What Is A Scrub Nurse?

"An assumption about the role is that they help by assisting the surgeons by passing instruments, where as in fact Scrub Nurses do a lot more."

Amira describes the role of a Scrub Nurse, outlining the skills that are required, interview advice and tips on how to gain experience.

Topics covered in this article

What To Expect From Your Job As A Scrub Nurse?

What Skills Make A Good Scrub Nurse?

How Do You Deal With The Emotions Of The Job?

What Keeps Me Excited About Being A Scrub Nurse?

My Interview Advice For A Scrub Role

Gaining Experience As A Scrub Nurse

What To Expect From Your Job As A Scrub Nurse?

Scrub Nurses are apart of the surgical team and work in sterile conditions.

An assumption about the role is that they help by assisting the surgeons by passing instruments, where as in fact Scrub Nurses do a lot more.

At the start of the shift, they have to check the theatre list to check what cases are planned and then ensure the correct equipment is out.

For example, if we had a hernia list, I would make sure that a general set it out with the correct consumables.

In addition to this, they will ensure all the theatre is ready and appropriate to start the list.

This includes checking suction is working, the operating table is in working order as well as any possible attachments are available and the operating lights are working.

After team brief any necessary specialist equipment is also brought into theatre and is checked by the Scrub Nurse; specialist equipment are things such as microscopes, lasers and stacking systems.

The Scrub Nurse is also responsible for all surgical equipment and instruments used.

This means that they have to ensure all counts are correct and this has to be relayed back to the surgeons.

In addition to this, if any equipment is damages or faulty it is their duty to fill out a discrepancy form to ensure it’s either fixed or replaced.

Scrub Nurses also have to fill out the patient care plan with the procedure details and handover to the recovery staff.

What Skills Make A Good Scrub Nurse?

To be able to carry out a successful surgery there has to be effective teamwork.

Being able to work in a team is a vital skill for Scrub Nurses to possess.

This is because usually in theatre there are usually two scrub nurses (theatre practitioners), up to two theatre support workers, an ODP (anaesthetic nurse, an anaesthetist (sometimes an anaesthetist consultant and registrar) and multiple surgeons (depending on the procedure).

Each individual has a different role to play in ensuring the procedure runs smoothly.

Team work in theatres is important as it allows for structure.

This is because everyone is aware of their role and what is expected of them.

This means that no two people are doing the same thing as this can negatively affect the patient or even delay starting a list.

Communication is a vital skill for Scrub Nurses.

This is because they are constantly communicating with multidisciplinary team.

Patient safety is paramount so if something isn’t relayed back to the surgical team it could end up affecting the patient negatively.

Also Scrub Nurses have to communicate with ward staff and update on things such as when the patient has to stop drinking fluids and even what time the patient would need a pre-med.

In addition to verbal communication, written communication is also important.

Surgical procedures have to recorded electronically and the patient’s care plan has to be completed.

Problem solving and critical thinking is also a skill that Scrub Nurses should possess.

This is because they will need to adapt to the situation if the procedure was to go wrong or even if the equipment was to fail.

Scrub Nurses need to be able to judge, analyse and respond and quickly and appropriately to changing situations in the theatre.

For example, if there was a bleed, I would ask my circulating staff to hand me big swabs (22X22s), ensure suction is on, make sure diathermy and bipolar ready for use, have ties and sutures available.

Scrub Nurses need to be able to anticipate what the surgeon will need next to ensure that equipment is ready and available instead of fumbling around for things when it’s asked for.

This is because surgeons already have a massive amount of pressure on them therefore if the Scrub Nurse is able to anticipate things ahead of time it ensures the procedure runs smoothly.

How Do You Deal With The Emotions Of The Job?

When I first started working in theatres, I found it surprising how emotionally distressed I would feel in certain situations.

I think this was mix of transitioning from adult nursing to working with children combined with the fact I was a new mum to my ten-month-old son.

I used to find it distressing when children or babies would cry in the anaesthetic room or even when they would cry whilst being extubated (removing the endotracheal tube when recovering a patient).

To stop myself getting emotional I would often have to remind myself that these patients needed the procedure and it would improve their overall quality of life.

