Can a surg. tech. "circulate" a case -give medications? - page 2

At the hospital where I currently practice we sometimes have 2-RNs and 1-Surg. Tech in a room (on good days). In some cases the Surg. Tech. is allowed to "ciculate" the room with one of the RNs. My... Read More

  1. by   HazeK
    Quote from Linda J
    I have refused to allow the ST to spike IV bags or give me drugs when I am scrubbed
    Question: if YOU are the RN, why are YOU scrubbed in and no other RN circulating in the room??? IF only one RN available, why isn't the tech functioning in their role as a scrub nurse (legal!) and you be ciruculating?

    They cannot circulate. Period.
    They CAN be immensely helpful, WITHIN their scope of practice!!
  2. by   Dixiedi
    Quote from DawnEyes
    I originally had a pretty sharp response to the attitude displayed by Mike...until I read the link posted above (Should ST's circulate?). Now I'm just simply curious....what exactly has spawned such an intense (and I do mean intense, from some of the posts I've read) hatred of ST's? I mean, some of the people got downright nasty! I would think that with the amount of condescending comments RN's receive from doctors because the rn's didn't attend four years of medical school, they would think twice before passing the s**t down a level. (Overheard from a doctor once: "There's no way I could have been JUST an RN. I had to be something more than that." I'm not an RN (yet!) but that comment pissed me off just the same.)

    ......

    "Judge a man not by how he treats his equals, but by how he treats those beneath him."
    I have found there is a lot of hostility towards anyone who is not an RN in the threads around here. And, there is a very strong preference to those with BSN behind their name.
    It's sad, they are nurses, no more no less than any other nurse or other support tech.
    If they actually understood the health care system they would understand that there is more than enough room for every one of us and pt care would not be jeopardized.
    I am not saying every RN has this attitude! I said only I have found a lot of it here. There are so many who think they should not have to actually be a nurse on the floor, even though they want to be a staff nurse, because they have a BSN.

    It's so sad. So very very sad.

    It's also very funny. When I was in nursing school the head nurse of the ER was an LPN. Of course her shift charge nurses were RNs, but the unit head nurse was an LPN. Oh my how times have changed.
  3. by   stevierae
    Quote from Dixiedi
    I have found there is a lot of hostility towards anyone who is not an RN in the threads around here.
    I don't have a BSN. Never wanted one, never will. I want to practice hands on NURSING--not move up in management. And, as I said, I have worked, and continue to work, with some awesome, awesome OR techs. Why the heck would they want to circulate? Why would they want to take on the added responsibility or headaches for a scrub tech's pay? Anytime my tech is not scrubbed in I am making sure he or she is taking a much deserved break!!

    I don't need anyone to "help" me circulate--if some crisis develops that needs another nurse, (or if I really, really just need to get to the bathroom) I know how to get on the phone and ASK for another nurse! There's usually SOMEBODY available, either ordering supplies or sitting in the lounge!
    Last edit by stevierae on Jul 5, '04
  4. by   Dixiedi
    Quote from stevierae
    I don't have a BSN. Never wanted one, never will. I want to practice hands on NURSING--not move up in management. And, as I said, I have worked, and continue to work, with some awesome, awesome OR techs. Why the heck would they want to circulate? Why would they want to take on the added responsibility or headaches for a scrub tech's pay? Anytime my tech is not scrubbed in I am making sure he or she is taking a much deserved break!!

    I don't need anyone to "help" me circulate--if some crisis develops that needs another nurse, (or if I really, really just need to get to the bathroom) I know how to get on the phone and ASK for another nurse! There's usually SOMEBODY available, either ordering supplies or sitting in the lounge!
    I was commenting on another post that noted hostilities in the thread. I did not say that any one nurse was hostile. It was a general statement, not naming any person or persons. I really don't know why you took what I said personally, I didn't direct it at you.
    I will not be harrassed like this by someone I didn't even speak to! You surely owe me an appology.
  5. by   carcha
    Same old, same old, we have this question every week about the role of the tech vs the role of the rn. I'm surprised people are not hostile towards the whole thing. Just a few observations here from england. One, in response to "Dawneyes" and the comment I believe about the 2 year tech course vs the 2 year rn course. I myself took a three year rn course, a two year midwifery course, and a one year or course. I can tell all of you out there , any or tech working with me in the past did not circulate and was closely supervised while scrubbing and if I'm in charge of the room I will take those responsibilities very seriously. I just cannot understand why if there are CST who feel they are as good as the RNS, then go back to school do your rn training and you will be as good as us. This whole topic just annoys me, lots of people bash the RNS for their attitude but lets face it when the s%t hits the fan those same people are quick to hide behind the RNs as the innocents who were just doing what they were told by the RNs. The only way to settle this argument is to just have RNs in the OR and I look forward to the day.
  6. by   stevierae
    Quote from Dixiedi
    I was commenting on another post that noted hostilities in the thread. I did not say that any one nurse was hostile. It was a general statement, not naming any person or persons. I really don't know why you took what I said personally, I didn't direct it at you.
    I will not be harrassed like this by someone I didn't even speak to! You surely owe me an appology.
    ***** "Harassed?" Where the heck did THAT come from?! FYI, I was not speaking to YOU--I was addressing the topic in general--it comes up allllllll the time in this section of the bb. Just do a search and you will see what I mean.

