Tuesday, December 10, 2013

Dr. Orthochick's Guide to Proper OR Etiquette

1. Never finish scrubbing in before your attending

2. When the entirety of the room yells at you for breaking sterility, apologize profusely and go back out and scrub. If someone else breaks sterility, keep your mouth shut

3. If someone elbows you in the face, you are at fault

4. The first rule of draping the patient is to not contaminate yourself. The second rule is to actually section off a sterile field.

5. Preface all requests with 'I'm sorry to bother you but would you mind passing me the ____'

6. When adjusting the lights for your attending move them away from the field first so that when you bring them back, everything looks brighter

7. Actually being able to see what's going on is overrated


  1. Hah! I love it. The first one is quite strategic, because I find that every attending has a slightly different sequence for scrubbing up, so I try to follow their lead.

  2. Not a medical professional, but as the person stuck running sound, #6 applies to mics as well as lights.

    Turn it down and then put it back where it was - it will be PERFECT.


  3. Ha. Agreed...except I usually don't take responsibility of someone elbowing me in the face.

  4. Those rules apply to everything as a med student, with the following variations:

    1. Your attending is always right.

    2. When given any sort of feedback, no matter how wrong, you should apologize profusely and thank them for taking the time to give you feedback in a non-sarcastic tone of voice.

    3. You are there to take the blame for everyone elses mistakes, including, but not limited, to being elbowed in the face.

    4. When participating in any sort of procedure, you should show everyone that you know where the sterile field is by making exaggerated avoidance gestures any time you are near it.

    5. Preface all requests with 'I'm sorry to bother you but would you mind passing me the ____'

    6. Under promise, over deliver

    7. Actually being able to understand what's going on is overrated. You should look it up yourself when you go home.

  5. #1 definitely varies. I had always thought that was the rule (med student here), then I got barked at by a scrub nurse for scrubbing in after my attending (literally finished 15 seconds after he did). She likes to help him drape the field but also didn't want me to self gown. So now when I go to an OR with a different, I just ask.

    And you forgot #8. You will always cut the suture either too short or too long.

  6. #1 is different for here, too. Residents and staff get paged when the pt is in the room. Med students don't. It's the med student job to know when the patient has arrived and be there on time. Since I don't go to Hogwarts SOM, my telepathy is kinda weak. So, med student should be in the OR room before the patient, help get pt to table, put in foley, get gloves and gown, page resident that patient is there. Then the resident and student scrub and drape while the nurse preps. Then finally the attending, god like in his anticipated coming, arrives.

  7. I do the best I can not to sneak up on someone who is scrubbed in. They're involved in a procedure and not looking at me, so there isn't some catlike stealth I'm engaging in for the most part. I do end up having to walk behind them for whatever reason, so I always announce my presence with a "I'm right behind you". Which could end up sounding kind of ominous "I'm riiiiight behiiiind yoooooou…."-- but at least I haven't scared anyone into dropping instruments yet.