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Summertime, and the Scrubbing is Easy (…or is it?)

Summer in the OR from Coast to Coast.

In summertime, as the old song says, “Fish are jumpin’ and the cotton is high.” People are jumping, too – into lakes, onto mountain bikes, and away from sparks as we light off summer fireworks. Summer is the time when we get outside, and if we’re not careful, get ourselves into trouble.

This month, the NBSTSA wondered just how all that fun in the sun affects the workload and case types encountered by surgical techs across the country. To find out, we interviewed CSTs on both coasts about their experiences of summer in the OR. Our West Coast perspective came from Renee DuPont, a 25-year certified CST and clinical coordinator at Glendale Career College. The East Coast perspective came from Brandy Belvin, CST, who has been certified for three years and works in a Level One trauma center in Chattanooga, TN.

The National Board wanted to know whether there was a difference between summer and winter cases. In California, Ms. DuPont told us, she doesn’t see much difference because the weather is the same all year round. However, she noted that this may be different at a trauma center, especially around the holidays. “Fourth of July, you’re going to see more burns from fireworks,” she said.

Ms. Belvin confirmed that her hospital does see some differences during the summer. They are located in the city, but also close to a lake and mountainous areas. That means that they get all the usual urban cases plus ATV and boating accidents, hiking accidents, and more. “We see a lot of just about everything,” she said.

Ms. DuPont has also worked in Illinois before relocating to California. She said that she had not seen many changes in her cases when she moved, but that the attitude towards surgical techs was different. She also said that things have improved a lot in the time she has been in the state. “I know the State Assembly here has worked very hard to get things changed,” she said.

When asked if they thought there was an overall difference in practicing on the East Coast vs. the West Coast, both Ms. DuPont and Ms. Belvin said no. They both felt that the type of facility was a much bigger factor. “Ortho cases are what you see most at any hospital,” Ms. DuPont said. “And at any university hospital anywhere, you’ll see the bigger cases being done.”

However, we did hear about regional differences when it comes to scheduled procedures. Ms. DuPont said she sees more elective surgeries in the summer, with school- and college-aged patients taking advantage of summer break to recuperate. Ms. Belvin, on the other hand, said that she sees them more often in the winter.

Finally, we asked if they had any advice for new CSTs about to embark on their first summer in the OR. Their replies were so great that we decided to print them in their entirety.

DuPont: “Just stick with it. Go in with a positive attitude and a hunger to learn and the world is yours. It’s the most exciting field anybody could ever choose as a profession. … I’m blessed to be working in this field for as long as I have.”

Belvin: “Be prepared for whatever, because you really never know what’s going to roll through the doors. When you think you’ve seen it all, you get a case that proves you wrong. Prepare for the worst and hope for the best.”

Do you have any stories, advice, or questions to share about summer in the OR? Share them with us online and be part of the conversation at facebook.com/theNBSTSA!

Thank you very much to Renee DuPont, CST, Brandy Belvin, CST, Donna Henderson, CST/CSFA, and Connie Bell, CST for all of your assistance with this article!

 

Historical Spotlight

This month, we begin a new series focusing on men and women who have helped shape the surgical professions. Our first historical spotlight is Dr. John Snow (no relation to Jon Snow). Dr. Snow’s work changed our understanding of how disease spreads and helped lay the foundation for modern sterile technique.

Today, every CST and CSFA knows the importance of sterile technique to protect patients from infection. But if you stepped into an operating room in 1850, you would find a very different story.

For over a thousand years, people believed that disease was spread by “miasmas” – poisonous vapors that caused the air itself to become decayed. That “rotten air” then spread sickness to everyone who breathed it.

Before microscopes allowed us to see bacteria, this idea didn’t seem as odd as it does today. Contaminated areas smelled bad and made people sick. It seemed logical to early scientists that the smell was carrying the disease.

Not surprisingly, the miasma theory was no help in preventing surgical infections. Medical authorities in the 1300s recommended “purifying” a room by burning incense. To their surprise, no matter how good the room smelled, patients continued to die from infection at a high rate.

Outside the operating room, sanitation was even worse. Raw sewage filled streets and drinking water. As you can imagine, this caused quite a “miasma.” In London alone, thousands of people died in outbreaks of cholera.

Enter Dr. John Snow, a respected medical researcher. Snow knew that scientific evidence did not support the miasma theory. He suspected that cholera was spread by “some material which [was] being unintentionally swallowed” (Snow, 1849).

During one of the cholera outbreaks in London, Snow interviewed victims and tracked the cases on a map. He found that everyone who had gotten sick was drinking water from the same source – a public water pump nearby. At his recommendation, city authorities shut off the water pump, and the outbreak ended. The evidence was hard to deny: the substance making people sick was in the water, not the air.

Dr. Snow’s findings were a huge step forward for the study of infection. Not only did they prove that miasmas were not real, they showed that the people drinking the contaminated water had no idea it was making them sick. That meant the cause of infection must be too small to see, smell or taste.

Snow also discovered that boiling the water stopped the spread of disease. In his article about the outbreak, he recommended that all drinking water be filtered and boiled – the beginnings of the process of sterilization. (Louis Pasteur, the most famous name in sterilization, didn’t patent his process until a decade later, in 1865.)

Unfortunately, not everyone was convinced by Snow’s work. It took more than thirty years before the medical community accepted what we now call the germ theory of disease. Snow himself would never see his work achieve fame, or know about the many lives he saved. He died in 1858, just three years after publishing the study.

The path from a dirty water pump to a modern sterile OR was long and took the work of many people. But without Dr. John Snow, it might never have come to be. So the next time you’re setting up instruments, take a moment to say thanks to Dr. Snow. Without him, your sterilizing equipment might include an incense burner instead of an autoclave.

For more information about the topics in this article, please see the sources below:

Sterner, Carl S (2007). “A Brief History of Miasmic Theory.” Available for free online at carlsterner.com

Johnson, Steven B (2006) The Ghost Map: The story of London’s most terrifying epidemic. Riverhead Books. Available from theghostmap.com

The John Snow Society. johnsnowsociety.org

Hook, Sue V (2011). Louis Pasteur: Groundbreaking chemist & Biologist. ABDO Publishing. Available from amazon.com
 

The Back Table

 

Marketing Tip

What does your email address say about you? It’s fun to email friends from imthecoolest@dude.com, but it might not make the best impression on employers. Make sure you have a professional email address, such as yourname@gmail.com, to use as contact information on your resume and other professional documents.

Study Tip

Break it up! Learning is all about sprints, not marathons. Studies have found that we focus better when studying in small chunks with short, frequent breaks. Try to schedule your study sessions in 30 minute sections. Work for 25 minutes, then take a 5 minute break. When you come back, you’ll be refreshed and ready to learn!

Calendar of Events

 

NBSTSA Board of Director’s & Committee Orientation, September 2016, Denver, Colorado

Iowa State Assembly Meeting, September 24, 2016, Des Moines, Iowa
 
OR Manager Conference, September 21–23, 2016, Las Vegas, Nevada

American Society for Healthcare Risk Management Annual Conference, September 25–28, 2016, Orlando, Florida

ASA Fall Meeting, September 30–October 1, 2016, Orlando, Florida

New CSTs and CSFAs

Congratulations to all the newly certified CSTs and CSFAs who passed in summer 2016! Click here to view them all.
 

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Visit jobs.nbstsa.org today to view hundreds of career opportunities in the surgical technology and surgical assisting industries.
 

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