Scrub nurses and techs all have stories of stupidity. Mine is of contaminating myself putting on my gown, one, two, three times, in a row, in exactly the same way, on an OR light. Felt like I had not two brain cells to rub together.
Another nurse, just getting to the point in scrubbing where she started to work alone, told me this story about herself. A delay with the patient, she decides to open and set up. When her circulating nurse gets back, he asks her "Don't you want to put on gown and gloves first?" She had all her sterile set up, but all contaminated setting it out with bare hands.
We all have a moment, when that tunnel vision takes over, when we find ourselves at our destination, unaware of how we got there, and realizing we've missed an important step. We like telling new people, who are feeling incompetent, that we all felt that way and it does get better.
Learning the OR is all kinds of hard, because we can't slow down for new people. Learning at speed, with innumerable variations, and cranky people. Add that we forget how hard it is, the first time we don sterile gown and gloves, the sense of where we are in space, draping properly, trying not to break very expensive equipment. Nurse hired with me broke four laparoscopes in one go, dropped to the ground, pure accident. Tens of thousands of dollars to replace at the time. No, she was not charged, but she felt dreadful.
When we drop an item, it can be nothing - a paper gown, a pair of glove, or an expensive stapler, or a living related kidney. I know of one of the last, surgeon moving it through a substerile room from the family donator to the recipient, and ... something happened, the kidney was on the floor. This is irreplaceable. The surgeon weighed the risks and benefits, thoroughly rinsed the kidney in sterile saline, then antibiotics, and attached it to the patient. No doubt with great anxiety. We really don't have a three second rule in the OR. On the other hand, fingers are reattached, and are hardly sterile, and frequently work just fine.
I often wonder about sterility, if we actually achieve it, or simply an approximation that often works. I'm pretty meticulous, but a lot of surgeries before the idea of sterile technique did not result in death or even infection. Much of what we do has not been scientifically tested, it's more protocol and habit. But our habits do keep in pretty safe.
Not to say our habits don't save us, and breaks in technique don't cause problems - to the negligent, over time. But one time? Probably not. On average. As a whole. So, we are vigilant, but the accidental breaks, once in a while, don't seem to be a problem. As far as we can tell.
When nurses from the floor visit the OR, we tell them their idea of sterile is not ours. And it really isn't. What they call sterile, we accede to call Clean. Clean contaminated we see in my facility, usually not Dirty/Infected. These are
defined categories, with specific criteria.