wedding/engagement rings and the OR

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anomalii

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So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time? The diamond is a bit raised (ring is made of white gold) and I'm always afraid it will rip through the gloves. I also am allergic to some of the scrubbing material so I use iodine and come in wet, will that do anything to the jewelry? Thanks :D.

Edit: yes, i do remember being taught that you cannot scrub with upper extremity accessories but was in some doubt as on the rare occasion, i noticed someone keeping a wedding band. Maybe it was bad example, an act of haste, or whatever but I wasn't sure if somehow i remembered incorrectly. I'm asking to see what others do in this situation as I currently keep the box the ring came in and put the ring away in the box and lock up the box which seems like the safest way to do it, but is pretty inconvenient.
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anomalii said:
So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time? The diamond is a bit raised (ring is made of white gold) and I'm always afraid it will rip through the gloves. I also am allergic to some of the scrubbing material so I use iodine and come in wet, will that do anything to the jewelry? Thanks :D.
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Most surgeons I've worked with put their rings around their necks (in a necklace) or in tied it to their scrub pants.
 
anomalii said:
So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time? The diamond is a bit raised (ring is made of white gold) and I'm always afraid it will rip through the gloves. I also am allergic to some of the scrubbing material so I use iodine and come in wet, will that do anything to the jewelry? Thanks :D.
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lazymed said:
Most surgeons I've worked with put their rings around their necks (in a necklace) or in tied it to their scrub pants.
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You can't scrub with jewelry (or watches). You wouldn't want to subject your rings to iodine anyway as it stains gold. I always wear a pearl necklace in the OR which holds my 2.19ct diamond engagement ring safe and secure.
 
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anomalii said:
So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time? The diamond is a bit raised (ring is made of white gold) and I'm always afraid it will rip through the gloves. I also am allergic to some of the scrubbing material so I use iodine and come in wet, will that do anything to the jewelry? Thanks :D.
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Everyone has a different trick for this. Some people tie it into their scrub pants, but that seems like a time bomb to me. Others place it in the front pocket of their scrubs, which also seems like a time bomb. I also had a boss at SLU who had a ring tattoo.....pretty bold, IMO....

The first thing that I did was buy a less expensive ring, knowing that I could very well lose it at some point. Don't go with titanium, though, because they can't cut that one off your finger. If you're a female, make sure your nice ring is insured...I think it's about $10/month, but it might be less.

When in the OR, I drop my watch and ring into the left pocket of my white coat. When I leave the OR, I put both of these on again. This has worked for me for 4 years.

When on the wards, I always wear my wedding ring. This helps my OCD to kick in if it's missing from my finger. Also, it keeps all the horny nurses in check....although it sort of encourages some of them....
 
SLUser is right about a cheap ring. Good idea. My friend's wife spent about of month making his and he lost it during residency. No fun at all.
 
SLUser11 said:
Don't go with titanium, though, because they can't cut that one off your finger.
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This is actually not true. I checked with our ER attendings to be sure, and they can get a special cutter for titanium rings from several local jewelry stores. I wanted a second "back up" ring because I knew my chance of losing the original is directly proportional to the cost. I was considering titanium, but its so light it feels like a cracker-jack prize, and instead I got Tungsten-carbide, which is near indestructible.
 
SLUser11 said:
Everyone has a different trick for this. Some people tie it into their scrub pants, but that seems like a time bomb to me.
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I once spent a good amount of time rummaging through the dirty scrubs hamper at the VA after accidentally tossing my scrub pants in there with the ring still tied on. Didn't realize it for a while after changing...
 
toxic-megacolon said:
This is actually not true. I checked with our ER attendings to be sure, and they can get a special cutter for titanium rings from several local jewelry stores. I wanted a second "back up" ring because I knew my chance of losing the original is directly proportional to the cost. I was considering titanium, but its so light it feels like a cracker-jack prize, and instead I got Tungsten-carbide, which is near indestructible.
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Same here man, plus I like the "heaviness" of it.
 
