The Scrubbing Process

So, I thought today would be like any other day Monday spent in the surgical wing of the hospital. Get to work by 6:30am, make some coffee, read a textbook, change into scrubs, and watch surgeries. On the list of surgeries for the day, I noticed that 4 of the 6 surgeries scheduled were similar Bilateral Hamstring Releases. I’d seen this particular surgery before so it was exactly anything new for me to watch. Don’t get me wrong, still amazing to watch and I learn something new every time I watch the same kinds of surgeries because the type of operation performed is different based on patient to patient. Didn’t think much of the surgeries and went on about my day, expecting to be walking in and out theater (O.R.) 6 times. And that is exactly how my day was for the first 3 out of the 6 planned surgeries for the day.

As Eduardo and I were walking back from the break room back to the theater (O.R.), Dr. Horn stopped us in our tracks next to the scrub area as she was walking out of the theater. I began stepping to the side so that she could move past us so she could begin scrubbing but was taken aback when she began directly speaking to us. I could not believe my ears when she said, “since the next three surgeries are going to be the same, I thought each of you could scrub in to each one.” 

WHAT?

I turned to Eduardo to see if he registered the same words that were just spoken to the both of us. I volunteered so quickly you wouldn’t even believe it. Which to my surprise was relief to Eduardo. He said that I could go first so that he could watch to see how I did everything and pretty much to experience it first just in case I didn’t like it, he could turn down the option to scrub in. I was perfectly fine with it and turned to Dr. Horn to see what she’d like me to do first. 

She first told me to roll up my long sleeve shirt to the point where my scrub shirt was covering it. I did what I was told and then proceeded to take of my watch and medical alert bracelet and handed it to Eduardo to hold for me. I turned around, grabbed a surgical mask, then stepped onto the wooden panel to where the sink was. Dr. Horn handed me a scrub brush and began to explain the scrub steps to me.

First, you must always hold your arms at a 90 degree angle with your hands on top. You don’t want to drop your hands because “dirty” water will drip down your sterile arms after you finish scrubbing. 

Step One: Do not touch the faucet with your hands  but with your elbow.

Step Two: Wet your hands and arms then take the scrub brush, pump soap onto it and begin working on your hands mainly focusing on your nails, back of your hands, as well your palms.

Step Three: Once you feel you are clean enough, use your elbows to turn the faucet again and rinse your hands. Turn off the faucet and using the same elbow, pump some soap onto your hands and begin washing your hands again and start working your way up your forearm stopping right before your elbow. 

Step Four: If you feel you’ve cleaned your forearm enough, rinse again, pump more soap with your elbow and wash your hands and wrists one more time.

Step Five: Focusing now on the webbing between your fingers, make sure you pay attention to that area because many people forget to wash that part of their hands as well around the wrist. 

Step Six: Once you feel completely clean, rinse off one last time and walk to the theater but make sure you open the door with your back because you don’t want to sterilize your hands by touching the door and have to repeat the process all over again. 
 

We both walked into the theater and walked over to where the napkins, gloves, and gowns were and she began explaining gowning process to me as well.

Step One: Grab a napkin but only dry your hands and wrists. 

Step Two: Only once your hands are completely dry, can you grab another napkin and begin drying your forearms. 

Step Three: (Gowns are folded) Pick up your gown by the corners and let it drop but don’t let it touch the ground. Slide your arms into each sleeve and wait for one of the nurses to pull the tabs and gown corners out from the sleeves. 

Step Four: When putting on your gloves (she measured my hands against hers before we began the scrubbing process) you can only touch certain parts. For the first glove, you can use your clean hand and pinch it up enough so that you can slide your hand into it but with the second glove, go underneath the folded up part so that you don’t let the gloved hand become unsterile. 

Step Five: Once you’re gloved, undo the tie where your gown drawstrings are, hand the covered end to a nurse, turn and take the end from the nurse and tie it to the other end. 

Step Six: Even though you are scrubbed and clean, always keep your hands in a boxed area of your body to ensure that your hands stay sterile. The boxed area is from under the nipple line to the top of your navel. You don’t want to raise your hands around the facial area because we did not scrub it nor should you let your hands drop because we didn’t sterilize everything that you hands could possibly touch if you let them down.

Wow, so many steps. I was already nervous about the fact that I was allowed to scrub into surgery let alone remember all these other steps. Not that I think I’ll be allowed to scrub into another surgery any time soon but if by some miracle I’m allowed to, these 12 steps from the scrubbing process to the gowning process were a lot to take in, in a short amount of time

I honestly felt that the entire scrubbing process was much more intense and stressful than actually helping out during the surgery itself. 

Dr Horn likes to finish surgeries in a timely manner because there are benefits to finishing early such as that it’s easier on the body, less anesthesia time, and it’s overall cheaper. She does not rush through surgery, she just doesn’t feel the need to take an excessive amount of time to operate when she doesn’t need to. 

So, after the whole scrub and downing process, I walk over to the table. Have spending about 4 weeks watching surgeries, you get used to doing certain things so that you don’t disturb the doctors and nurses while the operation is taking place. Doing like like waiting in the corners until everything is set up, making sure you are not within a certain distance of the surgical tools and stepping out of the way when the professionals need to accomplish something. So once I was settled at the surgical table, I still moving out of the way of the surgical tools and the professionals and apologized every time I thought I was in the way. The scrub nurse that was in charge of the nurse for the day, told me to stop saying sorry all the time because I was sterile so I wasn’t doing anything wrong. She told me to place my hands on the table and to get comfortable with standing in place. Not in the sense that it would be a long surgery because I knew that with this particular surgery, Dr. Horn could complete it in less than 45 minutes but because I needed to be more assertive and make sure that I didn’t scrub in for nothing, to remind me that I will be helping. 

With each surgery I watch, it can at times become a bit boring but that’s also because I’m usually standing in the back trying to tip-toe to see what is being done. But with this one, I was up close and personal and could really see what was going on. Well, as well I could for an incision sit that was less than 2 inches long. My part during surgery was holding the retractor so that they surgeon could feel inside the patient to make sure that there were cutting the correct tendons and to feel it the muscles surround the incision sight were being to loosen up some. I started with holding the retractor on the child’s left leg for Dr. Lupes and then switched over to the other side to hold for Dr. Horn. My role in the surgery was very minimal and honestly unnecessary but it was still awesome to be able to play a small part in surgery and I feel more accomplished being able to do that. 

But you know what, it's an experience I'll never forget and something that many people have not done! No one can take away or even debate with that fact that I assisted with surgery! No matter how boring the surgery may have been to the doctors who were really performing the surgery, it'll be something that I can look back on and brag about for the rest of my life!