Can a surg. tech. "circulate" a case -give medications? - page 3

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   stevierae
    Quote from cristinak
    . and trust me if someone says take a break then i am out the door before she/he can finish telling me!!
    YOU GO, GIRL!!!

    I used to work at a place where the techs would break between every case, and I thought that was a great practice--still do. Otherwise, they may not get a break, other then lunch. I feel like they are entitled to breaks in between cases as often as they can grab one, to make up for the days that they might be scrubbed for 8 hours at a stretch. (Same goes for RNs who were/are scrubbed all day.)

    Sadly, bare bones staffing and pushing us to move faster is all but eliminating that practice in most facilities--the "desk" expects the scrub to open the case while the RN gets the patient.

    My response to this practice? Hell with what the desk says--my scrub (whether my scrub is an RN or a tech) is getting a break when I say he gets a break, and if that means between every case, (which is how I like to see it done) then that's the way it will be. I am in charge of my room--not the desk. If any scrub of mine is ever "spoken" to by the desk for not being in the room opening, I tell the scrub to tell the desk to take it up with me. OR, I go to the desk and tell them if they have a problem with how I run my room to take it up with me. No one has yet.
    Last edit by stevierae on Jul 7, '04
  2. by   shodobe
    After reading all of this, I can only say that it is very old stuff and needs to be put to rest like all of the other threads concerning this or BSN vs ADN, etc.... Everybody has an opinion be it right, wrong or indifferent. I don't intentionally mean to hurt anyone's feelings or their professional demeanor. Just because I have an opinion, be it so strong, doesn't mean that I would ever ignore a person's qualities. We all have to get along with each other and work towards the patient's well being. Also, for RN2B204, yes RNs can run the OR entirley without ancillary help, though it would be tough! There isn't a state in the union that can stay open without RNs, Federal law. The hospital would have to close down if the staff consisted of anybody else than RNs. Hospital can not run with LPNs, CNAs, CSTs or whatever. RNs are the backbone of any hospital. Check it out if you don't believe me. Also you will find out that there are only policies for the use of RNs in hospitals, especially the OR. It would be interesting to see if I am wrong, but I don't think so. Mike
  3. by   x3_mom
    I am not sure why some surg techs want to Circulate. I didn't, yes, I did expand my knowledge and attended school to first assist,but I have no desire to circulate. I am perfectly capable of assisting the circulator if he/she needs it. I have been very lucky to work with RNs who trusted me and my abilities. I was trained in school re: the meds that we use on the surgical field and will help the circ by pouring these onto the sterile field, I will then set the empty bottles down so that should the circ have questions he/she could examine them, the Circ usually obtained the meds for the room from the Pixis. I have IV pushed meds at Anes request because the RN was not avail, I did this only after confirming what the med was and the dosage to be given, in these cases the anes provider would only draw up the amount of med that was to be given. If an RN does not want my help then I will take a break and let them do their job. But if the surgeon is standing there tapping his/her foot to get the case started, then I can and will (having been trained in school and checked off by the hospital) help position the patient, prep, insert foley, etc.

    I will say that I now work for a surgeon and I work under his and MY licenses not the RNs. After going through all proper chanels and obtaining my privledges to assist the surgeon, I had a RN write me up for closing skin on an excision of a skin lesion that was about 1 1/2" long. I was trained and creditionaled for this and had performed the same procedure numerous times before, unfortunately this RN is one of the few who feels she has to flex her muscles now that she is in the OR (she started 1 month prior and had NO prevoius training).

    I realize that I am rambling but I one last statment, to those who mistakenly believe that in Texas the Surg Tech is licensed and did so to take the RNs place, you are very wrong.

    The Surgical Assistant in Texas is the Licensed person not the surg tech. Also the reason that we are pushing for the licensure of the surg tech is not to take the place of the RN, very few CSTs want to do that and those that do, in my opinion are fools. We are pushing for licensure to protect the patient, as you RNs say every patient deserves a RN, then in that respect every patient deserves a properly trained surg assist. Until the field is regulated by states then hospitals will continue to train anyone they want to scrub. Including those with NO MEDICAL TRAINING.