    Frankly, I don't think any operating room nurse could care less (or even know) whether their OR RN colleagues have BSNs or not. The only reason we ever even know is the newer RNs care about putting BSN on their nametags, and they make no secret about wanting to move up in management or be charge nurses--most older RNs, myself included, could care less who has what degree, as long as they can do the job--and that means scrubbing AND circulating. That means--ANY RN who works in the operating room should be able to scrub AND circulate. If they do not know how to scrub, they need to LEARN.

    But, that's the subject of another thread, and one that has already been done to death.
    Last edit by stevierae on Jul 6, '04
  7. by   Rn2b204
    Let's everyone calm down and take a breather. I am currently a nursing student and reading these post about the field of nursing that I am highly interested in makes me sick to here the nurse bashing the ST or CST. I hope I don't develop the "HIGH AND MIGHTY" attitude making others feel beneath me. What seems to be the problem no one is trying to take your job as a RN but everyone has a role and why blame, which I hear a lot of nurse say about techs they are not licensed and they won't be named in the lawsuit if something goes wrong. Why would something go wrong if you are a prudent nurse and know what your role is while you are in charge of the OR. If your hospital policy is to have a CST in the OR for whatever reason then they have to be there but to say that they can't be blamed or named if something goes wrong so you don't want them there. Seems to me that you don't want to be the only fall guy or do you think all CST are not competent enough to work in the OR? To suggest for someone to go back to school so they can be as good as you is a ignorant thing to say so when you become an RN that makes you better than the next person that is not a RN? RN's can't run the hospital by themselves nor the OR by themselves. Let's not bash each others occupation because everyone in the health care field MD, RN, LPN, TECH, HOUSEKEEPING, ETC. all have the same priority and that is the PATIENT/CLIENT.

    excuse the rambling and all the typos and such

    I am commenting to Carsha about what she posted.
  8. by   DawnEyes
    most older RNs, myself included, could care less who has what degree, as long as they can do the job--and that means scrubbing AND circulating.
    I completely agree with this.

    To make a reaaaally long post short...this could go back and forth forever...I also agree with those that say techs should not be *the* circulator. We have neither the training nor the licensure to do so. I will help out if/when I can, but I know what is --and what is not-- my job. I like our place in the OR. Just as there are those that would prefer not to earn a BSN from an ADN, there are those that would prefer not to be an RN at all and just continue being a good scrub. Your degree does not determine the type of person you are, good or bad/better or worse. How you treat other people certainly does.

    And like it or not, I think the ST profession will be around for quite a while, due to 1) (as Mike said) the fact that we are cheaper and 2) There simply aren't enough RN's to go everywhere some would like them.

    As for those that continue to bash their heads against the wall in anger when thinking about ST's...I don't know what to say or do for you except hand you a beer, watch in amusement, and *maybe* call a doc or another RN when you finally pass out from the concussion.
    Last edit by DawnEyes on Jul 6, '04
  9. by   Marie_LPN, RN
    Same poop, different thread.

    This thread reminds me of work too much.
  10. by   stevierae
    Quote from LPN2Be2004
    Same poop, different thread.

    This thread reminds me of work too much.
    I just LOVE your little dog pic!

    Is he a pug? Is he yours? He is just adorable--looks like he is laughing...
  11. by   cristinak
    I have been reading this very long thread and I would like to make a comment if I may, please no yelling, screamin, hollerin, throwing a temper trantum or anything with what i have to say!!

    Being a CST student ( i know a cst student posting here. the nerve of me!:chuckle)
    I am very interested in how my role in the OR is or will be perceived by others of the medical profession. I know that I am the low man on the totem pole in the OR and I know that just by reading these post some people do not see the need for us, but is the CSt profession as a whole really that bad of a deal, I would think that the Rn's would like having someone to help you when needed and someone to prep and clean the OR. From working in hopsitals I see the nurses running around doing 9 million other things.
    Whats wrong with having someone trained to do just this and other roles in the OR, I personally would not want to give meds to a patient first of all i am not comfortable doing that unless i have training and then if there is a rn there. please be my guest. Now i would pass an RN the meds if needed or whatever they wanted me to do,
    I decided to go into this profession because of what it consisted of, I get to be there in the action and learn about stuff that I didnt know about, I love to learn new things and if an RN wants to teach me stuff then great but I am not gonna take over thier job and run them out of the OR. I mean are CST that bad or a job or are the RN's just having a really bad day!!

