Fundamental Perioperative Nursing: Decompartmentalizing the Scrub and Circulator Roles

Historically, operating room nurses served in the scrub and circulator roles. Today registered nurses predominantly circulate and the scrub role has been delegated to surgical technologists. While the registered nurse may no longer routinely take on the scrub role, he or she needs to be comfortable and confident delegating and supervising the scrub person. In our setting, many registered nurses in perioperative were not comfortable in the role of scrub person. A scrub fellowship for registered Nurses was developed by Scottsdale Healthcare and collaborators to encourage the RN to have more involvement in the scrub role. The scrub fellowship program teaches experienced perioperative nurses how to scrub on the majority of high-volume procedures in their specialty unit. Scrubbing increases the perioperative nurse's knowledge about procedures and provides direct experience and appreciation of activities at the sterile field. This gives the nurse greater competence at delegating the role, a learned skill that requires experience as well as effective communication. Furthermore, the experience in the scrub role improves the nurse's ability to identify and speak up about potential patient safety concerns at the sterile field, and gives the perioperative nurse confidence and competence to supervise the person assigned to the scrub role.