Staying Sharp
I fulfilled every scrub tech’s dream the other day. I stabbed a surgeon.
Okay so technically, he kind of stabbed himself, but I definitely helped. The sad part of this story: he’s one of the nice surgeons. So why did I (we?) stab him? Well, let me tell you.
We were working on a hand and it was laid out between the surgeon and PA sitting opposite each other. I was contentedly handing instruments and ogling all the cool structures in the hand. Instead of trying to pass instruments around all the hands and retractors, I’d established a “safe zone” with a towel at the end of the hand table. Smart right? Yeah, but only if they use it.
I’d been warily eyeing a double skin hook that was being put in a taken out with some regularity. (I personally think that skin hooks were designed by Satan with the singular purpose of stabbing unsuspecting people.) The surgeon set down the skin hook in my safe zone and asked for a kasdan, signaling to me that we were at a point where skin hooks were probably no longer needed. My right hand offered him the kasdan and my left hand immediately went for the skin hook. Not. Fast. Enough. I grabbed the handle of the skin hook and tried to twist its evil, satan-engineered, stabby prongs down into the towel, but before I could get it fully flipped over, the surgeon plopped his hand down right on top of the skin hook. OUCH! He immediately jerked his hand back and saw the skin hook hanging from his glove.
He turned and stared at me, like I was some sort of deranged hand-stabbing lunatic out for blood. “OH MY GOD I AM SO SORRY! ARE YOU OKAY?” I wailed. He carefully dislodged the hook and inspected his hand to assess the damage. Internally, my first thought was “Well this is convenient. At least if he needs to fix his hand, he’s totally qualified to do it.” Luckily, the puncture was so small there wasn’t any blood. In fact, you couldn’t even see where the hook had gone into his hand. “It’s okay. It’s only a flesh wound,” he joked. We took all the necessary steps to make sure he was okay, the field wasn’t contaminated and continued the surgery. As everyone settled back in I said, “Now that I’m done stabbing you for the day, what can I get you?”
Accidents happen. We are constantly passing stabby, pokey, and slicey objects around during cases; and even with the highest degree of caution, sometimes shit happens. I was mortified when I got my first (and so far only) needle stick, but everyone around me seemed completely un-phased. I was doing a hernia case with a doctor who was very nice, but worked at a pace that can only be described as “frantic.” We were securing mesh with pop-off sutures and he was handing back needles almost faster than I could load the next stitch. We were down to the last two stitches and as I reached to take the loaded needle driver, I moved and he twisted the needle driver in a way that it stuck squarely in the pad of my middle finger. First, I yelled, “EVERYONE STOP. I’VE GOT A NEEDLE STICK.” The second thing I said was, “It’s a good thing we had that meeting yesterday!” which garnered a snicker from my circulator.
Talk about timing. Just the day before, we had a huge meeting about blood and body fluid exposure and what do to in case of needle sticks, scalpel stabs, etc. With one flick of a hand, I’d just become a statistic on what NOT to do to stay safe in the OR. We isolated the instrument off the field, brought in another tech, and I went about a two hour long process of filling out paperwork, getting blood drawn, and talking to Occupational Health. It seemed like the entire OR knew about the incident by the time I got back on the floor. I was embarrassed beyond belief and disappointed in myself for allowing it to happen. Everyone who talked to me told me not to worry about it and shared their experiences of on-the-job injuries. It was like the scrub version of that little kids book “Everybody Poops” only in this case it was “Everybody Gets Stabbed.”
If you’re new to the scrub world, I have two messages for you.
Safety first! It’s not just another pointless memo they hang in the break room. Make safety the keystone of your practice even if you have to nag your surgeon, circulator, or CRNA about it. A little nagging is worth it if you prevent injury to yourself, your patient, or your coworkers.
You’re gonna to get stabbed…or poked with a needle…or something at some point in your career. It is not a reflection on your overall ability as a scrub (unless you have truly horrendous technique, in which case you should maybe consider a career where you can’t potentially kill people. I hear Starbucks is hiring.) All you can do is be educated on how to handle the situation and consider whether or not there was something you could do differently the next time to avoid a repeat stabbing.
As for me? Now that I’ve been on the giving and receiving end of things, maybe I’ll see if those Kevlar surgical gloves are still a thing. Or maybe not.
Until next time, stay sterile.
