Scrubbing

With my orientation coming to an end, the time has come for me to learn the role of the "scrub nurse" during a cesarean section. From the beginning, this has been the one aspect of my job that I dreaded learning. Why? Mostly because of the high stress environment that cesareans usually are - especially on night shift, where I am. Usually the operation is being performed as an emergent resolution and everyone is under a lot of stress - compile that with any little extra thing and people - yes, specifically doctors - tend to lash out at the closest thing/person to them: THE SCRUB NURSE.

What a silly reason to not want to learn another skill that can only make me more valuable as a L&D nurse... But, it's the truth. And, I've seen more than one instrument being "tossed not so gently" at a scrub nurse and heard more than one "not so nice" word being yelled at them too.

I've gotten some advice from a nurse I've come to admire... She said she actually likes to scrub and I confided in her my fear of being yelled at and having things taken out on me with no room for error... She said she doesn't let it get to her and never takes it personally. She said that if the doctor cannot even hold it together to do an operation - which is his job, then it is the doctor's problem, not hers. The instruments are lying right there within both her and the doctor's reach, so if she accidentally hands him a straight mayo instead of a curved mayo, and he's in such a rush to have the correct one, then he is perfectly capable of reaching over and grabbing the right mayo, for goodness sakes.

So, last week was my learning week.... I scrubbed in on some - yet didn't do the scrub nurse job yet... I start that this week - Tomorrow AM I have two sections to scrub in for....

What are the roles of the scrub nurse? We are responsible for the sterile field. We set up the sterile instrument tables and drape the patient.... If anyone breeches the sterile field, they hear about it from us.... We then proceed to assist the Dr and his assistant by handing them instruments, suctioning or blotting blood with a sponge from the field to improve the surgeon's vision of the field. During repair, we load needle holders with the appropriate sutures (chromic, vicryl, etc.) according to what layer the Dr. is repairing. For example, the uterus takes a different type of suture than does the peritoneum...and the peritoneum takes a different type than the bladder flap, etc. We may help establish homeostasis by assisting with cauterization of bleeders. The scrub nurse also takes part in the instrument count before, during and after surgery to ensure nothing was "left behind."

So, all in all it is not a hard job, but like I said, the scub nurse must hold it together under pressure, know her instruments and not take lashing out behavior personally.... I'll work on it. Thankfully, the vast majority of sections I've attended the doctor's behaved themselves just fine.... It just so happens that the few times I've seen Dr.s lose their cool it was during a section -- Directed at scrub nurses....