The War Against Surgical Caps

[VisionaryTics]

https://www.bostonglobe.com/business/2016/08/31/hat-wars-flaring/abr7FuB9EZna1FRtECDR1K/story.html

I personally can't stand the bouffant. And in any operation where I'm wearing a headlight, the weight of the light pulls the bouffant off, and half my hair is exposed.

Maybe the AORN should write a position paper about scrub techs sticking their fat noses over the face mask constantly.

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[Pir8DeacDoc]

My FB comments on this article :
My thumbnail opinion: A bunch of busy bodies at AORN need a life. You can't chastise one group for lack of data while simultaneously producing none yourself and expect people to take you seriously.
And the AORN spokesperson who tried to portray this as the big mean surgeons trying to hurt patients is doing nothing to help. At the end of the day I can assure her, and any other nurse, that I fret and stress over patient outcomes far more than they do. Long after their shift is over the patient is still in my office over and over again looking at me to fix the issue. So save the divisive talk where you act like AORN are the only ones that care about patients.
Show me some good data and not conjecture and then we can talk

 

[Psai]

It's a really ****ing stupid fight by the nurses. It makes no sense. The first time i heard a nurse talk about ear bacteria i laughed out loud because it's so ridiculous. You know what kills patients? Not being able to hear one another in the or because some stupid nurse thinks that we should put a lunch lady hat over our ears. What next, a full body ortho suit for everyone in the hospital to keep their eyebrow viruses from infecting patients? It's idiocracy here

 

[meister]

Has it really come to this?

 

[deleted547339]

I've had f****ng scrub nurses who made me put a Bouffant down over my ears because they said it wasn't covering enough hair. So insane.

The ACS was really, really stupid to cite "tradition". That was a dumb move.

Hopefully common sense prevails in this, although the globe fanning the flames is unlikely to help.

It concerns me that an attending surgeon says things like"a scrub nurse made me...."

 

[ThoracicGuy]

I've had f****ng scrub nurses who made me put a Bouffant down over my ears because they said it wasn't covering enough hair. So insane.

The ACS was really, really stupid to cite "tradition". That was a dumb move.

Hopefully common sense prevails in this, although the globe fanning the flames is unlikely to help.

I have never had anyone tell me to pull my bouffant down over the ears. I prefer it to the cap as I feel like I get to hot with that style.

 

[deleted547339]

Well (a) I'm not an attending and (b) this was when I was an intern, but still.

Eh, still stand by my point.

 

[LucidSplash]

I think the argument is ridiculous and a head covering is a head covering. I am annoyed that I am made to wear a hospital bouffant over my cloth scrub cap (which I wear because as a woman with short hair it holds my hair better).

But I will say for some of you menfolk that one of my attendings has started wearing the bouffant style and he swears he has stopped losing hair and is growing back.

 

[neusu]

Pure power play by the AORN.

Welcome to modern medicine, run by administration, decided by committee. As a whole MD's were asleep at the wheel in the 80s-90s and have to face the music now.

 

[deleted547339]

I think the argument is ridiculous and a head covering is a head covering. I am annoyed that I am made to wear a hospital bouffant over my cloth scrub cap (which I wear because as a woman with short hair it holds my hair better).

But I will say for some of you menfolk that one of my attendings has started wearing the bouffant style and he swears he has stopped losing hair and is growing back.

Not a surgeon, but if wearing a bouffant cap in the ICU is what it takes to get my hair to grow back, I'm willing to give it a shot.

 

[Psai]

I find the scrub cap so much more comfortable. However, I get horrible hat hair...the bouffant avoids that. Tough choices in life.

Bouffant and tie it in the back

 

[LucidSplash]

Also, one of my bosses is a slightly different breed and is known to wear a shoe cover on his head at times. I would like to see this become a fashion statement if the traditional male cap is removed.

 

[Psai]

Also, one of my bosses is a slightly different breed and is known to wear a shoe cover on his head at times. I would like to see this become a fashion statement if the traditional male cap is removed.

That is awesome

 

[Trauma Surgeon]

Interesting to see that you guys are fighting the same battles that we fought over here in Europe for maybe a decade!
We usually reach i middle ground, for the surgical cap the decision was that no personal caps are allowed, but no need to have the all covering used by ortho/vacular interventionist.

