Sterility

[fusionfire32]

Hello fellow or nurses,

Have a question. Where do your surgical tech stand during surgery. I was taught to set up according to the side the surgery is going to be and stand opposite the side of surgeon. I learnt this because the surgeon could turn his/ her back while performing surgery to the tech when tech stands the same side of the surgeon. This is not considered best practice where I come from. So we used to stand the other side of the surgeon so we never have that issue. And also can see the case better.

What do you think?

[Rose_Queen, BSN, MSN, RN]

I've usually seen that the ST/scrub person will be on the side opposite the surgeon when possible. It also facilitates passing of instruments.

[fusionfire32]

Hi rose,

Thank you. I can now confirm that I am not silly in implementing that. Do you have any research to back that up. I want to ensure best practice. Actually, I had an argument with a RN who scrubs and claims that she has 30 years of experience. Her argument was that why can't I do what others do it all the time. I gave her my logic and she got really mad and was literally shouting ay me. So if it is evidence based, its time to change "we have always done it this way"

[NICU Guy, BSN, RN]

I used to work in surgery many, many years ago so my observation may be outdated, but the Surgical Tech is alway in the back of the room facing the front of the room with instrument tables behind them and around them. Surgeon is on the opposite side facing the back wall of the room.

[fusionfire32]

Hi Guy,

There are many ways to set up and the one that you mentioned is one of them. the only problem may be in that situation is when an assistant is involved, it does not leave a lot of space for them to assist and stand. on the other hand, anatomically, if the surgery is performing surgery in the lower extremity, that is possible. However, the most important concept is that the tech/nurse that scrubs stands on the opposite side of the surgeon for improved visibility and not passing instruments when surgeon is working and has possibly turned his/her back and the scrub person is handing instruments across the surgeon's shoulder or back. that is poor technique. I do appreciate you sharing your experience.

I would love to see if there is any literature for this topic. So that we can change our practices at our hospital.

[jeckrn, BSN, RN]

In the OR I work the techs where the techs set up is based on the case, number of surgeons, & the room. If it is a scope case and there is only one surgeon the tech will be on the opposite side of the surgeon to help drive the camera etc.

[birdie22]

Totally depends on the case and room layout. Are you turning the HOB 90*? We have some extremely outdated ORs that are super small yet have to accommodate all fancy new devices and technology that our surgeons "must have". You stand where you can fit and just always gotta watch your back (literally). Ideally, yes, the scrub should be opposite the surgeon, just makes sense in terms of workflow.

[RosesrReder, BSN, MSN, RN]

You stand based on room layout, type of surgery and physician preference of course. In our victorian style/aged OR's there is always some tweaking that needs to happen. Ideally, yes scrub is directly opposite but when there is a first assist, students, type of surgery, amount of equipment then you make it work however is best for that particular case.