What's up with RNs who refuse to scrub?

[stevierae]

This trend, at least in the Western states, is starting to irritate me more and more, the more I see it. I have been an OR nurse for over 20 years; scrub and circulate all areas; have done all kinds of trauma. Nowadays I only work as an OR nurse on a travel assignment once a year, to keep up my skills. The rest of the time I work as a legal nurse consultant and as an IV nurse educator.

So, what's up with these new RNs in some (not all) ORs who don't scrub, and won't learn? To me, it's like doing only HALF your job, and leaving your colleagues who DO scrub left to do their share PLUS yours. I really want an answer to this.

One time I went to a job interview to see if I could pick up some occasional per diem work at a local OR. Just for this stupid little per diem job, in an OR that is not even a trauma center, and does pretty much just VERY basic surgeries (i.e., lap choles, arthroscopies, breast biopsies, TAH-BSOs--you get the picture--) I was interviewed by the director PLUS the "charge nurses" of those areas--that is, general surgery, GYN, and ortho--all new grads. Out of the blue, the director asked, during the course of the interview, "What makes you angry?" I said, "OR nurses who refuse to scrub." Every one of the charge nurses stared at the floor. I realized, then, that NONE of them could scrub, nor would they ever learn. I knew I wasn't going to be getting that job!!! (I also knew I did not WANT that job.)

The funny thing is, scrubbing is fun; sometimes, you really bust your a** running around circulating big cases and scrubbing is a very welcome break, where you can almost let your mind go on autopilot--well, you can if you know what you are doing. Those prima donna charge nurses never will.

Oh, by the way--I always take my OR travel assignments in California, and ALL the OR nurses in those facilities scrub and circulate all areas. Are California OR RNs just better, more well-rounded RNs than the RNs in the rest of the Western region? I don't live there, but I teach there quite a bit, (as well as doing the aforementioned annual travel assignment) and I am beginning to suspect that this just might be the case. What is the trend like in the rest of the country?

[heartholder]

Not true. RN aren't taught to scrub anymore where I work. Scrub techs are less expensive... when I became an OR nurse 12 years ago, it was part of the orientation. I have 3 months of scrubbing and 3 months of circulating. I love to scrub and still get to on RARE occasions. I agree that a RN who can do both is a better nurse. but it isn't always that the RN refuses, economics play a large part in this. I agree that scrubbing is a welcome change from running your a$$ off as the circle in a big case.

what makes me angry.......lack of team work.

just an observation.

[meandragonbrett]

Originally posted by stevierae

Are California OR RNs just better, more well-rounded RNs than the RNs in the rest of the Western region?

Just because they RN scrubs doesn't mean they are more well-rounded than a RN who doesn't. It's a common trend for RNs to circulate only and Scrub Techs to do all of the scrubbing. RNs scrubbing is not allowed at my hospital.

[stevierae]

Where the he** do you live, meandragonbrett? And why do you allow yourself to get stuck in a situation where you have so little autonomy? Why not speak up and ASK to learn to scrub, rather than getting stuck in such a rut? To say that RNs who CAN scrub and RNs who CAN'T are equally well-rounded is simply nonsense. Ask any of your scrub techs who THEY would rather have as their circulator, given a choice!! If you don't scrub, you really cannot empathize with your scrub, you cannot really anticipate needs (other than what is clearly visible like laps and needles,) you can't suggest instrumentation that might work in a pinch if the commonly used instumentation is "out for repair" in use in another room or BREAKS while you are using it. If the surgeon nicks some major vessel and the patient starts bleeding out and your scrub yells out "Gimme a vascular stitch," you will have to waste critical time asking, "What kind, what size, on what type of needle" because you, having never scrubbed that type of case, won't be knowledgable of what most likely just happened (that is, what vessel was most likely nicked, and what the consequenses might be.). You CAN'T put yourselves in the shoes of the scrub, because YOU HAVE NEVER BEEN THERE. I firmly believe every OR RN needs to function in both roles; if not, you are only doing half your job.