The problem in Sweden started (in my opinion!) when no doctors were interested or could be forced to take the spots for administrative positions. The nurses were quick to sign-up for these spots when asked and they slowly but surely worked their way up in the chain of command and are making silly rules where they think they will minimize or marginalize the doctors and "SPECIALLY SURGEONS" by putting regulations on such things that ACS/Hoyt calls "tradition", and by doing so it will be kind of "socialized environment" in the hospital where you can not distinguish the different workforces by appearance. For example they have banned surgical scrubs (greens where I'm at) outside the OR. They tried on national level to ban lab coats for doctors, because the ""coats" were spreading infections, and the only study they could come up with was one from Japan where they had cultures from the coat sleeves… a worthless study…

If I were Hoyt/Zinner who are in the "untouchable league", if a ban would actually be put in place, I would sign-up for surgery in that OR and be wearing the cap, and by doing so backing up the other colleagues.

Good luck with winning your war!

PS. I still wear scrubs all day at work and several attempts has been made to discipline me and one attempt to fire me, hasn't happened yet…

 

[badasshairday]

In IR we use surgical scrub caps that are lead lined. I will not use a bouffant.

 

[Psai]

In IR we use surgical scrub caps that are lead lined. I will not use a bouffant.

You know you're actively killing patients with your hair bacteria right? Here's the evidence:

 

[joker2400]

Everybody wears the bouffant like a cap or expose more hair than the cap. I don't understand the argument

 

[Psai]

Everybody wears the bouffant like a cap or expose more hair than the cap. I don't understand the argument

The nurses want to dictate behavior to doctors. They already do so by their abuse of writing people up, making complaints, going to hr about workplace environments. Now it is overt, on a national scale with lots of publicity.

 

[neusu]

In IR we use surgical scrub caps that are lead lined. I will not use a bouffant.

You guys aren't exactly known for your respect for a sterile field..

 

[badasshairday]

You guys aren't exactly known for your respect for a sterile field..

Cute. We are sticking dirty catheters inside of people.

Joking aside, we work with tiny holes so it probably doesn't matter. But you know these people won't care.

 

[Señor S]

I divide my officers into four groups. There are clever, diligent, stupid, and lazy officers. Usually two characteristics are combined. Some are clever and diligent — their place is the General Staff. The next lot are stupid and lazy — they make up 90 percent of every army and are suited to routine duties. Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the intellectual clarity and the composure necessary for difficult decisions. One must beware of anyone who is stupid and diligent — he must not be entrusted with any responsibility because he will always cause only mischief.

 

[dilated]

The nurses want to dictate behavior to doctors. They already do so by their abuse of writing people up, making complaints, going to hr about workplace environments. Now it is overt, on a national scale with lots of publicity.

Exactly. This is just one front in this (mindbogglingly asinine) war - they are also making a strong effort to ban surgeons from bringing their bags into the OR at multiple hospitals I work at as well as several other ridiculous initiatives. The goal has nothing to do with patient safety, it's all about building a bureaucracy where they can establish control over the surgical staff via nursing-dominated committees and "writing you up" for discipline from those committees. It would be laughable except the endgame is actually quite serious.

I have a counter-proposal: since OR nurses are so worried about infection even though the surgeon bears all the responsibility and liability for infections, how about we get the OR nurses "skin in the game" by having them lose part of their pay for each SSI? After all, we're not about "paying for volume" in this brave new system, we're "incentivizing quality". CMS can roll it out as Pay4ORN Performance or something.

 

[meister]

Unlike us lowly rads/IRs you surgeons wear big boy pants, how are the nursing associations so strong now that they can even push you guys around? Insane.

 

[neusu]

Unlike us lowly rads/IRs you surgeons wear big boy pants, how are the nursing associations so strong now that they can even push you guys around? Insane.

Well, you IR/Cards/GI folks have managed to carve out your own little utopian procedural suites outside the control of the OR nursing Junta. Take notes, because they'll be coming for your surgical caps next!

