Just do it.

This is a bit of a rant.

I work weekends, hence the title of the blog. I have to be able to do just about any case that comes along. I understand that the wimps fine scrubs who work during the week are stuck in their specialties and don't have a lot of exposure to other specialties. I don't care though. There are certain cases spread through all of the specialties that every scrub working in a large hospital must be able to do. (I may make a list of these someday.) If you can't do them, go work out an outpatient surgery center, or L &D, or specialty hospital and let your position be filled by a competent scrub. Even if you don't see them every day, you gotta be able to day a crani for subdural, a thoracoscopy, an ORIF and other procedures in the "scary" specialties of ortho, CV and neuro, even if you a GYN, or Plastics or General scrub. You just have to be able to do them, or get the hell out of here.

There, I feel better.

Rules for Scrub Techs

Originally posted at Random Dafydd.

Today was a work day, and I was reminded of the set of rules I have been formulating for scrub techs. I was inspired by the Fat Man's rules in The House of God by Samuel Shem. Some of these are serious, a few are well known aphorisms in ORs around the country, and a few are just a bit cynical. Work for 16 years in an OR and you will end up that way too.

1. You can never have too many towels.
2. Pus is always under pressure.
3. There is no point in having preference cards if you refuse to believe them. (A preference card is a listing of what a particular surgeon will want for a particular case. They used to be actually on index cards. Now they are usually computer files.)
4. The preference card is always wrong.
5. It doesn't matter what the preference card says, never open an abdomen without having stick-ties open.
6. Never suck on the brain.
7. Sterility is a state of mind.
8. Give the Doctor what they need, not what they ask for. Only do this if you know what the Doctor needs.
9. Muscles are in the way. This is all a scrub really needs to know about them.
10. Know the boundaries of your circulating nurse's ignorance.
11. Sometimes it is as important to know the names of the surgeon's children as it is to know the names of the instruments.
12. A doctor who says he only needs three things for a case will need ten.
13. The patient is not on the back table.
14. Knowing why is more important than knowing when.
15. Never turn down a break.
16. Sit whenever you can.
17. Almost every time a sponge has been left in a patient, there was a correct count.
18. Every surgery, no matter how minor, is an opportunity to kill someone.
19. In a pinch, all you need on your mayo stand to start a case is a scalpel, two hemostats, a pair of pickups and pair of scissors. Everything else can be faked.
20. When setting up, the ideal is to touch everything once and only once.

There are more rules, but I can't think of them now. Maybe later.