Just putting it out there, in one of the hospitals which i worked in, the infection control committee banned any ring with stones, in all the hospital wards! only ones allowed were the plain wedding rings. I usually put my wedding ring in my scrub's front pocket, checkin every 1-2 minutes if it's still there lool
 
toxic-megacolon said:
This is actually not true. I checked with our ER attendings to be sure, and they can get a special cutter for titanium rings from several local jewelry stores. I wanted a second "back up" ring because I knew my chance of losing the original is directly proportional to the cost. I was considering titanium, but its so light it feels like a cracker-jack prize, and instead I got Tungsten-carbide, which is near indestructible.
Click to expand...

Well, I hope those jewelry stores are open when I'm in the ER at 2am about to lose my finger.

With as precious as I think my hands are, I refuse to wear any ring that will put up any fight at all if it needed to be cut off.

I think my ring is stainless steel, but I have to admit that I'm intrigued by the Tungsten-carbide....I think I'll wait until I inevitably lose this one first, though....
 
The tungsten-carbide ones are cool, because you can't scratch them. I've got a yellow gold ring (it was cheap when I got it, it probably doubled or tripled in value since then) that scratched up pretty quickly.
 
Yeah, you can't wear jewelry on your hands or arms while scrubbed in.

Most people:

1) wear rings around their neck
2) tie them to scrubs (see above hazards)
3) stash with cell phone/pager, etc. on desk in OR
4) leave them at home on days when in the OR

I did the last one as I am known for losing such things. I am still amazed I've had my Tag Heuer for 3 years and my sunglasses for 1.:D
 
Winged Scapula said:
Yeah, you can't wear jewelry on your hands or arms while scrubbed in.

Most people:

1) wear rings around their neck
2) tie them to scrubs (see above hazards)
3) stash with cell phone/pager, etc. on desk in OR
4) leave them at home on days when in the OR

I did the last one as I am known for losing such things. I am still amazed I've had my Tag Heuer for 3 years and my sunglasses for 1.:D
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I haven't lost anything so far. My ring is securely around my neck at all times. I couple of my colleagues who put their wedding bands on the scrub ties did lose them (ripping off scrubs without untying). I am also not in an unsafe area where I worry about being robbed. This kind of stuff hasn't happen to any of us at all.
 
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njbmd said:
I haven't lost anything so far. My ring is securely around my neck at all times. I couple of my colleagues who put their wedding bands on the scrub ties did lose them (ripping off scrubs without untying). I am also not in an unsafe area where I worry about being robbed. This kind of stuff hasn't happen to any of us at all.
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I've always been in a very safe place as well but I don't like wearing necklaces regularly.

I just misplace things or leave the OR and leave stuff behind. The staff knows me well enough to just lock things up, call me and I'll come and pick it up. :D
 
I worked with an attending who had one of those giant safety pins, and she slid her rings on it and pinned it to her scrub top. I thought it was a good idea, as long as you remembered to take the safety pin off your top every day.
 
anomalii said:
...do you guys keep your rings off or wear them the whole time? The diamond is a bit raised ...afraid it will rip through the gloves...
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I am quite surprised at the primary question. As noted below:
njbmd said:
You can't scrub with jewelry (or watches)...
Winged Scapula said:
Yeah, you can't wear jewelry on your hands or arms while scrubbed in...
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Maybe you have as yet to be introduced to proper surgical scrub techniques. If that's the case, I am quite sure, at any reputable teaching institution, you will be taught. If you should forget to remove your upper extremity "accessories", the scrub nurse will likely remind you and send you back out to the sink. Some will remind you with a polite whisper... some may make a dramatic teaching moment.

As noted, folks that scrub use a multitude of techniques. this can be tying your watches & jewelry into your scrub tie. It may include a necklace. It may include a large safety pin to attach to your scrubs. It may include just leaving the jewelry at home....
 
PAgirl said:
I worked with an attending who had one of those giant safety pins, and she slid her rings on it and pinned it to her scrub top. I thought it was a good idea, as long as you remembered to take the safety pin off your top every day.
Click to expand...



