Circulators

Sigh. Same ol', same ol.' This is deja vu all over again--it's just like the old "Who's better---A.A. RNs or BSN RNs." It never stops.

This discussion has been had ad nauseum on this BB, if anyone cares to do a search. (Or just ask shodobe or me.)

We are O.R. nurses who scrub AND circulate, and always have. We trained that way, and we expect other RNs to take the time and trouble to learn to scrub--all one needs to do is ASK to backscrub someone a few times, or take call--that's one way to get thrown into situations where you learn to be very proficient in a variety of scrub (and circulating) situations very fast.

One way to stagnate is to refuse to learn to scrub--or to confine yourself to only one specialty area--refusing to do trauma, ortho, or neuro; instead sticking with eyes or plastics--you know, the easy, predictable, non-challenging stuff.

Don't be so sure that OR RNs have very little training as scrubs. I learned to scrub as a Navy corpsman, in Navy O.R. tech school, during the Vietnam era.

When I got out and went to nursing school, and went back to the O.R., ALL the RNs with whom I worked scrubbed--and very proficiently.

By the way--what IS the difference between an ORT and an ST? I was not aware there was one. In the '70s and '80s, techs were called OR techs---even though many of them took a national certification exam.

Then, in the '90s, the terms ST and CST suddenly appeared.

What's the difference? I do realize that the "C" stands for "certified," and that STs who have the "C" prefix have taken a national certification exam." But, to me, the name change--from "operating room technician" to "surgical technologist" makes about as much sense as the name change from "housekeeper" to "environmental engineer--" people doing the same job, but with a fancy new title. What's the point? I don't care about calling myself an "operating room nurse" or even a "perioperative Registered Nurse." I usually introduce myself to patients, families and new staff simply as "the nurse in the room." (And when I was in Navy O.R. tech school, and graduated, I referred to myself as a "tech" or "scrub tech" or "O.R. tech--" as did the more experienced techs, even those who HAD taken the national certification exam.)

I think if one is confident in his or her skills and knowledge base, one does not have to insist on being recognized by a long, alphabet soup of titles after one's name.

One thing I will comment on---more and more, I am wondering what people are being taught in "CST" programs--because, more and more, I see this pattern---scrubs putting damned near their entire back tables up on their Mayo stands, rather than working from the minimum needed at any given time, and putting things in water in their soak pans once they are no longer needed.

What's up with that? I swear, I've started (and finished) big bowel resections and colostomy takedowns, Whipples, liver and kidney transplants, AAAs, etc. with scrubs who put an entire stringer of vascular clamps--plus every size of loaded hemoclip applier--plus long instruments--plus long ties loaded on deep passers---up on their Mayo at the beginning of the case--- an hour or more before they will be needed!

3, 4 or 5 hours into the case--or, even when we are getting ready to close----said vascular clamps, Hemoclip appliers, long instruments, long ties, etc. are STILL up on their Mayos (but by now coated with dried blood--could have been avoided by putting them in water to soak hours before.)

One last thing: For those OR techs---forgive me, STs, CSTs, whatever--who'd like more autonomy--I suggest you go back to school--either to become (first) RNs, then RNFAs or PAs--particularly if you want to first assist.

Like it or not, you are working under the state licensure of your RN circulator--YOU ARE NOT LICENSED---even if you are certified. He (or she) is in charge of the room--and he (or she) is the designated patient advocate---by virtue of the ANA and the corresponding state's Nurse Practice Act.

By becoming a CST and taking the examination a person proves that they have attended a CAHEEP or ABHES accredited program. Attending a program with this type of accreditation helps to assure that students are taught using a 'standardized" curriculum. The curriculum is based on the Core Curriculum for Surgical Technology, 5th ed.The Core is published by AST. AORN and ASA had a great deal of input.

Many at AST support a move to require licensure of surgical technologist. As it stands now, if a tech messes up, they often are just fired and move on to another job. It DOES not mean that the licensed tech ignores the important role of the RN as cheif patient advocate or places themselves 'above' the nurse.

IMHO, bad techs, needed to be taken OUT of the show Permanently. Pulling a required license assures that.

As a Certified Surgical Tech I have NEVER disrespected any nurse (RN or LVN). We are a team. I know for a fact that my professional success depends on the RN in that room.

I also don't care what folks call me. ORT, cool. ST, Fine. CST, okay too. Just plan 'ole tech, is hunky dorey. To be honest I prefer folks just call me by name. I don't like alphabet soup. I much prefer Chicken noodle.

Surgical techs and OR nurses are a team. This argument is foolish and only exists in the minds of people who can't understand that sucessful patient outcomes depend on the profesional success of EVERY member of that team.

(Nurse, Surgeon, X-ray tech, Surgical tech, lab, houskeeping, etc...)

Edited.

I agree with all of sunnyjohn's post except I do care what title I am called. I worked hard to earn the CST title. I deserve the same respect that I give the RNs who worked hard for their title.

Exactly.

Please read all of my post before jumping to conclusions.

This is somewhat off topic; it has to do more with the scrub role. While I believe that the role of circulator should not be replaced by a CST, I do believe that on the job training for scrub role should never be allowed (be it tech or nurse). It is just simply bad for the patient. A program for both (nurse and tech) should be the standard. The reason being is that bad habits are easily passed down and the “newbie” has no reason to question it. Therefore, they learn bad practice and will pass it on to the next student.

The point is that the newer techs have specialized training dealing with instruments, aseptic techniques and procedure. The training ranges from 11 mth. as a diploma to 2 years as an associate degree. This training should never be misconstrued as sub standard or easy.

This same token can be applied to the circulator role; techs do not have proper patient care training to efficiently deal with the role of circulator. Nurses go to school to specialize in patient care. They go 11 (12) mth as a diploma to 2 yrs as associate degree.

Am I the only one who sees this? Or am I totally getting it wrong? It is about the patient isn’t it?

ejwatts says:

This same token can be applied to the circulator role; techs do not have proper patient care training to efficiently deal with the role of circulator. Nurses go to school to specialize in patient care. They go 11 (12) mth as a diploma to 2 yrs as associate degree.

A nurses educational requirement ranges from, according to you, from 12 months to 2 years? Its more like (for RN's) 2 years to 4 years. A diploma program, by the way, is 3 years.

Sorry to tell you but, here the diploma LPN (LVN) is 11 (12) mth. My sister-in-law just finished. The ASN is 2 to 3 years depending what program one attends and how many hours are taken during the prerequisites (this is what I am doing) . Here there is also a LPN to ASN transitional program 1 year diploma + 1 year transition (a co-worker is currently doing this) . BSN is 4 years or 2 years then 2 to 3 years in an interrupted in a ASN to BSN. At least that is how it is here.

The point was not the exact length of the programs; it was that each is trained for specific duties. One is trained specifically for patient care and the other specifically for the procedure and that the schooling is approximately the same length with general studies being the same until the core programs. I do not have to do prerequisites because all mine transferred into the nursing program .

Ok, well I didnt think you were including LPN's in your estimation, and I include prerequisites as part of the total program.