There is so much that is done incorrectly in the title sentence. This is from a friend of mine. There was a large, involved open case and the scrub tech was searching for just the right instrument, neither too short, nor too long, nor too stout, nor too fine. Look at Goldilocks over here.
They had the circulator open at least 6 trays searching for this one instrument.
The circulator, who was fairly new, would ask to count all the new trays. The scrub tech refused and said that the instrument was the only thing they were going to take and to just add the instrument to the existing count sheet. They then instructed the circulator to take the tray out of the room.
Facepalm.
Never take a tray out of the room.
Always count the entire tray. Even if you don’t take the tray out of the room, I have caught scrub techs, and even surgeons and PAs rooting through the open tray. The open, uncounted tray.
Of course, they needed an instrument from the tray the scrub tech had dismissed from the room. With no additional trays that had the needed instruments. This led to even more trays being opened and dismissed.
Of course, the count was off and they needed to take a pre-wake-up x-ray to make sure that there were no instruments in the incision site. This leads to a prolonged wake-up from anesthesia because the scrub tech can’t break down the table (this means keep it sterile), or the patient awakened from anesthesia in case there is an instrument or a sponge or a needle that the surgeon needs to go back in for.
Always count the tray.
Never take a tray out of the room.
Never listen to someone who is telling you to do the wrong thing. The wrong thing that you know in your gut is the not correct thing.
It’s okay to call for backup.
Heck, call me and I will yell at them.
Dispatches from the Evening Shift 