In a post-nuclear Senate, holds on nominees aren’t what they used to be. And Republicans’ newfound powerlessness to stop President Barack Obama’s picks is starting to get to the GOP.  

Take, for instance, Sen. Rand Paul’s opposition to the nomination of Dr. Vivek Murthy to be surgeon general. The Kentucky Republican has blasted Murthy’s pro-gun-control views, as well as his involvement with the campaign operation Doctors for Obama.  

“As a physician, I am deeply concerned that he has advocated that doctors use their position of trust to ask patients, including minors, details about gun ownership in the home,” Paul said in a Wednesday letter announcing an intended hold on the nomination.  

Up until the “nuclear option” deployment last year, Paul could have blocked the Murthy nomination by mustering the support of Republican senators and getting the 41 votes needed to sustain a filibuster. That’s no longer the case. Now, Majority Leader Harry Reid, D-Nev., can get almost anyone he’d like confirmed with only votes from his own caucus, though he may have to overcome procedural obstacles that eat up precious floor time.  

To the extent holds still have value, it may be in generating headlines for Paul and others as they blast out press releases announcing their intentions — as Paul did for Federal Reserve Board Chairwoman Janet L. Yellen.  

Paul told Sean Hannity on Tuesday night that he is well aware of his diminished leverage.  

“We’ll do what we can to filibuster it, but you realize Harry Reid destroyed the filibuster. There is no filibuster. So when he took over and broke the rules last year, to change the rules, he got rid of the filibuster on nominations,” Paul said on Fox News. “So we can object, we can vote against him, we can tell the public that we don’t think it’s a good idea to politicize the position of surgeon general, but ultimately, he will have the power to roll over us because right now, the Senate operates under the iron-fisted rule of one man, Harry Reid. What he says is what goes.”  

It isn’t just a question of ideology. Sen. John McCain has been particularly vocal about the precedent changes undermining the ability of senators to get questions answered before confirmation.  

Speaking with reporters after an Armed Services Committee confirmation hearing Tuesday, the Arizona Republican blasted the preparation of Obama’s choice to be deputy Defense secretary, Robert Work. Work is a former undersecretary of the Navy.  

In McCain’s view, Work should have reviewed a Government Accountability Office report criticizing the Littoral Combat Ship program, of which McCain has long been a critic. While McCain’s palpable frustration with Work has led him to place a hold on the nomination, he knows that Reid and other Democrats can work around the objection using the debate-limiting cloture process.  

“Usually people come before the committee prepared,” McCain said. “Now, because of the nuclear option, they don’t have to care. They don’t have to care because they know that they can override any objections that we have.  

“This is the best example I can tell you of the results of the nuclear option,” McCain continued, adding later in the day Tuesday that “now we will see less and less qualified people nominated by the president of the United States without that burden.”  

In an exchange that’s gone viral on the Internet, McCain exposed the knowledge gap of Obama’s pick to be the next ambassador to Norway, a political contributor to the president.  

Nominee George Tsunis badly bungled a question about the Progress Party, saying it was among “fringe elements” when it is actually a political party within the Norwegian coalition government. Appointing campaign backers to plum diplomatic posts is nothing new, but the exchange between McCain and Tsunis was particularly remarkable.  

Since Republicans are reluctant to agree to unanimous consent requests to speed up nominations, particularly for the federal bench, in the aftermath of the nuclear option debate, Reid said Tuesday he would soon file cloture to move the nominations along.  

“It is a waste of the taxpayers’ time to go through the process we have been going through,” Reid said. “We are going to, in the near future, file cloture on all of them. If that is what the Republicans want us to do, then that is what we will do. The American people will see the colossal waste of time we have been going through, not only on district court judges but circuit court judges and all nominations.”  

Some Democrats and outside groups favoring more streamlining of the Senate’s procedures want Reid to go further than he did with the most recent use of the nuclear option, perhaps further curtailing post-cloture debate time to make it easier to clear the nominations backlog. McCain rejected that idea.  

“If Sen. Reid wants to destroy the United States Senate, he can do that, but his place in history will be badly tarnished,” McCain said.  

Of course, he made similar pronouncements before Reid pulled the nuclear trigger last year.  

Kerry Young contributed to this report.