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?

[P_RN, ADN, RN]

4 million years ago (mid 70's-told you I was OLD!!!) when I worked OR they could pay 3 scrub techs for what one RN cost. Crud, scrubbing was a whole lot more interesting than sitting there and documenting and playing fetch for the surgeon!

[shodobe]

Hear, Hear! P_RN. I did a total knee, total hip and knne scope today and wouldn't change this foe anything! I love the choice and the ability to do both. The hospital I work at has an ALL RN STAFF! I am very lucky in this and I have turned down several job offers at other hospitals because they use Techs almost exclusively and would reduce my scrub time down considerably. I do work part-time at other places that use Techs and they are very competent at their jobs. Mike

[Sarah, RNBScN]

Where I am from...you are hired according to the job description which includes scrub/circulate and float. Granted, we have some nurses who just circulate because they are "senior" which I don't agree with and have made it known during our staff meetings. They baby some because of "favourites" or they have a problem "drinking", camera shakes so bad that you are trying not to vomit. It is true and very sad what certain dept. can get away with. On the other hand, surgeons have favourite scrub nurses and only certain people are in that person(s) room. I don't agree with that either. Very political...I know so many nurses who left the OR because of all this type of crap.

[webbiedebbie]

Perhaps, "scrubbing" should be taught in nursing schools to alleviate the fear of it. However, I too, get claustrophobic in the sterile environment. I have to move around (circulate) and concentrate on other things to keep me focused.

Question, are more hospitals doing C-sections with OR staff now? Prepping my labor patient, circulating the section, and recovering the patient wears me out! The hospital where I work uses OR staff during the day and L&D staff at night.

[shodobe]

We trained the L&D staff to do their own C/S when it became a problem with the schedule. The OB guys wanted to do their sections when they wanted to do them no matter what the schedule was like. The general surgeons hated to be bumped for a failure to progress and loved it when they went down the hall. After 10 years of doing sections if the hospital ever thought of giving back the privledge of doing sections in the OR, I wouldn't hesitate to tell them what they could really do with them! There would be a revolt and mass exodus of OR nurses. Our problem now is, they can always find nurses and the time to do their sections in their department but are too busy at times to do the Tubals. I think a hospital that still does sections in the OR is living too much in the past. Just my two cents worth, Mike

[KarenHalse]

Hey, I would like to reply to this one...I am an RN with 28 yrs varied experience. I worked OR about 10 yrs ago and as alot of nurses I got purely fed up with the BS and left... Now, I have decided I wanted to do OR again and have been back about 3 yrs and I will be staying this time.

When I started OR the RN's were not taught to scrub. It was too easy to bring someone in from the local hamburger joint, teach them to scrub, and it was alot cheaper. This was in the Middle of Dixie, if that means anything.

Now, that I am among the majority of nurses that will be retiring sooner than later, I find it too hard to stand in one position for hours for at a time to scrub. It is very hard on my legs and back.

And there still is no one knocking on my door trying to teach me to scrub either.

Now, just because one does not scrub does not mean they cannot be a good OR nurse. If you are attentive to what is going on in the "field" you can anticipate the needs of the team...this is something that too can be learned. You DON"T have to scrub to learn procedures, it only makes it easier.

I have worked with many OR scrub techs and RN's that think all they have to do is walk into the room after it is opened up and set up. The attitude that the "table" is their only responsibility is pure BS. This is pure lazyness that has been allowed to happen by management. The equipment, supplies, as well as the patient are the responsibility of the "team"not just the circulator.

I do get angry with the scrub (Rn or Tech) when they are scrubbed and say "oh, I need this or that" and you are busy with the pt., or when their is an equipment problem and they look at you like it is your problem...etc. If they have helped me with the room and equipment, it is not so bad but the lazyness has to stop.

[POPRN]

I applaude you KarenHalse!!!! I too am an OR nurse and live in Dixie. Scrub techs outnumber the RN's 2:1 here. so of course the RN's rarely scrub. I also agree that management here allow the scrubs to be lazy. I am tired of running and doing what they are supposed to do. Your post mirrored my thoughts exactly.

[KarenHalse]

Well POPRN, I am glad to hear someone else feels like I do. I have started giving them notice by asking where were you when we opened, did you check the case before we started, this sort of thing. I do this a couple of times and then the next opportunity I say to them, what size gloves do you wear and I will open you a gown...this does make them realize that I am not going to put up with much of it. There are times when it cannot be helped but on a day to day basis..this ole girl is been down that road too many times!

I enjoy OR better now than I did a few years back. I think the shortage is helping us some. I find management is more receptive to listening when we talk now. I don't whine or complain about unimportant issues.

The main thing I know is now that I travel (just started last year), I only have to be here for a short amount of time. I can leave this miserable place and go to another one that might be a little more tolerable for better money and great places to explore (our country)...

[spineCNOR]

on the issue of scrub techs "slacking"--I have worked with many techs who, of course, have never circulated, and think that what they do is so much harder than what the circulators do, and so much more important to the case. I even had a tech tell me one "scrubbing is SO much harder than circulating".

After working in an OR where I scrub more than I circulate I know that is just not true! Yes, some cases involve more work for the scrub, some involve more work for the circulator. I think these techs think nothing of not putting any thought into getting the case ready because all the circulator does is sit!

Circulating is more thankless- I don't think it is as interesting, and the time tends to drag more.

I do not mean in any way to bash techs--I have worked with some very good, very knowlegable techs who were strong team players, and I've worked with some nurses who weren't team players! I just think the team work goes better if all members of the team understand and respect the job that other people on the team are doing.

[KarenHalse]

I agree with you and I am not into bashing anyone. That is just my point. We all have a job to do and we need to be functioning as a team. I think scrubbing would be very boring. Thanks for the reply.

[CVnurse08]

I am not a nurse yet and totally clueless on this subject so can someone please answer my silly question of what exactly is "scrubbing" ?? Thanks a lot for you all's help.

[POPRN]

No I am not bashing the techs. they are needed and some of them are very good at the team concept. but most of them just do what they have to do to get by. and then the surgeon THANKS them for all their hard work....the surgeon doesn't have a clue that I, the circle did all the opening and gathering of the supplies then interviewed the patient and made sure all the permits and labs etc... were in order. and NO I don't expect a thank you for doing my job...I hear at work that some of the nurses aren't team players, but I rarely get to work with another nurse. usually there are 2 tech and 1 RN to a room. If both techs aren't needed then one is supposed to help the RN. While I am getting the patient, the 2nd tech counts then usually goes on their break until the end of the case. Then they come back and give the other tech a break...that is what they call helping the RN!!!!!!!! sorry if I offend someone...

Please forgive me