WHAT IS SCRUB NURSE?

WHAT IS SCRUB NURSE?

Scrub Nurse, also called perioperative nurses, are registered nurses who assist in surgical procedures by setting up the room before the operation, working with the doctor during surgery and preparing the patient for the move to the recovery room. Scrub Nurse work in various clinical settings, including hospital surgical departments, private physicians’ offices, clinics and ambulatory (also called “day surgery”) centers. (Reference: Roles of a Scrub Nurse)

A scrub nurse will assist the surgeon as much as possible, within limitations, to facilitate the operation without incident for the optimum results for the patient. (Reference: Scrub Nurse/Tech Responsibilities)

Role of The Scrub Nurse.

The traditional responsibilities of the scrub nurse include ensuring that they are correctly ‘scrubbed up’, preparation of the instruments, trolleys and sterile supplies needed for the surgery, maintaining a sterile environment, providing skilled assistance to the surgeon during the operation, and performing the swab/instrument count at the end of the procedure (Taylor & Campbell 2000b). There are standard texts on the tasks and responsibilities of theatre nurses, but the scope and definition of the role of scrub nurse have been the subject of debate because their duties and responsibilities have changed over the years (McGarvey et al. 2000). However, the focus of most writing on scrub nurses has predominantly been on defining their technical duties, particularly in relation to assisting the surgeon (Woodhead 1995, Hind 1997, McGarvey et al. 2000), rather than examining the non-technical skills required to do the job effectively. Embedded within those descriptions of technical skills are cognitive skills (such as anticipation or making appropriate decisions) and teamwork skills, e.g. communicating effectively during the procedure (with the surgeon, circulating nurse and other team members).

Google Image: Scrub Nurse

Internationally, the qualifications/courses necessary before becoming a scrub nurse vary. In the UK, registered nurses may apply for a post in theatre upon completion of the initial three-year pre-registration programme. There is currently no national secondary qualification required to become a scrub nurse, although there are specialized courses which scrub nurses can attend at college or university. However, these are not a requirement for the post and are often only taken by nurses who are aiming to obtain a nursing quali- fication. Thus, it appears that scrub nurses acquire their expertise largely by learning once they are working in the role. (Reference: L. Mitchell and R. Flin, 2008)

Scrub Nurse Responbilities
As a scrub nurse we also have our own responbilities while we do our job. Some of the responbilities are:

1. Gather all instruments, sutures, drapes, etc. and set up scrub table in an aseptic manner.
2. Complete surgical hand scrub before donning sterile gown and gloves.
3. Gown and glove doctors.
4. Perform an initial sponge, needle, and instrument count as described in count procedure.
5. With the circulator, concurrently verify the name, concentration and expiration date of medications and fluids passed to the sterile field. Ensure medications and fluids passed to the sterile field are properly labeled with the solution name and concentration. Label syringes, basins and all other containers that may hold medications or therapeutic fluids. Clearly communicate with operative team regarding medications in delivery hand-offs and administration.
6. Arrange instruments and supplies so that they are easily accessible.
7. Knowledge of specific instruments and suture used for the procedure to be done.
8. Assist in the proper draping of the patient to insure sterile operating area.
9. Have all instruments ready when the surgeon needs them and to anticipate those needs.
10. Ensure aseptic techniques are carried out at all times. If a break in sterile technique occurs, it is the duty of the scrub nurse/tech to report and remedy the problem.
11. Clearly communicate with surgeon and circulator regarding specimen preparation as applicable. Inquire as to how specimen(s) will be labeled and how it is to be sent to the receiving department (lab, pathology, radiology, mammography, etc.). If specimen is routine (placed in formalin), it will be taken to the OR utility room, placed in the appropriate bin with requisition slip and noted in the specimen log book.
12. Complete the appropriate sponge, sharp, and instrument counts as described in the count procedure.
13. Close skin with automatic skin stapler, when indicated as directed by licensedindependent practitioner.
14. Dress the wound using aseptic technique and according to the surgeon's preference.
15. Remove drapes rolling away from wound, containing any fluids, blood, etc., that might be in the drapes and dispose of them.
16. Instruments taken to decontamination area covered and sharps disposed of in appropriate container.
17. At times of temporary and permanent relief by another scrub nurse/tech, provide a report of the progress of the procedure, a review of the sterile field setup, medications/fluids on the sterile field, any special needs or requests of the surgeon, and any other pertinent information deemed necessary.
18. Scrub nurse/tech will perform duties only within their scope of practice.

(Reference: Scrub Nurse/Tech Responsibilities)

So, that's why I think most of the jobs of Scrub Nurse is good and challenging to do. I kept my interest on that and hope that soon I'll be a Professional Scrub Nurse in hospital.

Restu Ayu S, November, Semarang.