    It is my opinion as a surgical tech / first assistant that the OR big enough for all properly trained personnel, each doing the job that they were trained to do, but able to assist others in the OR as and where needed.
  4. by   Marie_LPN, RN
    Just because i'm an LPN doesn't mean that i'm not worthy of being in the OR. And that's the kind of attitude i receive online and in the workplace when people find out that i'm "just" not an RN. Yet i'm not a surg tech either.
  5. by   stevierae
    Quote from LPN2Be2004
    Just because i'm an LPN doesn't mean that i'm not worthy of being in the OR. And that's the kind of attitude i receive online and in the workplace when people find out that i'm "just" not an RN. Yet i'm not a surg tech either.
    Ah, Marie. This is not a battle to take up with operating room nurses, all of whom are RNs. This is a battle to take up with AORN and the nursing boards of each and every state. I know of no state that allows LPNs or LVNs to circulate in the operating room. Now, if you don't scrub by choice, and you can't circulate, per nursing law and AORN rules, what option is there for an LPN in the operating room?

    Or, am I misunderstanding you--are you an LPN fulfilling a scrub role? What does your job description say that your role in the operating room encompasses?

    I cannot imagine AORN--or state nursing boards-- relaxing the rules to allow LPNs/LVNs to circulate. So, why not JOIN our ranks by becoming an RN if the OR is where you want to be as a nurse? We are NOT the enemy!
    Last edit by stevierae on Jul 7, '04
  6. by   Marie_LPN, RN
    I do not circulate. I do not WANT to circulate, however, i have been receiving training from a circulating preceptor, just for the knowledge of what the job includes, because this is included in my training.

    I scrub. That's my job. I AM an O.R. nurse

    So, why not JOIN our ranks by becoming an RN if the OR is where you want to be as a nurse?
    I just graduated LPN school a MONTH ago!!! For some reason, after doing 90 hours weeks consisting of full-time school and full-time work, i'm a little tired, therefore, school's on the backburner.
  7. by   x3_mom
    LPN2BE2004, I hope that you did not take offense to my post re: the surg tech being properly trained, you have stated that you are training to scrub and that you are an LPN. What I meant was the off the street- no medical training of any kind that the hospitals pay minimum wages and expect them to scrub surgical cases.
  8. by   batgirl629
    I am a first time visitor to this site and I had to register in order to reply, because I was so infruriated by some of the comments I read on this site. I am a CST (and damn proud of it) as well as a nursing student right now and I have been truly saddened today by reading these hostile and degrading comments about CSTs. Contrary to one comment, it is not the job of the RN in the room to "watch them" (STs), nor are we just there to do as we are told. I work at a very large women's specialty hospital and I do a lot of nursing and medical training. I train RNs to scrub, as well as how to do some aspects of the circulating role. Although my hospital does not have a policy for or against STs circulating, many of us have had to do the role out of necessity. When we have an emergency (especially from L&D) we are oftentimes sent an RN from the labor room to circulate who has never done it or hasn't done it in 6 months or more. CSTs do all the work and the RN fills out the paperwork and gives the meds. And frequently, we have to show them how to fill out the paperwork as well.

    I cannot believe the hostility I read on this website, but it only serves to further my determination to see STs get the respect and recognition we deserve. I can appreciate that nurses have a specialized training and education that STs do not get, however, RNs need to respect the training and education that we receive. I can also attest that I received a much better education for my associate degree as a tech than I am receiving in my bachelor degree nursing program. The tech bashing really needs to stop.
  9. by   stevierae
    Quote from LPN2Be2004
    I do not circulate. I do not WANT to circulate, however, i have been receiving training from a circulating preceptor, just for the knowledge of what the job includes, because this is included in my training.

    I scrub. That's my job. I AM an O.R. nurse


    I just graduated LPN school a MONTH ago!!! For some reason, after doing 90 hours weeks consisting of full-time school and full-time work, i'm a little tired, therefore, school's on the backburner.
    And you are to be congratulated for finishing school; it is, indeed, hard work, and you should be proud!

    And, you are a licensed practical nurse working in the operating room--but I would certainly look at your job description.