The nature of this job means that sometimes we do have distressing cases especially as we are a large trauma centre.Often times we do have patients that come in with a background of complex safeguarding issues but we have to ensure that our emotions do not get the better of us as this can negatively affect patient care.

At the end of the day the patient and their surgery have to be our top priority despite anything else.

I have to admit I do find it difficult working with patients with complex safeguarding issues as certain cases can be upsetting however, we have to remain professional and provide the best care possible.

Sometimes the procedure itself may become more complex and stressful.

In these situations, I try to remain calm and anticipate what may happen next.

This allows me to forward look at what I could need next.

What Keeps Me Excited About Being A Scrub Nurse?

I think the most exciting thing about being a Scrub Nurse is that not one case is the same therefore you’re continuously learning and seeing different things.

Especially in trauma as we do both plastics and orthopaedic trauma, we never know what is going to come to theatre.

Also, as a Scrub Nurse you’re directly involved in the surgery and I love this because we’re able to watch exactly what the surgeons are doing.

In one of our spinal cases, we had to do a double thoracotomy where we took out two ribs and I was actually able to watch the lungs inflate and deflate.

This was a completely surreal for me, I was in awe all day.

I love the human anatomy and I always love watching the incision as we get to see the layers of tissue.

As nurses we are taught about the human anatomy and physiology but we are rarely given the opportunity to actually see it in real life.

Also, often times we’re able to see the difference the surgery has made at the end of the procedure and this gives me a lot of job satisfaction.

It’s great because you’re able see how much you have improved the patient’s quality of life straight away.

My Interview Advice For A Scrub Role

My main piece of advice would be to research the hospital, look at what are the common procedures that they carry out and what theatres they have.

This will give you a rough idea of what to expect.

When researching the hospital, it’s always a good idea to read into their trust values too.

This is important as often times interviewers will ask if you believe you possess these values and how you would show them.

For example, in my interview I was asked about our hospital values which are: compassion, ambitious and brave.

I answered with saying:

“I believe I am compassionate as I am able to empathise with patients and treat them in a respectful manner. I believe compassion is extremely important in this job as often times children are not aware of the procedure, they’re having so treating them with kindness and respect is vital.”

As a follow up question, I was asked:

“Can you describe a time when you showed compassion in the work place?”.

I went on to talk about when I was a student and we had a patient with a very complex safeguarding background.

I mentioned how we had to be extremely gentle and empathetic towards her.

I think the most important piece of advice I can give is to be open and honest.

When I was being interviewed for my current role, I told my interviewers that I had no theatre experience.

There’s no point in pretending to be somethings you’re not as eventually you will get caught out.

Gaining Experience As A Scrub Nurse

During my rotation I had exposure to in the following theatres: laparoscopic, emergency and ENT.

This meant I was able to do a lot of general surgeries such as hernias, laparoscopic procedures and basic ENT surgeries.

However, I wanted to be able to scrub for more complex cases therefore whenever I had the opportunity, I would always volunteer myself to scrub for them.

If I didn’t feel confident then I would ask the second scrub nurse just to be close by in case I needed any help.

This really allowed me to build my confidence as I was doing things such as laparotomies within my first 6 months of being in theatres.

It’s important to note if you are scrubbing for a procedure, you don’t know or haven’t seen before and are feeling anxious.

My advice would be to speak to the surgeons and just say:

“Hi I’m scrubbing for the case, I haven’t done this procedure before, please can you tell me what you’ll be doing.”

Once you know what the procedure will entail you can talk yourself through the steps and have your instruments ready.

Also, I think it’s better to be honest from the start as opposed to trying to fumble your way through the procedure.

This is because you’ll be more nervous and more likely to make mistakes.

The role of a Scrub Nurse is interpreted differently by everyone but I think the main responsibility of Scrub Nurse is to be an advocate for the patient.

This is because the patient is anaesthetised and therefore not able to speak for themselves.

This therefore means that I have to ensure that everything is done to the patient’s best interests.

Not even just for patients but for their parents or carers too.

As a mother I can tell you that having your child be in hospital is the worst feeling ever so if I can provide safe and effective care for my patient, I think I have carried out my role as a Scrub Nurse.