 

[Donald Juan]

I think these restrictions against caps are ridiculous, and I hate that the articles against them have this underlying male chauvinism vs feminism undertone.

However, for me personally, I like to rock a full suit, bow tie, bunny suit over top, bouffant cover, loops, and headlamp for all surgeries. The goal is to go into the OR looking as ridiculous as possible. Anybody doing otherwise is amateur hour.

 

[bannie22]

The skullcap is more comfortable than the bouffont.

However, if there is well established research that there are increased infections with the skullcap I would gladly lose it. I would still like to identify an alternative because the bouffont is dreadfully uncomfortable and can be distracting.

 

[TypeADissection]

Bouffant and tie it in the back

Business in the front. Bouffant in the back. This decade will be the rise of the surgical mullet. I wish Scrubs was still on to parody this somehow with The Todd.

 

[DoctwoB]

On the topic of scrub caps, i understand they need to make a one size fits all, but is it really necessary to make it so it goes all the way down to your nose? I have a pretty big head and I have to roll it up so it doesn't cover my eyes.

 

[evilbooyaa]

On the topic of scrub caps, i understand they need to make a one size fits all, but is it really necessary to make it so it goes all the way down to your nose? I have a pretty big head and I have to roll it up so it doesn't cover my eyes.

The scrub caps don't even reach to my eyebrows. Guess I have a big head.

 

[OnePunchBiopsy]

I'm glad I lost my hair at 17 and started shaving my head clean. I wear skull caps and everyone in the OR gets the piss but me...

I've had one nurse even tell me this all started because nurses are jealous of surgeons getting to wear their scrub caps when they don't get to.

 

[Psai]

I'm glad I lost my hair at 17 and started shaving my head clean. I wear skull caps and everyone in the OR gets the piss but me...

I've had one nurse even tell me this all started because nurses are jealous of surgeons getting to wear their scrub caps when they don't get to.

Makes sense to me
Since when do nurses not envy what doctors have?

 

[SouthernBelle12]

http://bulletin.facs.org/2016/10/yo...s-decrease-morale-without-improving-outcomes/


Sent from my iPhone using SDN mobile

 

[Spectre of Ockham]

The made-to-be-cheap absolutely useless bouffant has no place in an OR. When you're pulling out a necrotic appendix or evacuation a gallon of interperitoneal puss you have the right to wear your dam cap which is comfy and sweet.

I'd rather wear a hood then a bouffant when strict aseptic conditions are called for also lunch ladies don't have to sit up for 6 hours without moving their legs and unable to touch your own face to adjust the bloody elastic digging into your skin.

 

[criticalelement]

If I have to wear a bouffant cap then the female staff cant wear any make up, jewelry, or fingernail polish.

All that should be banned.. Surgeons caps, all and any form of make up powder, mascara, ear rings, bracelets, blush. None of it.

Strictly enforced...

 

[VisionaryTics]

If I have to wear a bouffant cap then the female staff cant wear any make up, jewelry, or fingernail polish.

All that should be banned.. Surgeons caps, all and any form of make up powder, mascara, ear rings, bracelets, blush. None of it.

Strictly enforced...

We should also shave all our eyesbrows off. The scruff on the back of my neck that is not covered by skull cap is not hanging over the field for 10 hours like my eyebrows are.

I got yelled at yesterday for wearing a skull cap (operated at a hospital in the morning that allows them, in the afternoon at one that doesn't). The scrub tech started ranting at me (waited until attending wearing skull cap was out of the room, of course) about "squames".

Highlights of the conversation:
"These are AORN guidelines! You don't think they did studies to prove this stuff?"
"You doctors don't even care about infections, you just operate and leave, we are the ones who have to come in and drain abscesses."

 

[Psai]

We should also shave all our eyesbrows off. The scruff on the back of my neck that is not covered by skull cap is not hanging over the field for 10 hours like my eyebrows are.

I got yelled at yesterday for wearing a skull cap (operated at a hospital in the morning that allows them, in the afternoon at one that doesn't). The scrub tech started ranting at me (waited until attending wearing skull cap was out of the room, of course) about "squames".

Highlights of the conversation:
"These are AORN guidelines! You don't think they did studies to prove this stuff?"
"You doctors don't even care about infections, you just operate and leave, we are the ones who have to come in and drain abscesses."