    What is your title, if your job is to scrub but not deliver nursing care? Will you get a raise after you pass your LPN boards, or do LPNs take the same sort of boards we do?

    Do I recall you saying, or was it another poster, that in some states (perhaps yours?) the person who scrubs cases in the operating room must undergo LPN or LVN training first? I know that I have worked with several LPNs in various operating rooms, but they were hired (and paid, and their job description and title reflected it) as surgical technicians--and they applied for jobs that were posted for surgical technicians, and filled those spots--not vacancies that were posted under "Nursing." We were not allowed to delegate any nursing care to them.

    Older nurses such as myself (I was a Navy OR tech in the late '70s, then went to nursing school and graduated in '81) refer to ouselves as "operating room nurses." Our professional organization, AORN, used to be known as the Association of Operating Room Nurses.

    At some point, AORN became so adament that nurses providing patient care in the operating room be RNs--and even more adament that patients be assured and aware, that the nurses in the operating rooms delivering their care were RNs--that they changed the abbreviation AORN to mean this:

    "Association of periOperative Registered Nurses."

    So, you see, AORN is who you should clarify your title and current and eventual scope of practice with--it is they who make the rules. I would be interested in knowing if RNs in the OR are allowed to delegate patient assessment (that is, is it state specific? facility specific?) to LPNs who work in the OR, and I would be interested in knowing if LPNs who work in the OR can legally refer to themselves as operating room or perioperative nurses.

    Congratulations on finishing school! Now you will have to change your screen name, since you have now reached your goal!
  10. by   Marie_LPN, RN
    Quote from batgirl629
    I am a first time visitor to this site and I had to register in order to reply, because I was so infruriated by some of the comments I read on this site. I am a CST (and damn proud of it) as well as a nursing student right now and I have been truly saddened today by reading these hostile and degrading comments about CSTs. Contrary to one comment, it is not the job of the RN in the room to "watch them" (STs), nor are we just there to do as we are told. I work at a very large women's specialty hospital and I do a lot of nursing and medical training. I train RNs to scrub, as well as how to do some aspects of the circulating role. Although my hospital does not have a policy for or against STs circulating, many of us have had to do the role out of necessity. When we have an emergency (especially from L&D) we are oftentimes sent an RN from the labor room to circulate who has never done it or hasn't done it in 6 months or more. CSTs do all the work and the RN fills out the paperwork and gives the meds. And frequently, we have to show them how to fill out the paperwork as well.

    I cannot believe the hostility I read on this website, but it only serves to further my determination to see STs get the respect and recognition we deserve. I can appreciate that nurses have a specialized training and education that STs do not get, however, RNs need to respect the training and education that we receive. I can also attest that I received a much better education for my associate degree as a tech than I am receiving in my bachelor degree nursing program. The tech bashing really needs to stop.
    Actually, it is the circulator's (RN) job to keep an eye out that the sterile field is not broken.
  11. by   Marie_LPN, RN
    My actual title is 'Licensed Practical Nurse, Perioperative Services'. And i know what my job description includes, enough said.
    Last edit by Marie_LPN, RN on Jul 8, '04
  12. by   x3_mom
    Quote from LPN2Be2004
    Actually, it is the circulator's (RN) job to keep an eye out that the sterile field is not broken.
    Actually, it is EVERYBODIES job
  13. by   stevierae
    Quote from LPN2Be2004
    My actual title is 'Licensed Practical Nurse, Perioperative Services'. And i know what my job description includes, enough said.
    I know. I was reading the Standards of Care for Emergency Nurses today--and it said on the first page, something like this, "Emergency nurse refers to a Registered Nurse working in the Emergency Room."

    So I thought to myself, "Hmmm. Now, I have know some darned good LPNs (and in CA, LVNs) who worked in the Emergency Room. So, what is this book insinuating? That LPNs/LVNs who work in the Emergency Room are not NURSES, and are not held to the standards of care for Emergency Nurses?"

    It's just confusing, that's all, and it's the fault of the professional organizations that govern us and write the standards and guidelines--I wish they would clarify them a bit better.
    Last edit by stevierae on Jul 10, '04

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