Should Surgical Technicians Circulate

Marie_LPN, RN, LPN, RN · May 25, 2004

I really hope i don't encouter too many i'm-better-because-i'm-an-RN attitudes when i start training (nor am i saying that all are or will be like that). I'm well aware of the differences in the education, job responsibilities, but i'll also remember these things when i go back for my RN, and remember where i came from, because i'm sure by then there will at least be one person that will try and treat me as a lesser person because i'm not an RN and here i am in the OR.. Sorry for the bluntness.

lindaloo51 · May 25, 2004

Personally, I don't treat anyone as a lesser person. We are a team and every team member has their job. EVERYONE is important. Where would I be without the processing techs to clean and sterilize my instruments? Where would I be without the purchasing department to deliver my packs and supplies? Where would I be without the anesthetist to keep my patient comfortable and pain free? Where would I be without the OR tech to work shoulder to shoulder with? Or any of the other support staff that I rely on to do their jobs just as I do mine.

I'll tell you where. Up to my a** in alligators. That's where I'd be. We are a team and we need to think as a team. We need to remember that we all do the best job that we can for the patient.

I am trained for my job, the tech is trained for their job. They are different jobs in the same room.

One last thought. A NASCAR race car doesn't get very far with a flat tire. All of the air needs to be contained.

Rnn2003, MSN, RN · May 25, 2004

thanks for the feed back...i agree that we are all a team with one focus in mind the patient and that patient's safety.

Marie_LPN, RN, LPN, RN · May 26, 2004

Thank you for posts #49 and 50, i needed that today.

shodobe · May 27, 2004

I personally don't think anyone of the above posters is really getting the gist of the question. It is not an issue of who is better or who does what. It is an issue of professionalism and what is in the interest of the patient. Every patient, and I mean every patient deserves an RN as their nurse in the OR, not an LVN or a CST but an RN. It is law in all states and will continue to be one unless the AORN folds up their tents and hits the road! I am NOT better than anyone when it comes to doing cases. All members of a team function well when they know how to anticipate each other's needs, but also know their limitations and job roles. Remember, the question was, "should surgical technicians circulate"? The answer is still no. The state of Texas is going down the wrong path when they think that allowing CSTs to do something they are not qualified to do is the answer to their nursing shortage. Remember every one in the medical field has a scope of practice to ahear to, so everyone should. Mike

Marie_LPN, RN, LPN, RN · May 27, 2004

I get the gist of what's being said, i am capable of that at least.

DNRme · May 30, 2004

I can hardly believe some of the things I am reading in this thread. For someone to say that nothing learned in nursing school will help in the OR is frightening to me. You really have no concept of what being a good, competent OR nurse is.

There are some basic ideas not addressed. What would limit the scope of practice of these techs? I certainly do not want a tech giving anyone I know blood.

I work with some great techs. Their training is task oriented. OR nursing involves many tasks, but we are always first and foremost an advocate for the patient at their most vulnerable time. I would have to leave the OR if this change were to come to NJ.

stevierae · May 30, 2004

There are some basic ideas not addressed. What would limit the scope of practice of these techs? I certainly do not want a tech giving anyone I know blood.

Why would you have a problem with a tech giving blood? What do you think pump techs in the heart room are? (I think their official name is "perfusionists.") Same thing with the people who work for Red Cross or private companies to run the Cell Saver for autotransfusion--they are techs, and very, very good at what they do.

I guess you are referring to an OR tech hanging donor blood from the blood bank, though, is that it? Of course, that is only in the scope of practice of an RN or the anesthesiologist, in the operating room setting--or, if it is spun down autologous blood from the cell saver, of course that tech who spun the blood down in the first place could and would give it--but not an operating room technician, who has not received training to do so.

RNKITTY04 · Jun 1, 2004

DNRme,

I DO know what makes a good OR nurse. I have worked in the OR for 10 years, maybe you should re-read my post before you slam me. And I still stick by my guns in that (at least in my nursing school) I have not learned very much in school that will help me in the OR.

eg.....The sterile technique they teach is a joke,no instruments ever covered, (you really should know what you are counting) positioning? I dont think so... I could go on but hopefully you get the idea.

I was under the impression that the OR is a specialized area and that nursing school just covers the basics, the rest you learn OTJ. They rotated us thru the OR for 2 half hour cases, IMHO don't really think that's gonna cut it.

txspadequeenRN, BSN, RN · Jun 1, 2004

I agree with the posted question CST should not replace RN's in the OR. But just how long do you think CST's go to school ,compare the clinical /classroom hours. Internship my foot, I spent every week doing an "internship". And yes that was before you can be "considered done with the program". There are alot of programs that require you to be a LVN/LPN before becoming a CST.

There is actually longer schooling involved to become a CST, then there is to become an LPN. And they are also required to do an internship, before they can be considered done with their program. They will then have to go through a hospital's orientation....................

PA-C in Texas · Jun 2, 2004

This entire thread makes me sick. Did the person who asked the question originally have any doubt that the answers would ALL be a resounding NO from RN's? Please.

I really love that attitude that you have to be a nurse to do anything in health care, and if you aren't, you have to answer to the nurse. Everyone in here thinks that nursing is the only place to branch off from, and that everyone should have a two year ADN degree. Well I don't. Nurses have hung the idea of licensure over the head of people for years and years. What are you going to hang over their heads when they are licensed? Well I have heard it today: "you are not an RN". So it goes from a quasi-legitemate argument over legality and practice issues to exposing the real reason- the turf war beneath.

I have heard about "important" duties of the circulating nurse, like "nursing diagnosis", "answering pages", "assigning rooms". Whoopty-doo. Is a fascinating "diagnosis" like "pain as a result of injury" really necessary, and can't the janitor see that a patient is having pain from an injury? Why can only an RN circulate? There hasn't been a legitemate reason given yet- only catchy slogans like "Every patient deserves an RN".

And then there have been people suggest that since the AORN forbids something, nobody can do it. Hmmm... What if we took nursing out of the OR picture? What the AORN says wouldn't apply anymore. Why? Because it only applies to nurses. The AORN doesn't have some special claim to the OR beyond the fact that nurses staff the OR. Nursing ethics and regulations only apply to NURSES. I have had nurses tell me that I can't do something because our State Board of Nursing wrote an opinon against it. That doesn't really matter to me. Hospitals need to take CST's out of the control of nursing and be done with it.

And then we have some nurses who beat their chest and essentially denounce other fields "because they aren't nurses" only to go on to say things like "oh we're all a big team :) :) :) ". Yeah, but you only feel that way if you're in charge.

carcha · Jun 2, 2004

Whichever way the last few postings put it the face remains that a person trained to do practical work ie scrub and hand over instruments does not have the necessary qualifications to also lead a team of or staff plus ensure complete patient care. As I have stated before in America I have worked with wonderful techs, in Britain I have in the past worked with wonderful practical nurses. They themselves would be the first to tell me they were proud of their role in the OR . I have no problem with that. They knew their job and their role. However they did NOT have the necessary experience, knowledge and in some cases interest to take on a role they were not trained for. My professional body tells me that as the registered nurse I am accountable for any decisions I make plus any duties I may delegate to a non registered nurse. Therefore I can tell you I will protect my licence at all costs. That means I am the nurse in charge of the room and I make decisions as to patient care. When the NMC takes that responsibility away from me then hey knock yourselves out. As to the posting about nurse training not preparing you for the OR. Of course it dosent and thats why I went to university to do a degree in perioperative nursing care. This is not about "us and them", its about legalities, patient safety, roles, responsibilities.