The person who does this at my institution, closes the safety pin around her bra strap. That way, if she forgets, she catches the bra strap when she removes her scrub top. A couple of times, the safety pin snapped open, scratching her shoulder and flinging the rings across the locker room floor.
 
anomalii said:
So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time? The diamond is a bit raised (ring is made of white gold) and I'm always afraid it will rip through the gloves. I also am allergic to some of the scrubbing material so I use iodine and come in wet, will that do anything to the jewelry? Thanks :D.
Click to expand...

Many people wear it on a necklace, but it's kind of a pain to take it on and off. Here is a clever necklace that makes it relatively easy:

http://www.wedlockcross.com/
http://www.wedlockheart.com/

Cheers
-AT.
 
JackADeli said:
I am quite surprised at the primary question. As noted below:Maybe you have as yet to be introduced to proper surgical scrub techniques. If that's the case, I am quite sure, at any reputable teaching institution, you will be taught. If you should forget to remove your upper extremity "accessories", the scrub nurse will likely remind you and send you back out to the sink. Some will remind you with a polite whisper... some may make a dramatic teaching moment.
Click to expand...

Actually, I do remember being taught to remove upper extremity accessories, but the thing is, I was not sure if I remembered inaccurately because I have seen some people keep their wedding bands, maybe it was bad example. Ever since I got engaged, I always kept the box the ring came in, put the ring in the box, and locked it up. That seemed to me as the safest way to go about it, although pretty cumbersome, I am thinking of getting a nice necklace to place the ring on.
 
anomalii said:
Actually, I do remember being taught to remove upper extremity accessories, but the thing is, I was not sure if I remembered inaccurately because I have seen some people keep their wedding bands, maybe it was bad example.
Click to expand...

Maybe you're thinking of people quickly putting on sterile garb (gown + gloves) during a bedside procedure, like when you assisted in deliveries during L&D. There's no way someone scrubbed into an OR case (i.e., scrubbing in at the scrub sink) still wearing their ring.
 
anomalii said:
Actually, I do remember being taught to remove upper extremity accessories, but the thing is, I was not sure if I remembered inaccurately because I have seen some people keep their wedding bands, maybe it was bad example...
Click to expand...
I will stick by my original post.... that is all upper extremity accessories are removed prior to proper scrub & gowning.

That being said, yes there are some attendings that ignore and will wear a wedding band. I have actually seen some industry teaching videos of real operations on real patients in which the expert/demonstrating surgeon wore their wedding band. However, these had all been low profile rings, at the ATTENDING level. I have never seen anyone try to get gloves on over a jeweled ring. And, in general, scrub nurses are very well intentioned, and as such feel deeply responsible to assure trainees do it correctly.... Thus, they observe the clock when they know you are scrubbing, often watch how you use the drying towels, often are sure you broke sterility (when you are sure you never touched this/that), and will see a shiny piece of gold/silver/watch band/etc....
 
I drop my ring into my wallet and keep my wallet in my back pocket while scrubbed. I have never had any issue with this method.
 
Buzz Me said:
Maybe you're thinking of people quickly putting on sterile garb (gown + gloves) during a bedside procedure, like when you assisted in deliveries during L&D. There's no way someone scrubbed into an OR case (i.e., scrubbing in at the scrub sink) still wearing their ring.
Click to expand...

No, they were full blown OR cases.

JackADeli said:
I will stick by my original post.... that is all upper extremity accessories are removed prior to proper scrub & gowning.

That being said, yes there are some attendings that ignore and will wear a wedding band. I have actually seen some industry teaching videos of real operations on real patients in which the expert/demonstrating surgeon wore their wedding band. However, these had all been low profile rings, at the ATTENDING level. I have never seen anyone try to get gloves on over a jeweled ring. And, in general, scrub nurses are very well intentioned, and as such feel deeply responsible to assure trainees do it correctly....
Click to expand...

