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?

[shodobe]

I just turned down a job because I wasn't going to get the amount of scrub time I felt was necessary. It is very important that I have that choice and not be put into a position of only scrubbing once in a blue moon. I agree with "HelpinHeart" that you need to it all to be a complete OR nurse. Mike

[mother/babyRN, RN]

Hmm, interesting stuff here. I don't think scrubbing makes you a better nurse as it is simply one more skill that can be learned. At our hospital the OR is always angry when they have to come in for a c/s, but they are not willing to work with us. We don't have enough staff to scrub, and if we did, I really can't see how we can scrub, circulate, recover and then care for the patients when there MIGHT be 2 nurses in delivery period. I understand the frustration here, but not everyone loves to do what you do, as most probably YOU wouldn't want to be working in delivery without proper training. Our facility won't dole out the bucks for a program to scrub, and my license is more important to me than someones opinion on the matter.....But, certainly an interesting debate, non the less...If anesthesia and OR were required to remain on site, they could spend their off hours or "quiet" hours helping out on the floors or showing us how to perform the way they would prefer....I am in no hurry to "learn" but, of course, had we the staff to support such an endeavor, I would be right in there with them, and of course, since anesthesia and OR are not required to be inhouse overnight, there have been numerous times when a stat c/s warranted me scrubbing. To the doc I simply say, "Better show me what you want and talk me through it and we will all get through this..."

It is simply, IMHO, what people prefer...Learning this task means only that you know something important and useful that you can utilize often and in many different scenarios..To say that this improves your nursing skills , to me is ludicrous- it does, however, certainly enhance them....

[medman]

stevierae

RN's are not taught to scrub these days and most facilities do not have the staffing to teach them. I have been a surgical tech for 18 years and an OR nurse for 2. I do agree that your better OR nurses are the ones with scrubbing abilities. In somewhat of a defense for those nurses who don't want to scrub, working in surgery is like another world compared to working on the floor. Most nurses who transfer to surgery don't last long, because you have too little time to learn all the essential equipment and supplies just to be able to function half way by yourself. When they see what the technicians do it scares them to death. I have been on both sides of the sterile field and it is my firm belief the most technical job is the scrub tech/nurse. I can see where that job would intimidate a new nurse and if he/she don't have to learn it, most of the time they will not. I would say it was not that they are all just lazy, just intimidated by it.

[kids]

Kids says (in a very tiny voice):

The ADN program I graduated from did an entire term in the OR...I LOVED to circulate and got pretty good at it...but I got dizzy and whoozy and freaked out scrubbing (claustraphobic).

When I got out of school one of the jobs I turned down was OR because I would have to scrub.

[shodobe]

I disagree with the post above stating "scrubbing" doesn't make you a better nurse, of course it doesn't, but it does make you a better OR NURSE! If you can't do both then you are only doing half your job. I would never tell a surgeon I didn't know how to do something, I would just do it. The experience allows you to get thru these cases without any stress and having the knowledge of scrubbing makes it just that much easier. Mike

[tqwood]

I only wish I had the opportunity to refuse to scrub. My institution employs CST's to scrub because they're cheaper. I've worked here for over 20 years, and probably have scrubbed fewer than 25 times. It's too bad, because I think an RN who can scrub is a better circulator.

[shodobe]

tqwood, are you saying you would like to scrub but can't because they use CSTs? I think I understand because I do have that luxury of choosing whether to circ or scrub. I think hospitals are shortchanging themselves by only using CSTs and not getting the use of their RNs. The person who can go both ways is much more useful in my opinion. Mike

[tqwood]

Mike-

That is exactly what I am saying. We run on such a tight staff that there are barely enough RN's to circulate the rooms, let alone scrub. Since a tech is paid about half of an RN's salary, my institution has opted to use techs in most scrub positions. I think we have a crop of RN's, who because they don't scrub, find it difficult sometimes to set priorities in patient care, not to mention the difficulty they encounter just trying to find an instrument that they can't identify.

[shodobe]

I do work at another facility that has hired new RNs and they will never be taught how to scrub because number one, they use alot of techs and number two, there is no one to teach them since the inservice person retired and they have no intention on replacing her. Sad, very sad. Any RN that gets the oppurtunity to learn how to scrub should because it does make them a better OR nurse. Mike

[Marijke]

I think I would get out of the OR if I wasn't allowed to scrub, especially in trauma and ortho.

Maybe some RN's refuse to scrub because they don't get the chance to do it enough. There are still cases I don't like to scrub for, because I feel I don't know enough about the procedure. This is why I force myself to scrub for it, so I wont feel like that next time.

Marijke

[MA RN]

ok folks,,,,, this is from an or nurse from 1987. old as dirt in knowledge but only 43 years ancient.

is used to scrub the vascular/general cases all of the time. i can no longer scrub because of my rheumatoid arthritis. can't do the 6-0 and 7-0 prolene's anymore. digits are stiff and reflexes are slow. so i just circulate now and get the new techs out of school to circulate with.

anyone else working with a similar disability?????

[cwazycwissyRN, RN]

Just food for thought. I am currently a circulating nurse only. In the last hospital I worked at we rotated from scrub, to recovery room nurse to sterile stores if needed. RN's were expected to have the ability to learn it all plus circulate. Lovely rual american hospital...I've since started a position at a larger hospital and have found it very nice to discontinue being the jack of all trades and the master of none. I enjoy the challenge of focusing on becoming a great circulator. I miss at times scrubbing, however I am aware that my RN degree does not make me a good scrub, only consistant experience along with a good orientation(most likely from a cst) would accomplish this. CST's have the opportunity for the constistancy needed to become excellent at their job....and they do. Place me in as a scrub here and there or when you need a body and that's what I'll be ...just a body trying to go though the motions, frustating a doctor . Sure a basic belly case would be fine but ortho or nero without constistant opportunities to get and keep the skills I'll leave it to the experts..THE CST'''s out there that never seem to get the praise for the excellent jobs the do.