New to your role as a scrub nurse? - These tips are for you! Check out the video at the end.
by Carla Graham, RN and Clinical Nurse Leader
There are a lot of things to remember as a new scrub nurse or surgical technologist. Maintaining sterility for yourself, and keeping an eye on your team at the same time is enough to keep your brain busy! As you continue to gain experience in the different services you work in, I've collected some tips below for you to work on that will keep you and your team safe, and show your surgeon that you are keen and paying attention to their needs.
1. Handling power equipment safely
This tip is number one for a reason! Power equipment is dangerous, and learning how to handle it safely on your back table and when passing to the surgeon means you don't hurt yourself, or them. Always make sure you are handling the equipment when it is in safe mode! If the surgeon wants the equipment "ready to use" (AKA safety off, ready, or live), do so only at the last minute to avoid any accidents. Make checking your power equipment is safe a regular part of your back table routine so you don't get hurt!
2. Passing instruments ready to use
This one's a bit tricky, but it really helps to know your instruments by name, as well as by use. Retractors are used and held differently than needle drivers, and handing them up to the surgeon such that they can hold them in a "ready to use" position makes a difference when thinking about efficiencies in the surgery. The surgeon is often concentrating and gets annoyed when they have to change the position of the instrument, or use two hands to adjust their hold, when they only have one hand free. If you're not sure how to hand up the instrument, give it your best guess but then pay close attention to how they use it so you can make sure you hand it up correctly the next time.
3. The Neutral Zone
OR nurses didn't always use a neutral zone - But they also got needle stick injuries a lot more often too! It is a super important part of the back table set up now. Just like having a loaded blade, sponge, tissue forceps, and cautery ready to go, using a neutral zone to pass your sharps is an essential part of your set up.
4. Suture Handling
Sutures are also sharps! So use your neutral zone to pass them up to the surgeon and receive them back (where possible). At the same time, be sure to manage the suture material, as they tend to be long and can easily fall off the back table or operating surface, which means they have to be cut off due to contamination. This wastes suture material, money, and time - as you'll have to wait for the circulator to get you a replacement if the surgeon asks for the same suture again. Don't make them wait!
5. Be Engaged
This one is tough when you're new. Do your best to pay attention to the surgeon and the surgery, and not just your back table! By watching what they are doing, you might learn an extra thing or two about the anatomy they are working on, the technique they are going to use, or just what they might want next. Being able to anticipate the next step is the ultimate scrub nurse goal! When you and the surgeon are working harmoniously, the surgery gets done so much faster!
I hope these tips help you become a better scrub nurse!
If you liked these tips, or have some tips of your own, comment below.
Until next time,
Carla
Carla is a Clinical Nurse Leader for Orthopedics in a busy tertiary care hospital in Vancouver, BC. She has been a perioperative nurse for more than 10 years, and along with her fellow CNLs in the Operating Room, helps with the in-house training of perioperative student groups twice a year.
Follow her on instagram @orthopedicnurse