Techs and MEDS?????

Marie_LPN, RN, LPN, RN · Feb 17, 2006

Depends on the facility. Some mainly have techs that scrub mainly, others don't. Where i work, the majority of who's scrubbing is LPN's and RNs. Very few techs.

(I'm waiting for that post from someone that comes along where someone says "only RN's scrub where they work, thank God.")

sunnyjohn · Feb 17, 2006

During my first school clinical rotation of surgical tech school, I often asked my professor why no nurses scrubbed at the hospitals I was assigned to. My professor was(is) and RN and asked me why I thought that was so. In my naivete I told her that I thought that the nurse did not scrub because they had "graduated" by value of their education and nursing license to a higher role. She partially agreed with me, but laughed her head off. :roll

The next day at the hospital I was assigned to a group of Filipino nurses. WHOA! I swear they were octopuses and not humans! They could do scrub tasks no more mortal could do AND NEVER ONCE broke sterile technique! The Mayo stand of those nurses would look like something out of a Betty Crocker cookbook. Surgeons and grabby residents could be freaking out left and right and they never even blinked! It was always "Curved up, flats down, sharps protected!" With one look they could calm a nutball surgeon or a wayward MDA! It was almost like a Jedi mind trick...

Being a mere student orthopaedic procedures like total knees and hips scared the doo-doo out of me. All the equipment and the pans of stuff! Dang if ths nurses didn't teach me how to scrub totals, open hearts and nuero by the end of that rotatation.

The REAL eye opener came when I saw my first eye surgery. I was hip deep in drugs! That is when an excellent nurse showed me the importance of labeling EVERYTHING! She told me that no matter who bellies up to the MAYO the sterile pen was the scrubs best friend!

I am a Certified Surgical technolgist (soon to be nurse) and proud of it. I am very proud of my profession and the wonderful people in it. In addition to great RNs, great CSTs, great LPNs, and yes, great hospital houskeepers taught me the importance of my job and my role in the team.

Good scrub techs don't take away from the circulator role. If they communicate, pay attention, stay vigilant and do their job right, they become an extension of those responsiblities.

shodobe · Feb 18, 2006

Marie, remember where I work we have an ALL RN staff, no Techs at all. It has been that way for as long as I have been here, almost 30 years. Now, once in a blue moon we will get a Tech from registry, but that is very seldom. The full-time staff is all RN and will be that way as long as my Director is in charge. Sorry.

Marie_LPN, RN, LPN, RN · Feb 18, 2006

Marie, remember where I work we have an ALL RN staff, no Techs at all. It has been that way for as long as I have been here, almost 30 years. Now, once in a blue moon we will get a Tech from registry, but that is very seldom. The full-time staff is all RN and will be that way as long as my Director is in charge. Sorry.

What i was refering to in my remark you're addressing are the posts in the periop forum where the statement is made "we have an all RN staff, THANK GOD". That statement practically pops up in ANY OR thread regarding anything less than an RN in the OR, and quite honestly, if i made such a remark regarding RNs in OR (there has been a fool or two that have in the past, talking like the circulator is their personal servant, and THAT went over well, if i remember), it would be perceived as rude in no time.

However, i relized from day one that every job and every titile in our OR is important to its function, therefore, i'd never do such a thing.

hondurena · Feb 18, 2006

CST's like sunnyjohn and LPN's who scrub in the OR like Marie seem to be conscientious, confident and secure in their role and very knowledgeable. I'd be comfortable knowing that you guys were scrubbed in on a case in which I or family were having surgery. Unfortuantely everyone doesn't share the same work ethic and everyone wont label meds and do what they are supposed to do. That's why when you guys start circulating and can tell those at the field whats right and whats wrong its because you've been there -- done that:coollook:

Owensaunt · Feb 18, 2006

The scrub is supposed to label not only the cup the circulator pours it into (med, concentration,exp date) but is also supposed to label the delivery device if applicable (syringe, asepto). The circulator shows the bottle to the scrub and the scrub confirms. Not everyone does this even though it's an AORN standard and usually policy in the facility. Accidents have happened when things aren't labeled. At a facility I used to work at a scrub acidentally gave the surgeon anti fog agent in an unlabeled syringe instead of local. That patient is a Millionaire now and has no mucus tissue lining her sinus passages/nares.

Marie_LPN, RN, LPN, RN · Feb 18, 2006

I have noticed that the label on the asepto gets soggy in no time, so it usually gets covered in an OpSite or Tegaderm.

Marie_LPN, RN, LPN, RN · Feb 19, 2006

https://allnurses.com/forums/f86/wash-woman-dies-after-cleaning-fluid-injection-85941.html

The above link, an EXCELLENT example on the importance of proper labeling.

sunnyjohn · Feb 20, 2006

One time a surgeon and a resident made fun of me 'cause I had so many labels on my stuff. I took out my sterile pen and stuck a label on both of them and the medical student! Anesthesia joined me and stuck a label on his head and one on the circulator!

The director came in to scrub so I could go on break. She brought in everyone she could find to show them the labels on the doctors! She said "That's how we avoid getting sued!" Everyone is still laughing at that one!

JLynnOR · Mar 8, 2006

(Before I posted, I didn't realize that there were four pages of posts on this. People on pages 2, 3, and 4 said what I was going to say--and better! Oh Well.)

The scrub is always supposed to have things labeled, even (as a previous poster mentioned) saline and water. If you're a non-OR-trained person, it might seem wierd. But we have double-checks in place that often seem a little redundant (labeling ad nauseam, repeating the med and concentration when we give it to the surgeon, etc.)

The biggest issue that I see in the situation outlined by the original poster is the fact that they weren't labeled. And, the surgical tech or scrub nurse is to repeat the med and concentration to the doctor as the med is handed.

"Quarter-percent Marcaine with Epi" If this wasn't done, the staff was not using the double-checks that are supposed to guard against error.

Many surgical techs have 2 years of training. Their training isn't as comprehensive as the training we've gone through as nurses, but it isn't like some other "tech" positions in which a person with a high-school education comes in off the street and receives a little on-the-job training.

mkmdbm7 · Mar 8, 2006

It is the acceptable process in a surgical setting that the circulator verifies medication, strength, and expiration date WITH the CST when the CST draws up medication to the sterile field WITH the RN circulator (a licensed and unlicensed co-worker are verifying med). ALL medications and solutions are then labeled on the sterile field.

The CST is sterile, and must handle the *sterile* medications on the field.

The medications are administered intraoperatively by the physician.

There are safe medication practices that are followed in the OR just like on a med-surg unit, but the process is not exactly the same as on a med-surg unit.

CuttingEdgeRN · Mar 8, 2006

I work in a 24 room OR suite. We have mostly certified scrub techs scrubbing and RN's circulating. I never pour medications onto the sterile field until the tech LABELS the cup. I show the medication bottle to the tech and also the expiration date. I watch her draw it up into a LABLED syringe. When asked for, she hands it to the surgeon while repeating to him exactly what it is. The surgeon administers it. All empty medication bottles are kept in view durring the procedure.