ROFL at the highlights

 

[adenocard]

http://www.generalsurgerynews.com/I.../Surgical-Caps-Get-Clean-Bill-of-Health/41337

 

[Bonferroni Correction]

Prepare for war... when they get back from break

 

[TypeADissection]

The AORN always finds a way to win. I think because they just bitch a lot more than we do, while we're busy actually working.

 

[Jolie South]

I'd like to do a randomized controlled trial looking at anesthesia/case time and complications as influenced by staff lunches vs staff staying in room the entire case like we do with no break. Methinks they would shut up about our hats.

 

[vhawk]

Something similar has been done, basically inferences drawn between the amount of traffic in the OR and infection rates, and then studies showing exactly how much in/out traffic there is (look it up, you will be astonished) and where most of that traffic is coming from. I'm sure that the AORN guidelines about mandatory "no leaving until the case is over" policies for circulators and scrubs are just letting the ink dry before being submittied

 

[AcademicNeurosurgery]

It's a really ****ing stupid fight by the nurses. It makes no sense. The first time i heard a nurse talk about ear bacteria i laughed out loud because it's so ridiculous. You know what kills patients? Not being able to hear one another in the or because some stupid nurse thinks that we should put a lunch lady hat over our ears. What next, a full body ortho suit for everyone in the hospital to keep their eyebrow viruses from infecting patients? It's idiocracy here

Had to come back to this thread - overheard a nurse explaining that a bouffant is best because of bacteria from earlobes and eyebrows falling into the field.

 

[Jolie South]

Who covers their eyebrows with a bouffant?!?!?

 

[badasshairday]

Highlights of the conversation:
"These are AORN guidelines! You don't think they did studies to prove this stuff?"
"You doctors don't even care about infections, you just operate and leave, we are the ones who have to come in and drain abscesses."

Wait. I'm usually the one who comes in to drain abscesses!

 

[AcademicNeurosurgery]

Who covers their eyebrows with a bouffant?!?!?

It was ridiculous. I don't mean to knock nurses or other health professionals because more often than not, they are wonderful people who meaningfully contribute to patient care. But things like this are useless when not supported by strong evidence. I also believe in "look good, feel good, play good" so as long as the evidence doesn't exist, I'm taking the skull cap over a bouffant every time.

 

[Jolie South]

It was ridiculous. I don't mean to knock nurses or other health professionals because more often than not, they are wonderful people who meaningfully contribute to patient care. But things like this are useless when not supported by strong evidence. I also believe in "look good, feel good, play good" so as long as the evidence doesn't exist, I'm taking the skull over a bouffant every time.

If there is no evidence, why belabor something? It's like when your mom told you to do something "because I said so."

In the same vein, we just got a relatively harassing email from my institution about how a resident was eating crackers and drinking coffee while doing notes at a nursing station. Apparently, a nurse told this person to stop and they didn't and it was reported to some "patient safety hotline." God forbid. JCAHO is the worst.

 

[ThoracicGuy]

If there is no evidence, why belabor something? It's like when your mom told you to do something "because I said so."

In the same vein, we just got a relatively harassing email from my institution about how a resident was eating crackers and drinking coffee while doing notes at a nursing station. Apparently, a nurse told this person to stop and they didn't and it was reported to some "patient safety hotline." God forbid. JCAHO is the worst.

That resident just got AIDS by eating at the nurses station... Don't they know the nurse was just trying to help???

 

[TraumaLlamaMD]

If there is no evidence, why belabor something? It's like when your mom told you to do something "because I said so."

In the same vein, we just got a relatively harassing email from my institution about how a resident was eating crackers and drinking coffee while doing notes at a nursing station. Apparently, a nurse told this person to stop and they didn't and it was reported to some "patient safety hotline." God forbid. JCAHO is the worst.

Wait, I'm not sure I've ever encountered a nurses' station that didn't have a bucket of candy or a tray of cookies stashed behind a monitor somewhere. Am I working in a Willy Wonka hospital or are MDs - the ones who don't get a rabidly protected lunch break - the only ones who can't eat at work?