Regardless, an upper extremity accessory is an upper extremity accessory jeweled or not. Attending or not, we are all subject to the same scrubbing recommendations. I would hope an attending of all team players would set a good example, of course the contrary is nothing new in my experiences in med school so far (not to say there aren't good attendings, there actually are many stellar ones). As for scrub nurses, I am well aware they are well intentioned and never had a grudge with any of them.

Thanks to everyone who has been helpful though.
 
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anomalii said:
but do you guys keep your rings off or wear them the whole time?... The diamond is a bit raised ...and I'm always afraid it will rip through the gloves...
JackADeli said:
I will stick by my original post.... that is all upper extremity accessories are removed prior to proper scrub & gowning.

...I have never seen anyone try to get gloves on over a jeweled ring...
Click to expand...
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I'm guessing you are just trying to reiterate what everyone else, me included has stated....
anomalii said:
...Regardless, an upper extremity accessory is an upper extremity accessory jeweled or not...
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Maybe just misreading... but the attitude change from the original question to what sounds like almost ~authoritative knowledge is odd.

I'm happy you got the answer... to question, I am guessing you already knew the answer to?
 
Good grief, my attitude has never changed. I remember what was taught but as a student, I always question things and wonder if something was not remembered exactly correctly or there was something else I had not considered. That being said, when I actually got my own ring, I recollected seeing rings in the OR and it got confusing. I stayed on the safe side and never wore mine in the OR but if there was a slight chance it was allowed, that was what I was inquiring about and/or if there was an easier way to deal with rings.

After reading what others said, it emphasized what I was originally taught. You are the one that said wedding bands were seen in the OR and you never saw a jeweled ring as if to say somehow a jeweled ring is worse and/or somehow a band is better. Similarily, you said only attendings did that as if somehow to say it was somewhat different for an attending. But after getting further support that says what I originally learned was right, my rebuttal is that it does not matter if the ring is jeweled or not and regardless of who you are on the team, if you are scrubbed in you are subject to the recommendations.

Don't read too much into it. It was just an inquiry from someone that got confused by bad examples. End of thread. Sheesh.
 
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I tie mine to my already tied scrubs (putting the ring through one of the "loops" and then tie the two loops together in a square knot). It is impossible to untie your scrubs without getting your ring.
 
anomalii said:
...you said only attendings did that as if somehow to say it was somewhat different for an attending...
Click to expand...
Please note the "preamble" to what I said... also note that I said they "ignored". None of which suggests or implies it is OK technique based on rank/position/status
anomalii said:
...The diamond is a bit raised ...afraid it will rip through the gloves...
JackADeli said:
I will stick by my original post.... that is all upper extremity accessories are removed prior to proper scrub & gowning.

That being said, yes there are some attendings that ignore and will wear a wedding band. ...I have never seen anyone try to get gloves on over a jeweled ring...
Click to expand...
Click to expand...
As for type of ring... please note it was your very question that raised the concern of the raised gem compromising the glove. I simply pointed out that when I have seen attendings "ignore" proper technique, it has been with low profile bands not likely to compromise a glove. Again a concern you mention with regards to raised gems.

Final point of clarification, it is not an issue of "recommendation", rather we are talking about proper technique. Not wearing any upper extremity accessories is proper technique and NOT simply a recommendation. A point I reiterated.

Again, I am glad you now appreciate this and lack confusion.
 
For one, I did not say it was NOT proper technique, I said it was what I was taught. Just because I did not explicitly say it was proper technique does not imply I don't acknowledge it. So my apologies for not using those exact words.

JackADeli said:
However, these had all been low profile rings, at the ATTENDING level. I have never seen anyone try to get gloves on over a jeweled ring.
Click to expand...
Yes, your highness, I did realize you used the word IGNORE. BUT you originally made it a point emphasized in capital letters that it was at the attending level which has nothing to do with proper technique.

If you don't have any further contributory information (i.e. of the original question regarding other means of handling rings in the OR), just leave this discussion as is.
 
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SLUser11 said:
This thread has gotten really stupid.
Click to expand...

