PhD, MS, MSN, RN, APRN-BC, CCRN, CDCES, CNE
Many of you may have watched popular drama television shows about the operating room or the comedy sitcom “Scrubs” and are now intrigued by what a “real” scrub nurse does on a daily basis. In this blog, we will explore the real world of scrub nurses and become more aware of the important roles they play.
A scrub nurse, also known as a surgical nurse or operating room nurse, plays a crucial and vital part in the surgical process. The entire surgical area is often known as the interoperative process, which includes preoperative (pre-op), surgical, and post-operative (PACU) areas.
Nurses work in all areas and indeed, they all wear scrubs, but their roles are much more important than the scrubs they wear. A scrub nurse is responsible for maintaining the sterile field during operations, and acting as a bridge between the sterile and non-sterile areas of the operating room.
While wearing sterile attire or “scrubs,” the scrub nurse assists the surgeon, surgical technologists (known as surgical techs), and other healthcare professionals in delivering optimal patient care. Scrub nurses are the unsung heroes of the operating room, working diligently alongside the surgical team to ensure safe and successful procedures.
The operating room (OR) is a complex and highly coordinated environment where various healthcare professionals work together as a team to ensure safe and efficient surgical procedures. Here are some of the key individuals that work in an operating room:
The surgeon is a highly skilled physician who performs the surgical procedure. They are responsible for diagnosing the patient, determining the appropriate surgical approach, and leading the surgical team during the procedure.
The anesthesiologist is a medical doctor who specializes in administering anesthesia to patients before, during, and after surgery. They monitor the patient’s vital signs, manage pain control, and ensure the patient’s safety and comfort are maintained throughout the procedure.
The scrub nurse is responsible for maintaining the sterile field during the surgery. They assist the surgeon by handing sterile instruments, sutures, and supplies. They are knowledgeable about surgical instruments and maintain a vigilant eye on the patient’s safety during the procedure.
The circulating nurse is a registered nurse (RN) who manages the overall nursing care and coordinates activities in the operating room. They ensure patient safety, manage documentation, monitor the surgical environment, and act as a liaison between the surgical team and other areas of the hospital.
Surgical Technologists, also known as surgical techs, work alongside the surgical team to prepare the operating room and assist during surgical procedures. They handle instruments, sterilize equipment, set up surgical trays, and ensure a sterile environment. The surgical techs may also assist with wound closure and patient transport.
An anesthesia technician assists the anesthesiologist in preparing and maintaining anesthesia equipment. They ensure that the anesthesia machines, monitors, and other devices are functioning properly.
Perfusionists operate the heart-lung machines during cardiac surgeries. They are responsible for managing blood flow and oxygenation while the patient’s heart is temporarily stopped during cardiac surgery.
A surgical assistant works closely with the surgeon to aid during the surgical procedure. They may suture incisions, assist with exposure, and perform other tasks under the direction of the surgeon.
Sterile processing technicians are responsible for cleaning, sterilizing, and maintaining the surgical instruments and equipment.
It is important to note that the specific roles and titles may vary depending on the healthcare institution. While the above roles are common, there may be additional specialized roles or variations in different surgical specialties.
A scrub nurse serves as a critical part of the surgical team and has unique responsibilities as outlined below:
Scrub nurses are responsible for ensuring the operating room is appropriately set up before each procedure. They gather and arrange all necessary surgical instruments and equipment and they collaborate closely with the circulating nurse to ensure a sterile and organized environment.
Maintaining a sterile field is of utmost importance during surgery to prevent infection and promote patient safety. Scrub nurses are experts in sterile technique, performing meticulous hand hygiene and donning sterile gloves and gowns. They assist the surgeon by handling sterile instruments, sutures, and other supplies during the procedure.
Scrub nurses have an in-depth knowledge of surgical instruments, including their names, uses, and proper handling. They anticipate the surgeon’s needs by having the correct instruments ready and in optimal condition, and they ensure that all surgical equipment such as lights, suction devices, and monitors are functioning properly.
Together with the circulating nurse, the scrub nurse serves as an advocate for the patient. They verify the patient’s identity, surgical site, and consent form before the procedure. Scrub nurses maintain a vigilant eye on the patient’s vital signs throughout the procedure and promptly communicate any changes to the surgical team.
Scrub nurses are responsible for accurately documenting various aspects of the surgical procedure, including the surgical count of instruments, sponges, and sharps. They communicate with the circulating nurse, anesthesiologist, surgeon, and other team members to ensure open collaboration and patient safety.
A scrub nurse’s day-to-day job can vary depending on their specific role and work area, but the following list outlines the skills and qualities that are needed to become a successful scrub nurse:
Scrub nurses must possess a thorough understanding of aseptic techniques, including sterile gowning and gloving, proper handling of sterile instruments, and maintaining a sterile field throughout the procedure.
Meticulous attention to detail is crucial to anticipate the surgeon’s needs, recognize potential risks, and ensure that no instruments or sponges are left behind in the patient. There is no room for errors in surgery.
Effective communication and collaboration skills are vital for working in the high-stress environment of the operating room. Scrub nurses must be able to communicate clearly, follow instructions precisely, and coordinate effectively with the surgical team. The greatest medical errors in surgery and medicine have been due to poor communication among team members.
Scrub nurses encounter various challenges during surgeries and must possess the ability to think quickly, adapt to unexpected situations, and troubleshoot any issues that arise.
The salary range for a scrub nurse can vary depending on factors such as geographical location, years of experience, educational background, and the specific healthcare setting. Generally, scrub nurses earn competitive salaries due to the specialized nature of their role.
Remember, actual salaries may differ based on individual circumstances. The average salary for a scrub nurse in the United States ranges from $62,000 to $95,000. Entry-level scrub nurses or those with less experience will typically earn salaries at the lower end, while those with advanced skills and experience may earn higher salaries.
If you are not yet a Registered Nurse, there are some preliminary steps you need to take first:
If you already have a registered nursing license, there are additional steps for you to consider in your journey to specialize as a surgical scrub nurse:
The idea of becoming a scrub nurse is an exciting and rewarding journey! The scrub nurse’s role is indispensable in providing quality surgical care and their expertise in maintaining a sterile field, anticipating the surgeon’s needs, being the key to the team’s communication, and advocating for the patient contributes to the overall success of the surgical procedure. The dedication and skills of a scrub nurse are invaluable, and the specialty is extremely rewarding.
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