jazz79

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So this is silly, but when you put on a surgical gown and hand that little cardboard rectangle with one half of the tie to the scrub nurse while holding the other tie, which was do you spin? To your left or your right? I've been yelled at all this week and I think I've spun both ways. Maybe they're just trying to mess with me:).
 

logos

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you want to spin so that the strap is wrapped around you. Where i worked. this is too the left.
 

vegas

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jazz79 said:
So this is silly, but when you put on a surgical gown and hand that little cardboard rectangle with one half of the tie to the scrub nurse while holding the other tie, which was do you spin? To your left or your right? I've been yelled at all this week and I think I've spun both ways. Maybe they're just trying to mess with me:).

Too funny :laugh:
 

Febrifuge

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I've been told to touch just the tie itself, not the carboard at all. Or maybe it's the white part of the cardboard, not the blue part. It can't hurt to just ask every time, "okay, so what's the right way to do this?" For all we know, different scrub techs have different ideas about what's "right." My attitude is, when in Rome.
 

DrMom

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left/counterclockwise.

and I *swear* that some of the scrub techs have their own rules. I've been told different things by different ones...and then had residents tell me later that the tech was FOS. *sigh*
 

logos

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I think sometimes scrubs are hard on students. The hospital I worked at didnt have medical students, but there were some PA students. There were a number of things that I could do that the PA students could never be able to get away with. Things like taking something from their table, going back and preparing something on their table, putting away sharps, gowning and gloving alone (takes some practice), passing off specimens, etc.
 

12R34Y

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logos said:
I think sometimes scrubs are hard on students. The hospital I worked at didnt have medical students, but there were some PA students. There were a number of things that I could do that the PA students could never be able to get away with. Things like taking something from their table, going back and preparing something on their table, putting away sharps, gowning and gloving alone (takes some practice), passing off specimens, etc.
I find it hard to believe that passing of specimens and putting away sharps takes the skill of a medical STUDENT and that PA STUDENT couldn't do the same thing. do you think you have a pecking order higher than them or something? you don't, but that's an interesting post nonetheless. We all know that those PA students pretty much just clean rooms and such and the medical students hang in the doctor's lounges and perform open heart surgeries all day.

please...
 

logos

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12R34Y said:
I find it hard to believe that passing of specimens and putting away sharps takes the skill of a medical STUDENT and that PA STUDENT couldn't do the same thing. do you think you have a pecking order higher than them or something? you don't, but that's an interesting post nonetheless. We all know that those PA students pretty much just clean rooms and such and the medical students hang in the doctor's lounges and perform open heart surgeries all day.

please...

No, its just sort of a I dont know you and you're new, so dont touch my stuff sort of thing. Never touch anything on their table or they'll freak. I'm not a med student (i start next year). I was something like an OR assistant...say like a nurses aid. I'm saying that they sometimes would let the people who were higher than me do certain things that they would let me do, just because those people were students.
 

doc05

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don't take anything off the mayo stand. each scrub tech has a different system, and you shouldn't mess with it. you'll end up getting stuck with a sharp if you're not careful.

and as for the cardboard, if you're passing it to someone who's sterile, it doesn't matter if you touch it. but if you're passing it to a circulator, then don't touch the cardboard to avoid contaminating your gloves.
 

Febrifuge

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doc05 said:
and as for the cardboard, if you're passing it to someone who's sterile, it doesn't matter if you touch it. but if you're passing it to a circulator, then don't touch the cardboard to avoid contaminating your gloves.
THANK YOU for a complete and logical answer! On my day shadowing in the OR I decided not to ask the nurse/ tech to explain, for fear I'd sound like I was challenging them or resisting the advice. But it should be standard to explain to newbies why things work the way they do. We tend to remember better that way. :D
 
B

Blade28

I'm confused...there's only one way to spin. You don't want to spin in the direction that causes the string to "open up" your gown, you want to go the other way.

I think there may be different types of gowns out there, but the kind I've seen (in 4 institutions now) always require me to spin counter-clockwise.
 

ears

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My experience is that the usual arrangement of the ties is that there is a short tie on your left, and a long tie on your right. You remove the short tie from the card, and hand the card with the long tie to someone. You then turn to your left, so that the long tie goes behind your back, take the tie out of the card, and tie them on your left side.

If some moron manufacturer made a gown with the long tie on the left, and a cheapskate hospital bought them in that manufacter's inevitable going-out-of-business sale, then it'd be reversed.

As for the card, it starts out sterile. If you hand it to someone sterile, it stays sterile, and you don't need to worry about touching anything. If you hand it to someone who's not sterile, your half is the half with the tie. The non-sterile person touches the half without the tie, and never touches the tie. After you let go of the card to spin, you do not touch the card again; just pull the tie out of it.