I'm pretty new to posting here, but one thing is sure, some people absolutely live for semantics. It is amazing how many amazing lawyers were not because of medicine.
 
anomalii said:
...this may sound stupid, but do you guys keep your rings off or wear them the whole time?...
Click to expand...
anomalii said:
...Attending or not, we are all subject to the same scrubbing recommendations...
anomalii said:
...you are subject to the recommendations...
JackADeli said:
...it is not an issue of "recommendation"... Not wearing any upper extremity accessories is proper technique and NOT simply a recommendation...
anomalii said:
...I did not say it was NOT proper technique...because I did not explicitly say it was proper technique does not imply I don't acknowledge it...
Click to expand...
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Again....
the attitude change from the original question to what sounds like almost ~authoritative knowledge is odd.

Again....
I'm happy you got the answer... to question, I am guessing you already knew the answer to? Again, I am glad you now appreciate this and lack confusion.

It seems clear to all, you now have a full understanding of proper scrub technique as it relates to your original question ...you apparently now understand it is not simply a "recommendation"....

I am happy for you....
anomalii said:
...If you don't have any further contributory information ...just leave this discussion as is.
Click to expand...
Always a nice touch to follow a rant.... You'll fit in nicely......
 
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I'll reinforce SLUser's warning about titanium rings . . . the ring cutters that I've used in the ED several times can get through gold and platinum without much trouble. Titanium is really hard to cut off -- I've tried with the "special" ring cutters and they aren't the panacea that they're sold as.
 
[YOUTUBE]http://www.youtube.com/watch?v=yuqgI0g-Tc4[/YOUTUBE]

http://www.titaniumstyle.com/titanium_tungsten_ring_cut-off.htm

"Titanium rings can be cut off with manual or motorized ring cutting tool.
All 3 grades of titanium: aircraft grade Ti-64, supper hard ti-662 and pure Ti-CP can be cut off with this tool.

ring-cutting.jpg


In our tests we used 7mm titanium ring. It took 4 minutes to cut off Ti-CP ring, 8 minutes for Ti-6/4 and 12 minutes for Ti-6/6/2
We used manual ring cutting tool with a new, high grade blade. The process is quite simple. The lower jaw of the cutter slides between the ring and finger. The circular saw is turned by the handle to cut through the ring.
Most hospitals emergency rooms will have motorized ring cutting tool which will do the job even faster.
 
Umm, at our ER there are two ring cutters, one has been used so much it is kinda bent and barely cuts through a wimpy ring and the other isn't much better. I guess maintenance might have some tools we could borrow (like whatever they ended up using on the guy who put a nut on his "bolt"
 
Whatever you end up deciding to do with your ring, I think the most important thing is to be very consistent with it. I almost lost my ring a few times early on, but now I have a routine that works for me (put it through the left tie on my scrubs then tie it tight enough that I have to untie it to get it off. If ends are really long I tuck them in. Any time I have to untie, the ring goes back on my finger until the next case. Sometimes if I have a long day without bathroom breaks, I forget that I am not wearing it, but since I always untie by pulling with my right hand the ring will hit my finger and remind me to put it back on.
 
SocialistMD said:
I tie mine to my already tied scrubs (putting the ring through one of the "loops" and then tie the two loops together in a square knot). It is impossible to untie your scrubs without getting your ring.
Click to expand...
I do the same. Once the scrubs are tied, thread it through and then tie again. There's no way you can take the scrubs off without the ring falling off. Done.
 
When I forget to take my ring off, I just tie it to my scrubs, but I'm also really scared of forgetting them. So, my preference is to basically leave my ring on my desk at home when I know I will be wearing scrubs and put it back on when I'm dressed up with my white coat, shirt, and tie.
 
DoctaJay said:
When I forget to take my ring off, I just tie it to my scrubs, but I'm also really scared of forgetting them. So, my preference is to basically leave my ring on my desk at home when I know I will be wearing scrubs and put it back on when I'm dressed up with my white coat, shirt, and tie.
Click to expand...
If you're doing ortho, that's a lot of time not wearing your ring.
 
lol, good point. I may have to rethink this strategy. Not sure though what would cause more damage, me not wearing my ring for 70% of my residency, or my losing my ring during my PGY-1 year.
 