    Agian this is just my ramblings and i am sure no one cares but i thought you would like to read my opinion. Thanks for reading.
    Last edit by cristinak on Jul 6, '04
  12. by   stevierae
    Quote from cristinak
    I have been reading this very long thread and I would like to make a comment if I may, please no yelling, screamin, hollerin, throwing a temper trantum or anything with what i have to say!!

    Being a CST student ( i know a cst student posting here. the nerve of me!:chuckle)
    I am very interested in how my role in the OR is or will be perceived by others of the medical profession. I know that I am the low man on the totem pole in the OR and I know that just by reading these post some people do not see the need for us, but is the CSt profession as a whole really that bad of a deal, I would think that the Rn's would like having someone to help you when needed and someone to prep and clean the OR. From working in hopsitals I see the nurses running around doing 9 million other things.
    Whats wrong with having someone trained to do just this and other roles in the OR, I personally would not want to give meds to a patient first of all i am not comfortable doing that unless i have training and then if there is a rn there. please be my guest. Now i would pass an RN the meds if needed or whatever they wanted me to do,
    I decided to go into this profession because of what it consisted of, I get to be there in the action and learn about stuff that I didnt know about, I love to learn new things and if an RN wants to teach me stuff then great but I am not gonna take over thier job and run them out of the OR. I mean are CST that bad or a job or are the RN's just having a really bad day!!

    Agian this is just my ramblings and i am sure no one cares but i thought you would like to read my opinion. Thanks for reading.
    Sigh. Once again, I can only speak for myself, and I have always worked with awesome OR techs. I mean, I have worked with a few prima donna techs who can only do one specailty and that's IT, but I have worked with MORE then a few prima donna NURSES who could only do one specialty--and THEN all they could do was circulate! To me, those NURSES are a much bigger pet peeve, and I wish they'd just go into management and go to meetings all day, because as colleagues they are fairly useless--they can only do half the job.

    Now--I will say it again--I think the issue on this thread is the patient ASSESSMENT aspect of circulating. There have been some folks who posted here who feel that they are qualified to do patient assessment, even though they are not operating room nurses.

    I REPEAT: In an operating room, patient assessment CANNOT BE DELEGATED BY AN RN TO ANYONE BUT ANOTHER RN. No matter how highly I respect a tech's knowledge and skills, I simply cannot delegate patient assessment to him or her. Our professional governing body, AORN, says we can't. Every state nursing board says we can't. If we did so, we would lose our licenses to practice nursing.

    THIS is the issue that is being discussed--nothing else. Patient assessment, and scope of practice. We are not talking here about opening laps or pouring NS. We are talking about life and death.

    Again, when my tech has a free second, I want him to take a break, as he may have been scrubbed for 4 hours, and will soon be scrubbed for 4 more. At least I got to sit occasionally--he didn't. Why would ANYBODY turn down a break? Why would ANYBODY choose to stay in the room and pour fluids and open supplies when he could be kicking back in the lounge? However, if he wants to , that's fine----no one is saying that he can't or shouldn't!

    That's not the aspect of circulating that is being debated here, but rather the PATIENT ASSSESSMENT role, which is an ongoing role that may change from minute to minute!! Not only must we continuously ASSESS, we must INTERVENE, and we must evaluate those interventions to see if the goals we had in mind were actually accomplished, based on our assessments and interventions.

    Earlier, someone made the comment that we OR nurses had not defined "circulating."

    To him, and to any readers of this thread who think that was a perfectly reasonable question: The fact that you asked a question like this is is proof of why it would be dangerous for you to circulate in the operating room.

    If you must have the role DEFINED for you, well, then, you have absolutely NO business thinking you are capable of fulfilling that role. This is not meant unkindly--it is simply stating a fact. It would be dangerous patient care. It would be akin to me going in and attempting to do a craniotomy, or at least drill burr holes in a patient's skull, simply because I have seen it done thousands of times. Just seeing it done over and over doesn't make me a neurosurgeon.
    Last edit by stevierae on Jul 6, '04
  13. by   cristinak
    stevierae thanks for your response.. I am sorry if I may have touched a nerve w/ anyone as Iwasnt meaning to.. Now from what I have been told from another posting webpage. that in Ohio ( i live on the border of Oh and Ky) that the CST's do not have a specific scope of practice.. agian i repeat this is what i have been told, i have not checked this out personally. If I am asked to do something that I am not familiar with or I do not feel comfortable doing then I am not going to do it, I know that I can proabably get ripped for it later, but the patient is much more important . Now as far as patient assessment, i havent gotten that far along in my studies to know if we are even trained in that area. but I will always let the RN do her job and assist where needed. and trust me if someone says take a break then i am out the door before she/he can finish telling me!!

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