As for scrub techs... in the OR, they are right. Period. It's their job to maintain the sterility of the field, and they have (and should have) wide latitude to carry out that responsibility. If they tell you you contaminated yourself or something else, step away and say "Thank you." You cannot win by arguing with them. And if you cop an attitude, they will not trust you. (And you wouldn't either, in their shoes.)

On the other hand, my experience has been that there are lots of good scrubs nurses/techs who really look out for you if you're respectful and nice to them. I don't mean sucking up, I just mean treating them like professionals who know their job. And if a smart scrub nurse is looking out for you in the OR, you have a great chance to look like a star with the attending. (As Febrifuge points out, this principle applies in many areas of the hospital, but the effect is greatest in the OR, I think.)
 

ILuvScut

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12R34Y said:
I find it hard to believe that passing of specimens and putting away sharps takes the skill of a medical STUDENT and that PA STUDENT couldn't do the same thing. do you think you have a pecking order higher than them or something? you don't, but that's an interesting post nonetheless. We all know that those PA students pretty much just clean rooms and such and the medical students hang in the doctor's lounges and perform open heart surgeries all day.

please...
As an aside though, MS3's are higher on the food chain than PA students. One is going to be a physicina and one is going to be a physician assistant. Plus 3 years post college vs. 2 years in either certifcate/BS/MS program. It is my experience on the wards that the med students are given preference....this is especially evident when the PA students aren't around and the res make comments saying such.
 

Spiff

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ears said:
As for the card, it starts out sterile. If you hand it to someone sterile, it stays sterile, and you don't need to worry about touching anything. If you hand it to someone who's not sterile, your half is the half with the tie. The non-sterile person touches the half without the tie, and never touches the tie. After you let go of the card to spin, you do not touch the card again; just pull the tie out of it.
Most of the cards have a colored portion where the tie attaches and a non-colored portion. The colored portion is your section of the card to hold. Whoever takes the card grabs the noncolored portion of the card.

And if a smart scrub nurse is looking out for you in the OR, you have a great chance to look like a star with the attending. (As Febrifuge points out, this principle applies in many areas of the hospital, but the effect is greatest in the OR, I think.)
This is good advice. If you can, go in the room early and introduce yourself to the circulator and scrub tech. Let them know you will be scrubbing in and ask them if they need you to pull an extra gown/gloves. See if they need any help. Offer to put in the Foley/help with SCDs/hose/get blankets/transfer the patient do whatever else they need. Respect their jobs and learn from their experience.

Do this type of stuff and you will often find the right tools/scissors in your hands at the right moment your attending/resident wants you to do something, you may magically find yourself in the best position to see the case, and you might even find that someone is watching your back when you forget things.
 

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Do this type of stuff and you will often find the right tools/scissors in your hands at the right moment your attending/resident wants you to do something, you may magically find yourself in the best position to see the case, and you might even find that someone is watching your back when you forget things.
You could not possibly be more right. Treating the scrub techs well is like gold. The scrub techs have been in the OR with lots of students and hear all the same questions (surgeons do not know too many questions to ask so they repeat them over and over). If I am struggling to answer a question, I have had srub tech write the correct answer down on something and flash it to me. Not to mentionall the other stuff mentioned previously as well.

Always help them out when you can, get the pt ready, do the foley, put on the venodynes, drop your gloves and gown if they need it.. and always ask them if there is anything they need. Many times the circulator is running around and rather than break scrub, the scrub tech will just wait for the circulator to come back around to ask for something... always ask and they will appreciate it immesurably.
 

Dr.Evil1

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Spiff said:
This is good advice. If you can, go in the room early and introduce yourself to the circulator and scrub tech. Let them know you will be scrubbing in and ask them if they need you to pull an extra gown/gloves. See if they need any help. Offer to put in the Foley/help with SCDs/hose/get blankets/transfer the patient do whatever else they need. Respect their jobs and learn from their experience.

Do this type of stuff and you will often find the right tools/scissors in your hands at the right moment your attending/resident wants you to do something, you may magically find yourself in the best position to see the case, and you might even find that someone is watching your back when you forget things.
I have found this to be true as well. If you go into the rooms before hand and pull you stuff and generally look like you know what you are doing you will learn alot of respect. Being nice and personable is a big bonus too. It is hard to be downright mean to someone you have had a plesant conversation with in the past. I think that most scrub tech hatred is due to experiencing people (students) messing up their system/contaminating their fields. If you can break through their hard outer shell you will often find a sweet gooey center.

That being said some people are bastard coated bastards with bastard filling. I had a scrub tech PIMP me once about the muscles in the neck in front of the attending. He pointed to the sternohyoid or omohyoid muscle and asked what it was. I wasn't sure but guessed one of the two anyway. He barked "Wrong...those are the STRAP muscles". It took me a second to explain to him that the strap muscles are actually made up of these two muscles plus two more etc. He kind of shut up at that point.