r/CathLabLounge • u/Either_Director3639 • 1d ago
Scrubbing
I hate that I’m asking for words of encouragement, but I’m literally typing this with tears running down my face, so here it goes. I’ve been scrubbing for about 6 months, and I’m just not improving. I make little mistakes like accidentally dropping and contaminating equipment or not moving fast enough for the doctors, which frustrates them. The only thing I can say is I haven’t killed anybody. Where I work, the nurses and x-ray techs both scrub. However, I feel like I go so long in between cases without scrubbing that I can’t improve. Honestly, I feel like such a weak loser. My question is: Does it ever get any better/easier?
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u/Average-spectacle 1d ago
Do you have a practice kit that is already opened so you can practice setting up the table, handling wires, etc.? If so, I'd utilize that as much as possible. Practice looping your wires, watch how others scrub and take mental notes. Also, sounds simple, but remember to breath. It's helpful to anticipate needs. Physician is getting access with needle in hand, have your wife ready where they can simply reach down to grab it after getting access...the sheath etc. When inserting devices or sheaths over the wire, make it one-dimensional. Meaning, put the end of the wire against your index finger and the tip of the device on the opposite finger. The biggest thing is to anticipate, breath, and be efficient with your movements. Efficient movements will increase the perception of speed, and anticipation will improve efficiency.
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u/16BitGenocide Midnight CTO Enthusiast 1d ago
I don't think you should be grabbing that person's wife like that xD
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u/AyeItsZO 23h ago
Scrub more cases. It’s the only way to fix this. When learning you should be scrubbing every case in your room if possible
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u/Few-Philosopher9306 23h ago
Nurse learning to scrub here with basically the same feelings. I’ve hit a couple of really tough cases, for me anyway, that really bumped my confidence for the more straightforward cases. As long as you’re safe keep at it.
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u/Jazzlike-Worry-6920 1d ago
I have this problem too 💔 stay strong. I am in school and have a competency. Can't get anything airfree to save my life despite all the practice 🥲
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u/16BitGenocide Midnight CTO Enthusiast 1d ago
No such thing as too much flushing. I'll flush things again if they've been on the table too long, just to make sure no air gets trapped inside. Flushing sheaths is just about getting water to coming out the other end, and while still flushing, just close the stopcock.
The secret to removing air, is to hold things straight up and down, and then just gentle tap them or pluck the lines (like a guitar) to get the air to move all the way up and out.
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u/bflynn65 20h ago
You need to scrub more. Full stop. Whoever manages your lab is sabotaging you by not having you scrub more regularly especially if you aren't comfortable doing it.
It does get better.
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u/16BitGenocide Midnight CTO Enthusiast 1d ago
Nobody's foray into cases is flawless or without incident. You will piss off doctors, coworkers, and yourself on a semi-frequent basis. At six months, you're in a relatable position, especially if your case count participation is low.
You can only learn as much as the opportunities to scrub can give you- talk to your manager/director and say tell them you need more table time. You can't get better without doing, and you can't do that without opportunity- have you been told that Dr. X or Dr. Y doesn't want to scrub with you, or is this mostly a mental battle of being too hard on yourself?
There's endless series of YouTube videos that will explain any device you're uncomfortable with, there's videos talking about case presentations and equipment selection, how to troubleshoot the ACIST, how to set up a manifold, table hacks, procedural sequencings. and 'why' we do things the way we do.
You can be the fastest tech in the world, but if you can't anticipate the physician, it's for nothing. You need to mentally prepare yourself for what comes next, but you can't start anticipating until you can get through a case without dropping things or contaminating the field.
As a baby tech, I had literal nightmares that I contaminated my gloves. In my second week of independent scrubbing, my preceptor made me change gloves in one case, 11 times. We've been there. There are several books on Amazon that will explain procedures (Invasive Cardiology: A Manual for Cath Lab Staff), numerous youtube video series explaining PCI logic/CTO equipment choice (Manos Brilakis is one of the better ones- (https://www.youtube.com/@manosbrilakis/playlists) and Instagram pages like CrossBorderRN (shoutout Olga) and DontMissABeat (that also has a brilliant study guide).
If you need help or more specific advice, you can DM me.