[stevierae]

P.S. It's NOT a common trend. I believe this "trend" is only common in the South. It does seem to be coming MORE common, but it is NOT because of economics, it is, from what I have observed, laziness on the part of RNs who have NEVER scrubbed and REFUSE TO LEARN, even when offered the opportunity. I have seen RNs quit rather than have to fulfill that function.

[meandragonbrett]

Stevie,

I haven't done anything to myself:) I'm not a nurse yet! I just work in the department and I see what goes on. I think things would go better if we did have RNs as well as techs scrubbing, b\c we often have problems with our scrub techs(I won't elaborate) But administration isn't going to allow that to happen. Most of our circulators have scrubbed before in previous jobs, but the general concensus(sp) is that things would be better off. And I probably made no sense in that post, sorry!

Brett

[memphisgurl]

brett are u at baptist east? I use to work at baptist east about 4 months ago in surgery.

[shodobe]

stevierae, I couldn't agree more with you. I have been in the OR for 25 yrs and when I first started we had nothing but an all RN staff! We had to go both ways or we were out of work. We just hired our first tech and she has a lot to learn. My sup refused to hire techs because she wanted the options of us going both directions for our strenghths and weakness. An RN that doesn't scrub and circ is only half an OR nurse. You can teach practically anyone to circ but it takes a special person to do both. Just my two cents worth. Mike

[stevierae]

Mike, THANK YOU for validating what I have been saying for years!!!!

NOTICE THAT MIKE IS FROM CALIFORNIA!!!!

Take note, all you prima donna RNs who refuse to learn to scrub. One day, the tide is going to turn again (it always does) and you will find yourselves out of jobs, done with your years of only doing HALF the job anyway, as Mike so eloquently put it. No OR will hire you, because you cannot fulfill both roles, so are therefore not cost-effective.

Not only that, you will be desperately trying to play "catch up," frantically attempting to learn YEARS of technology that has passed you by, simply because you REFUSED TO LEARN IT while it was new. You will be WAY behind the rest of us who kept up our skills and could TRULY call ourselves well-rounded operating room nurses.

Who, do you think, is going to come to your aid at that point? We sure won't. I am really tired of offering to backscrub with people to help them learn new procedures as they are implemented, so that they can stay current (as well as ONE STEP AHEAD) ONLY to have them sniff "I don't scrub." I just don't understand how people get away with that behavior; never have, never will!!!

P.S. Mike, I have my own Legal Nurse Consulting firm. Please e-mail me privately if you are interested in being added to my subcontractor/expert witness database. Notice, other OR nurses who DON'T scrub: Mike can function as an expert witness, while you will never meet those qualifications. He can earn a great deal of money, and his expertise, in legal cases, may be instrumental in landmark decisions that will affect patient care and health law forever --can you say the same?

[heartholder]

I have asked for YEARS to learn to scrub. management refused me and the other RN's who asked. I learned how to scrub by watching the techs. and I can manage most cases that I have been asked to scrub on. NOW NO one can learn to assess a patient or learn the legalities of the permit and charges and charting by watching the nurse do it. I do hope the tide turns and management in the south realize the importance of allowing RN's to become more effective and versatile by scrubbing.

but techs are less expensive to pay. and now they are putting techs in the OR as second circles. as talented as techs are in the scrubbing role. they are useless as a 2nd circle.

as for you BOYs from the west...ya'll come down and see me sometime....:blushkiss

[stevierae]

Hey, I ain't no boy. "Stevierae" is a childhood nickname, and, anyways, I am a big fan of Stevie Nicks AND, of course, the late, great, Stevie Ray Vaughn.

[stevierae]

P.S. Ya know, I actually AM toying with the idea of taking a travel assignment, operating room, in either Tennessee (you are right, it truly IS God's country!) or West Virginia. Does your facility use travelers?