gowning question for the OR

[psurocks]

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I have a question for the surgeons....Ive noticed at the hopsital Im rotating as a pharmacist the docs leaving the OR to: going to the floors to see chart or talkin to pts in the waiting room with their cap on, and then they go back into the OR with tat same cap....i actually asked one of them and he told me to mind my own business...one of the hosp directors told me this happens everywhere, is this true? and if yes, isnt this going against the basics of scrubbin and the reason its done?

thanks!

 

[beaverfetus]

part of the gown, the gloves, and the instruments are the only things that are considered "sterile." Scrubs, caps, loupes, etc are in this kinda weird middle ground. if a doctor inadvertently touches his cap after gowning he has to re-scrub or change gloves. The point of a cap, which is not sterile, is simply to keep hair and dead skin from falling into the field. You won't often see a surgeon head butting a surgical field, unless s@#t has really hit the fan. Scrubs are also not sterile, which is why they are kept completely under the gown.

At the same time, most institutions have rules about where scrubs can be worn, many prohibit wearing scrubs and caps outside of patient care areas, and want them all to come from inside the hospital (no taking scrubs/ caps home). Most places dont care if doctors wear their scrubs or caps as long as they remain inside "patient care areas" (the hospital)....I can't really comment further on scrub policy, which is the realm of infection risk control doctors and administrators.

Many surgeons have snazzy cloth caps. As a matter of practical importance, I would advise you not to ask about the sterility of their caps, or point out the losing record of their favorite college football team.

Enjoy your stay in the OR. If you get sprayed with blood, try not to pass out or cheer like the front row at a Gallagher concert.

 

[psurocks]

part of the gown, the gloves, and the instruments are the only things that are considered "sterile." Scrubs, caps, loupes, etc are in this kinda weird middle ground. if a doctor inadvertently touches his cap after gowning he has to re-scrub or change gloves. The point of a cap, which is not sterile, is simply to keep hair and dead skin from falling into the field. You won't often see a surgeon head butting a surgical field, unless s@#t has really hit the fan. Scrubs are also not sterile, which is why they are kept completely under the gown.

At the same time, most institutions have rules about where scrubs can be worn, many prohibit wearing scrubs and caps outside of patient care areas, and want them all to come from inside the hospital (no taking scrubs/ caps home). Most places dont care if doctors wear their scrubs or caps as long as they remain inside "patient care areas" (the hospital)....I can't really comment further on scrub policy, which is the realm of infection risk control doctors and administrators.

Many surgeons have snazzy cloth caps. As a matter of practical importance, I would advise you not to ask about the sterility of their caps, or point out the losing record of their favorite college football team.

Enjoy your stay in the OR. If you get sprayed with blood, try not to pass out or cheer like the front row at a Gallagher concert.

there seems to be a hint of hubris in there....actually we were on a nursing station, i started the convo by telling em bout the I and D meeting we had earlier in the week and to tell them wat was in the pipeline policy wise and to get their thoughts, only after i asked them wat they did and then they basically just wanted to end the convo there

 

[beaverfetus]

When I think of hubris, I think of Achilles battling a river god, which is awesome, but I was more going for a cheap chuckle. Guess tone is hard to parse online though... didn't mean to offend. lets part ways at that.

 

[sponch]

the cap is so everyone knows you're a surgeon and not to mess with you. just kidding. i don't take it off cuz i get crazy hat hair and don't want to walk around looking all disheveled.

what's really funny are the gyns who wear their cap and those booties that go up to their knees. i tried to wear those once and nearly fell over.

even funnier are the caps for guys with beards.. the ones that cover up the top and side of your head and your neck.. they look like midieval knight helmets.

funniest are men who wear bouffants.

 

[njbmd]

I have a question for the surgeons....Ive noticed at the hopsital Im rotating as a pharmacist the docs leaving the OR to: going to the floors to see chart or talkin to pts in the waiting room with their cap on, and then they go back into the OR with tat same cap....i actually asked one of them and he told me to mind my own business...one of the hosp directors told me this happens everywhere, is this true? and if yes, isnt this going against the basics of scrubbin and the reason its done?

thanks!

The surgical cap is only there to keep my hair from falling into the incision. It is not sterile (it is clean) and it does not come in contact with anything that is on the sterile field. If my cap becomes contaminated with blood, I change it after the case (Guess what, I have more than one). Most of the time, I don't remove my cap to speak with patient's families in the waiting area because I will go into the recovery room after speaking with families. When I go to the floor, I usually change my clothes unless it's an emergency situation that can't wait. In any case, a surgical cap (unless its contaminated with fluids) is not a fomite that spreads infection.

 

[psurocks]

thanks for the replies

today i saw some on the floor today who had em off, and others who didnt....guess its a personal preference? althou I think at the hospital Im at right now they are gonna implement a new policy

I just wanted to get inputs of surgeons themselves

 

[Winged Scapula]

Its definitely a personal preference as well as necessity. Females and males with long hair generally can't fit into the nonbouffant hats so prefer the bouffant. As for keeping it on, if its been a long day and my hair is smushed, I'd just as soon as keep the hat on.

 

[psurocks]

When I think of hubris, I think of Achilles battling a river god, which is awesome, but I was more going for a cheap chuckle. Guess tone is hard to parse online though... didn't mean to offend. lets part ways at that.

i got no problems🙂....the surgeons and us are really close(most of em, few here and there not on board with us), whenever they have a pt on some med (that they arent familiar with) and they need to know if they can operate on em or not, they know who to call, and on the flip side, they are very receptive to our antibiotic recommendations.

 

[chrisisinnocent]

what's really funny are the gyns who wear their cap and those booties that go up to their knees. i tried to wear those once and nearly fell over.

I refused to wear those booties until one day I saw an uterus with an abrupting placenta inside being opened, and two liters of blood instantly made a beautiful arc into the air, and landed with a nice splashing sound on the floor. Yes it makes me look like an idiot but I would rather wear those than end up with shoes filled with blood and amniotic fluid. I just don't wear them outside the OR.

 

[Habeed]

Question : can you get out of having to wear the sillly cap at all if you shave your head?

Granted, if I shave my head it gets itchy and you need that hair for insulation in cold hospitals...

 

[Winged Scapula]

Question : can you get out of having to wear the sillly cap at all if you shave your head?

Sorry you still have to wear the hat.

Granted, if I shave my head it gets itchy and you need that hair for insulation in cold hospitals...

Exactly. Your head would freeze in some of those rooms.

 

[madtowngirl]

I believe JCAHO does not allow hats and booties to be worn outside the OR. That doesn't stop some people at my hospital though.

 

[Winged Scapula]

I believe JCAHO does not allow hats and booties to be worn outside the OR. That doesn't stop some people at my hospital though.

JCAHO doesn't allow a lot of things that I do (including drinking a soda at the nurse's station).

Which reminds me of some of this ridiculousness...I got reprimanded for wearing the "wrong scrubs" (ie, I wore the ones from the main OR to the outpatient ORs...same building, different floor) yet the volunteers in the waiting room are told to call out patient's family members by FULL NAME when the doctor arrives/calls which seems like a HIIPA violation to me. 🙄