Should Surgical Technicians Circulate - page 5

Should Surgical Technicians be permitted to circulate in the O.R?... Read More

  1. by   Marie_LPN, RN
    I get the gist of what's being said, i am capable of that at least.
  2. by   DNRme
    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.
  3. by   stevierae
    Quote from DNRme
    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.
  4. by   RNKITTY04
    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.
    Last edit by RNKITTY04 on Jun 1, '04
  5. by   txspadequeenRN
    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.

    Quote from suzanne4
    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....................
  6. by   PA-C in Texas
    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.
  7. by   carcha
    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.
  8. by   stevierae
    Quote from PA-C in Texas
    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. .
    Jimmy, I don't feel that you have to be a nurse to do anything in health care. I have worked with some awesome, awsome operating room technicians, respiratory therapists, pump techs, and PAs. You are a PA. You can diagnose and treat, and are presumably very good at assessment and physical exam and intervention. Your scope of practice is quite a bit broader than that of the average operating room technician--not all, because some have been trained extensively to first assist, and do so very well, in the military (I was when I was a Navy tech) but most straight out of tech school are not. When you compare yourslef to most CSTs, you are comparing apples and oranges.

    I would never take it upon myself to tell a PA what to do or how to do it--he or she is working under the physician's license. But the TECH in the room is working under MINE. That's the difference. And we are bound by the rules of AORN and the state nursing board; if we don't follow the rules, we can lose our licenses. Simple as that. And as long as AORN is our governing body, we can't just pretend they don't exist.

    I am probably the least territorial nurse I know. If a PA wants to come in my room and balance the microscope or set up the fracture table or prep or put in the foley or put on a tourniquet or do whatever else needs to be done to expedite getting a case actually underway, I welcome his or her assistance. Unfortunately, in many places, the opposite is encountered--you don't see the PA until he or she is scrubbing alongside the surgeon.

    Also, be truthful--I am betting that if you saw a nurse daring to tie knots or suture, you would throw a fit. Why? Does one have to be a PA to tie knots, retract and suture? Many RNs, and techs, especially those of us who trained in the military, are really good at it. But most PAs think of that as their exclusive territroy, and, after all, they get paid for doing it. I don't think it's right for us to do it for free and take away a source of income for those who do it for a living.
  9. by   Marie_LPN, RN
    Quote from PA-C in Texas
    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.


    LOL!!! Thank you!
  10. by   PA-C in Texas
    Quote from stevierae
    Jimmy, I don't feel that you have to be a nurse to do anything in health care. I have worked with some awesome, awsome operating room technicians, respiratory therapists, pump techs, and PAs. You are a PA. You can diagnose and treat, and are presumably very good at assessment and physical exam and intervention. Your scope of practice is quite a bit broader than that of the average operating room technician--not all, because some have been trained extensively to first assist, and do so very well, in the military (I was when I was a Navy tech) but most straight out of tech school are not. When you compare yourslef to most CSTs, you are comparing apples and oranges.

    I would never take it upon myself to tell a PA what to do or how to do it--he or she is working under the physician's license. But the TECH in the room is working under MINE. That's the difference. And we are bound by the rules of AORN and the state nursing board; if we don't follow the rules, we can lose our licenses. Simple as that. And as long as AORN is our governing body, we can't just pretend they don't exist.

    I am probably the least territorial nurse I know. If a PA wants to come in my room and balance the microscope or set up the fracture table or prep or put in the foley or put on a tourniquet or do whatever else needs to be done to expedite getting a case actually underway, I welcome his or her assistance. Unfortunately, in many places, the opposite is encountered--you don't see the PA until he or she is scrubbing alongside the surgeon.

    Also, be truthful--I am betting that if you saw a nurse daring to tie knots or suture, you would throw a fit. Why? Does one have to be a PA to tie knots, retract and suture? Many RNs, and techs, especially those of us who trained in the military, are really good at it. But most PAs think of that as their exclusive territroy, and, after all, they get paid for doing it. I don't think it's right for us to do it for free and take away a source of income for those who do it for a living.
    Actually, I firmly believe that if someone is qualified to do something, they should be able to do. I have long argued for Paramedics in the ED being able to practice at their advanced level. If RN's have been in the military and know how to suture, more power to them. I have NO problem with people using their skills to the full extent.

    You talk about techs who aren't qualified coming right out of school. Well the new graduate RN isn't qualified to first assist either.

    Also, as I have stated before, AORN and State Boards of Nursing don't have exclusive claim to regulating what happens in an OR. They only have some say because nurses work there. What if the hospital said that CST's could be in charge also? The AORN and state boards can't do jack about it because CST's do not have to abide by what they say. What about the ones who are licensed? By what rationale are they going to be kept from circulating? Because "they aren't nurses"?

    Riiiight.....
  11. by   cwazycwissyRN
    Thought provoking thread here. Nice to see the interest in the OR.
    I have been astounded by some of the coments.
    I work with some extremely good techs. Some of them are going to nursing school. I would be so very disappointed if they felt that what they are learning in school.....is not applicable to the OR.
    Techs can contibute to the patient outcome in such an important way. They know the surgery, the equipment, the surgeons preferences and so on. To me the unseen responsiblilities I have as an RN..... is to know things such as>>>>
    Is my patient a diabetic and what fluids should I expect to be administering? When and how to do blood sugar tests. How to administer insuling.....at what rate IV. How about a code....what drugs to administer and when and how to shock at how many jules....what drugs are in what drawer of the crash cart. What meds are not conpatible and what the patient is allergic to. What is the patients labs so that I may be able to obtain products needed in a timely manner. Is there is multi system failure? How much has been out of the foley and what is the significance of the output. What is the side effects of the drugs I (or anesthesia)administered that I am observing the patient for? What is the patients DNR status and does the family really understand what happens to the status in the OR. Why is anestesia asking me for NS instead of LR and what is hesban used for.....or manitol....or ect. hot lines, level ones, difficult intibation carts, airways. airways ..airways....
    Is this stuff important in the OR too. Yup team work! respect for each others roles!!!!! I would hope we never confuse the roles under the false pretense of the word teamwork. Our roles are specialized....each of of them. We can certainly assist each other in our roles. But hopefully respect eeach others roles in the mean time.
    I certainly believe the person who comes out of school saying they did not learn much that applies to the OR may want to reconcider her role in the OR.
    YOU ARE NOW A PATIENT ADVOCATE AND THE PATIENT IS RELIANT ON YOUR PROFESSIONAL ABILITY TO KEEP THEM SAFE THOUGHOUT THEIR SURGICAL EXPERIENCE. That means medically safe, as well as surgically safe.
    Good luck to all. Enjoyed reading all of these responses....a little controversy can cause alot of growth.
  12. by   stevierae
    Quote from PA-C in Texas
    Well the new graduate RN isn't qualified to first assist either.
    And that's why you don't see new grad RNs in the OR first assisting!! In fact, you RARELY see RNs first assisting unless they are RNFAs! Wherever I have worked, one has to apply for hospital privileges to be able to first assist--simple skill and knowledge is not good enough--and those rules are made by the hospitals.
  13. by   DNRme
    Quote from stevierae
    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.
    Yes, I was using donor blood as my example

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