DoctaJay said:
lol, good point. I may have to rethink this strategy. Not sure though what would cause more damage, me not wearing my ring for 70% of my residency, or my losing my ring during my PGY-1 year.
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I'm telling ya, you can't go wrong tying it within a knot with the loops on your scrubs. You can't take your scrubs off without the ring coming out. I think you'd notice it there when changing no matter what time you're getting out post-call.

And don't worry. You won't see the inside of an OR while an intern, so you probably won't be taking your ring off. :smuggrin:
 
Why is everyone so paranoid about getting their finger chopped off anyway? Are the ER people kleptomaniacs? Should I be worried?

anomalii said:
So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time?
Click to expand...

No, it will sound stupid every single time. Have no doubt about that.
JackADeli really drove this one home so remember him and thank him every time you scrub in.
 
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I haven't worn my ring except on vacation and long weekends since I became a resident. My wife doesn't seem to care. Especially after some of my fellow residents have slipped there's into the laundry multiple times.
 
If my wedding ring begins to be a problem I will deal with it like a surgeon. I will get divorced.
 
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I'm really terrible about losing things and my engagement ring is over 150 years old so I was very worried about losing it because it's irreplaceable. When shadowing and doing research this summer, I bought a cheap silver band that I wore and kept my official wedding jewelry at home. The few times I was allowed to scrub, I just tied my ring to my scrubs. I almost lost it once, but it wasn't a big deal since the ring cost $10 and had no sentimental value. I think I'll be using this tactic for the rest of my career. My husband is a lot less anxious about me losing my wedding jewelry which is a plus.
 
amw385 said:
I'm really terrible about losing things and my engagement ring is over 150 years old so I was very worried about losing it because it's irreplaceable. When shadowing and doing research this summer, I bought a cheap silver band that I wore and kept my official wedding jewelry at home. The few times I was allowed to scrub, I just tied my ring to my scrubs. I almost lost it once, but it wasn't a big deal since the ring cost $10 and had no sentimental value. I think I'll be using this tactic for the rest of my career. My husband is a lot less anxious about me losing my wedding jewelry which is a plus.
Click to expand...

My dad did that and lost his wedding ring after throwing his scrubs into the hospital laundry post call.
 
VisionaryTics said:
My dad did that and lost his wedding ring after throwing his scrubs into the hospital laundry post call.
Click to expand...

That is why I just slip my rings on and tie the bow (as opposed to tying it on the string then tying a bow). If I forget to grab them as I untie, the rings will fall on the floor and make a sound. Plus, the way I untie usually results in the rings sliding to my fingers and that helps me remember to grab them. The major downside is if I don't catch them when I untie to pee, but now I tend to untie well before being in front of the bowl to avoid them falling in. I think the best bet is to get in the habit of doing something (whatever route you decide on) because then you will decrease the chance of forgetting.
 
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"That is huge!" "It's so sparkly" "it's pretty" "Your husband did well." "Your husband loves you plenty". "I love your ring."
 
hand jewels for someone performing surgery is unthinkable. use the Frodo method.

Tbh who would want to wear a marriage ring in such a high stress hormonal ambient such as the hospital.
 
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anomalii said:
So I just got engaged and this may sound stupid, but do you guys keep your rings off or wear them the whole time? The diamond is a bit raised (ring is made of white gold) and I'm always afraid it will rip through the gloves. I also am allergic to some of the scrubbing material so I use iodine and come in wet, will that do anything to the jewelry? Thanks :D.

Edit: yes, i do remember being taught that you cannot scrub with upper extremity accessories but was in some doubt as on the rare occasion, i noticed someone keeping a wedding band. Maybe it was bad example, an act of haste, or whatever but I wasn't sure if somehow i remembered incorrectly. I'm asking to see what others do in this situation as I currently keep the box the ring came in and put the ring away in the box and lock up the box which seems like the safest way to do it, but is pretty inconvenient.
Click to expand...
that's what she said.
 
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