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

Specialties Operating Room

Published

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 question is when a surg tech "ciculates" can they spike IV bags or give medications to the scrub RN for the surgical field? I have refused to allow the ST to spike IV bags or give me drugs when I am scrubbed because I think that this exceeds her scope of practice but I am not sure. I have asked this question to AORN without results but I think this question goes beyond AORN into the Board of Nursing Practice Act. Please help me to bring some clarity to this situation.

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!

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

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.

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.

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.

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!

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
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.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

My actual title is 'Licensed Practical Nurse, Perioperative Services'. And i know what my job description includes, enough said.

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

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.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

It's clarified for me just fine, probably because i read it for what it is, isntead of thinking too hard on it. As long as i'm within my scope, and doing my job, that's what matters to me.

Bye ;)

Specializes in operating room.
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.

Amen, I to also look forward to this day.

AMEN

:angryfire

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.

+ Add a Comment