Is the scrub nurse breaking down her table too soon?

This question i s causing conflict be- tween the surgeons and nurses in our

operating room. One surgeon became quite angry when a scrub nurse broke down her table (contaminating it) after the tape was applied to the patient's wound. He informed the OR nursing personnel that he did not want the OR table contaminated, nor the scrub nurse to leave with the instruments, until he dismissed her. He asked what would the nursing personnel do if he had to open the patient's chest in an emergency? All sterile instruments, linens, and equipment are kept in our OR.

Is he correct in his statement that the OR table should not b e contaminated until the patient i s awake from anesthesia?

Q

Could the instruments used in the ab- dominal cavity or another area be used for the chest?

It i s a policy in most ORs, and we be- A lieve i t should be, that the Mayo stand with a knife and sufficient instruments to handle a trachea collapse, hemorrhaging, or any like emergency that can occur in the OR remain sterile until the patient has left the operating room.

The experfs research

Even though there are sterile instruments and linens in your operating room, valuable time can be lost in opening sterile supplies when every second counts for the patient in an emergency situation.

When we consider the relatively short extension of time the instruments must re- main sterile, we would agree i t is a small price to pay for the patient's safety and well-being. Some surgeons are more metic- ulous than others about such details, but if patient care is involved, we welcome the demands that such a surgeon makes.

Any sterile instruments on the Mayo stand, regardless of their intended use for abdomen or other site, can be used for emergency intervention. Such instruments can often be life saving until appropriate chest and other instruments are made

available.

We have had several new instruments break and the manufacturer told US

this was due to improper marking. Because the other hospital in our town barrows our instruments, we believe we must mark our instruments. Can you tell us the proper way to mark our instruments to prevent breaking them?

Q

The best way to imprint surgical in- A struments is by using an electro-etch device. When using the electro-etch with a stencil, i t produces a permanent, legible mark without damage to the instrument.

AORN Journal, July 1974, Vol 20, N o 1 97

The reason your instruments are breaking is due to your using a vibrating tool. Instru-

When etching instruments, you may also want to consider date stamping them with

ments should not be marked with a vibrating tool because this tool creates in- dentations that can hide dried blood and pus. Also, this tool can cause hairline cracks resulting in instruments breaking. When the finish on an instrument i s broken by a vi- brating tool, the seal the manufacturer has put on the instrument also is broken, re- sulting in spotting, discoloration, and cor- rosion.

the year they were purchased. Some manu- facturers do date stamp their instruments, others do not. By having instruments date stamped you know the life of your instru- ments.

Rose Marie Mc Williams, RN and fhe Professional

Advisory Board

And fhaf's #he way if i s . TO: All personnel FROM: Department of definition SUBJECT: Surgical definement (Supercedes all previous directives)

Surgeon Leaps tall buildings in a single bound Is more powerful than a locomotive Is faster than a speeding bullet Walks on water Gives policy to God

Anesfhefist Leaps short buildings in a single bound Is more powerful than a switch engine Is just as fast as a speeding bullet Walks on water if the sea i s calm Talks with God

Circulating nurse Leaps short buildings with a running start

Is almost as powerful cis a switch engine. Is faster than a speeding BB Walks on water in an indoor swimming pool Talks with God if special request is

and favorable winds

approved

Scrub nurse Rarely clears a Quonset hut Loses tug-of-way with a locomotive Can fire a speeding bullet Swims well Is occasionally addressed by God

. . Surgery residenf Makes high marks on the wall when trying

Is run over by the locomotive Can sometimes handle a gun without

Dog paddles Talks to animals

Surgery intern Runs into buildings Recognizes locomotives two out of three

Is not issued ammunition Can stay afloat with a life jacket Talks to walls

Surgery extern Falls over doorsteps when trying to enter

buildings Says, "Look at the choo-choo" Wets himself with a waterpistol Plays in mud puddles Mumbles to himself

Surgery supervisor Lifts buildings and walks under them Kicks locomotives off the track Catches speeding bullets in her teeth and

Freezes water with a single glance She is God

Reprinted from the College News, pub- lished by Kansas City College of Osteo- pathic Medicine.

to leap buildings

inflicting self-injury

times

eats them

98 AORN Journal, July 1974, Vol 20, N o 1