the OR suite relies on the OR nurse.
There are lots of nurses too who are bossy (it is the nature of thei job really and required as manager of patient care), and nurses who are bullies, and nurses who are passive aggressive. The only thing about OR is that you may be forced to be confined in one room with oil and water. That is not the case in most other nursing specialties (dialysis being similar to OR perhaps).
I have worked in both types of OR. What I can tell you is that legally you are considered the primary circulating nurse. Techs are not nurses. They have a role, a responsibility, and a place like the rest of us, but ultimately they are not nurses. They do not have your scope of practice, your ability to insert your scope into a situation, or your qualification. They know it , they made the decision to become a tech rather then a nurse yet now expect you to stand back while they run the joint.
Ironically the best ORs are those where both techs and RNs understand their scope and work within it. The worst ORs are those where RNs are expected to almost apologize for taking their degree.
The reason we are in the ORs?. To provide liability in the event there is a screw up. While the techs may not feel we are needed, the truth is you can work independently in the OR as an RN. Many techs cannot get a job in ORs. I would if I were you find an OR where your qualification is respected and utilised.
shodobe
1,260 Posts
Been gone from here for a very long time. Just retired after almost 40 years in the OR. I run my room NOT some Tech. Simple for those out there who allows this to happen.