do u sit down when scrubbed?

shodobe · Oct 1, 2003

You can sit for certain cases such as eyes or AV fistulas and maybe ortho hand cases. Sitting for a lap? She better be about to pass out or something or she will get ignored. Disrespectful towards the surgeon also. Mike

carcha · Oct 1, 2003

thanks mike now I dont feel like such a ***** for refusing

chartleypj · Oct 2, 2003

How on earth can a scrubbed person hand instruments and see what a surgeon is doing perched on a stool? How does she think she will maintain a sterile field sitting? I agree, it is disrespectful.

Is she out of her mind? Please do her a favor and direct her to AORN's Standards and Recommended Practices, 2003. Tell her she can SIT to read this.

Paula

kathyann · Oct 4, 2003

AORN recommendations state that it is proper to sit when scrubbed only if you will be sitting for the entire case ( IE: eye cases, AV fistulas...) So, you were not wrong.

That said, we do have a scrub tech with a bad knee that also sometimes sits on a stool if we are stuck waiting for longer than expected for the Dr. to arrive. The best solution is to scrub in and set up, then break scrub until the Dr. gets there if you are uncomfortable standing for that period of time.

witzend · Oct 4, 2003

We had this discussion several months ago when the surgeon was delayed and a scrub was caught sitting down waiting. The rule of 'sterile' levels was involked and we were all forbidden to sit when scrubbed. Naturally all sorts of hackles bristled and qualifications listed re A-V fistulae etc, etc... Perhaps there's a reason she needs to sit down - perhaps she needs support stockings, cardiovascular assessment, fitness training or someone's said something to her early on re the perils of long hours on her feet? A mystery to be solved! We had a nurse who wanted to scrub for everything too. Two years later he's one of our mainstays and an oasis in a desert of disinterested scout. If all else fails, remove the chair from the room!

squeek · Oct 5, 2003

In oz we too sit for the odd hand case, facial plastics etc however wouldnt dream of sitting for anything else.....

the most enthusiastic scrubbers tend to stay in OT the longest...

BarbPick · Oct 5, 2003

OK, lemme give this a try.....If this is a Nurse scrub, she is in violation of the state nurse practice act. If your are the RN Circulator, if you allow it, you are in violation of the state nurse practice act. I took the Medical Legal Consultant Course, have practiced on the side and am ready to take the certification exam (yay)!

As a medical nurse for the past 28 years, I still remember Nursing 101.

I remember during my rotation in the OR, in-between passing out from all the blood, (j/k) that you can only be sterile if your hands are near your chest, high above the waist. They have to be in complete view of the circulator. The RN Circulator is the state's Legal witness of the proceedings.

Now I render my formal opinion (gimme a break, OK)?

The scrub person is wrong, and you are legally responsible. At the least, say no, at the most, kick her out of the case.

Barbara

shodobe · Oct 5, 2003

Barbpick, I think this is a little too picky. I have been doing this for 25 years and I will sit down whenever I can to save my legs and back. This is far more important than some obscure legal issue and besides where are you going to see any legal action based on whether a scrub sits down or not? I am comfortable in knowing if I have contaminated myself or not and do not have a problem, when I circ telling the scrub if they are getting close to contamination. I think we can as OR nurses be a little anal on certain stuff and I know you will say that you are only quoting your states NPA rules. I do agree however that a person can't sit for the type of procedure that was mentioned above and only should sit when the whole scrub team sits, but when I am scrubbed in and waiting for the surgeon to appear, I sit. Mike

carcha · Oct 6, 2003

thanks u all, I really wondered if I'd been around too long and lost touch with the real world , nice to know some things havent changed and common sense is alive and well.

witzend · Oct 9, 2003

Dear Barbpick,

the trouble with fundamentalism is ... Your statement coincides with what our managers pronounced: that we could only sit if the surgeon did, in homage to the novice's instruction of waist high sterile levels. However, life is not black and white, EVER. What about D&C's. Radical vulvectomy? Vag hysts? Try and do one of those sitting down next to the surgeon! I'm five feet tall, most of our ortho boys are over six foot [as strong as oxs' and half as clever(!)], I'd have to wear platform shoes ... At least I'd have an excuse for throwing out the overhead neuro table ... Good on you for studying law, now reconcile the steel of law with the soft flesh it dictates to and achieve something positive.

"We are bright feathers on the breath of God".

The venerable Bede

stevierae · Oct 10, 2003

I think you guys all need to lighten up a bit. OK, I know what AORN Standards of Care and Guidelines say, and I KNOW I will get flamed for this, but, heck---some of the best scrubs I have ever worked with sit for AAAs, radical prostatectomies, Whipples, cranis, etc--that is, any long, boring procedure. They simply raise their stools up WAAAAAAAAAY high and sit. If anyone has a problem with it, they can always put a sterile mayo stand cover or a drape sheet over their stool--but consider this:

Your back IS NOT STERILE ANYWAY--nor is below your waist sterile. If you sit and your hands are at the level of your mayo stand--so what? How can anyone accuse you of contaminating anything? Remember, your back is not sterile EVEN IF YOU ARE STANDING UP, despite what some people seem to think, the way they pass back and forth behind the surgeon while scrubbed, to retrieve instruments left up at the head of the bed. That, to me, is a much bigger infraction, and a definite break in sterile technique.

I also have a problem with people who "guard" their back tables before starting the procedure (after setting up) by standing there with their gloved hands crossed over their chests and tucked under their arms. That is ALSO a break in sterile techinique--a MAJOR one.

Look, in 5 years we probably won't even be wearing masks, for all (?) the good they do anyway. Practically everything we now do by rote probably already qualifies as a sacred cow; if not now, it soon will. If you disagree, look at your infection control rates--I seriously doubt that they are out of control. I really don't think it matters one way or another whether one sits or stands for a procedure, and I am a CNOR, and I have been doing this for over 25 years as well. Stop trying to reinvent the damn wheel and looking for trouble where there is none! Try to have some fun at work!