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Editor's Page: Up for Debate
Ever feel like you're drowning in a sea of rules and regulations?
Dan O'Connor
Publish Date: December 1, 2015   |  Tags:   Editors Page
OR Excellence

Interested in presenting at the 2016 OR Excellence Conference (orexcellence.com), which will take place at the beautiful Hyatt Regency Coconut Bay resort in Bonita Springs, Fla.? We are accepting proposals for keynote talks, general sessions, 3-hour pre-conference workshops and breakout sessions. Submit your presentation proposal to [email protected].

All submissions must be received by December 29, 2015. ORX speakers receive complimentary registration for the 3-day conference, a complimentary 2-night hotel stay and airfare reimbursement. Thank you in advance for your proposal and for making ORX surgery's can't-miss conference.

Chuck Knight, RN, BSN, CNOR, wears Crocs in the OR. With no shoe covers. And he places a piece of surgical cloth tape over the toe of his Crocs to prevent him from tripping.

Ding. Ding. Ding.

In the hyper-regulated world of surgical nursing, that's a triple violation. Per infection control best practices and OSHA, shoes must be enclosed (Crocs are backless) and fluid-resistant (Crocs have holes on top). And the cloth tape that lets Mr. Knight's Crocs glide across the OR floor harbors a lot of bugs — and a good bit of dangerous lint, too.

Mr. Knight would be better off going sockless in the OR. AORN has no official position related to wearing socks in the perioperative areas, even though AORN (and your colleagues!) would prefer you to wear some form of absorbent footwear.

OR nurses can be fanatical about their rules, especially those governing surgical attire. Some are the vigilante enforcers, pouncing on the slightest infraction or strand or hair peeking out from under a cloth cap (that had better be covered by a paper bouffant!). If we had a quarter for every finger-wagging e-mail we've received after we published a picture of a nurse wearing a dangling mask — "It's either down and off or up and on" — we'd have quite a stack of coins.

"As an educator for surgical services, I support having rules and regulations," says a reader. "Otherwise, staff will do whatever they please. In surgical services, there must be strict rules and a strong team surgical conscience."

A sizable faction of OR personnel don't always agree or don't always follow the head-to-toe dress code or other guidelines, either because they think they know better or they simply don't like being told how to practice. That's what got us thinking about this month's cover story, "What's the Harm?". With the help of our readers, we teed up a few of surgery's sacred rules and regulations and took a swipe at them. Our story is sure to tick some off.

Do you let your staff launder scrubs at home?

OSM logo

  • yes29%
  • no71%
  • SOURCE: Outpatient Surgery Magazine, November 2015, n=472

Chief among the sacred rules is the home-laundering of scrubs. Whether to launder scrubs at home or at an accredited healthcare laundry facility is a highly emotional issue for some. AORN states all items worn in the semi-restricted and restricted areas must be facility-laundered. When we asked nearly 500 readers last month if they let their staff launder scrubs at home, 29% said yes. "Since you asked," a reader says, "why is it okay for the surgeon to wear in scrubs but staff can't?" Which begs another question: Why do we react so strongly to AORN recommended practices?

"Nurses react strongly because following the guidelines sometimes requires changes in practices and long-standing beliefs and routines," says Ramona Conner, MSN, RN, CNOR, editor-in-chief of AORN's Guidelines for Perioperative Practice. "These changes may require fundamental changes in the organization's culture and personal practices. Change is always difficult, even when done for a good reason that benefits patient and personnel safety."

For the record, AORN says laundering surgical attire at home is a safety hazard for the patient, the healthcare worker and the community. "The evidence is compelling," says Ms. Conner. "When nurses review the evidence and consider the implications of home laundering for themselves, their families and their community, the emotional reaction to change is replaced by reason and the inherent desire of all nurses to place the safety of their patients and others first."