Should Surgical Technicians Circulate - page 6
Should Surgical Technicians be permitted to circulate in the O.R?... Read More
Jun 5, '04Quote from RNKITTY04First of all, I didn't slam you. Please read the post by cwazycwissyRN. There is soooo much more to being a good OR nurse that just the mechanics of it. I hope in nursing school, one of the things that is being cultivated is "judgement." You look at things very differently when your scope of knowledge is increased. This applies to many things in life.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.
As you said, your exposure to the OR in school was lacking. We all need to remember that we are responsible for "patients" and not for "cases." You need to know about everything going on with your patient and how you can best manage that while the patient is under your care. Everything you are learning about disease processes, meds, teaching, etc. is important to being as I said before, an advocate for the patient during their most vulnerable time.
Finally, I have yet to meet a tech or LPN that became an RN and did not find it to be much more than they thought it was going to be.
Jun 5, '04Ok, I'd like to think I have an open mind and what was posted does make sense to me. I certainly don't think I know it all (very far from it actually)
I did just find out yesterday that I got approved to do my transitions in the OR. I am very excited as this has never happened at my school before, and I have bascially fought tooth and nail for this since last year.
Anyway.... on my way to learning all the things I DON"T know about circulating.
I do have 2 questions though, Do you think they will want me to scrub alot or will they let me concentrate on the circulating part?
Also after I do my 120 hours of transitions and if they like me well enough to offer me a job, how long of a orientation could I expect? (in general)
Thanks for the input.
Jun 5, '04You probably will not be scrubbing at all. You will be learning the didactics of working in the OR. And right now you are in a student capacity for a different role, so you will be expected to learn those skills. You may have been in the OR for a long time but things will now be from a different perspective. If you work at that facility once you finish, you will be expected to go thru the same orientation that all of the nursing staff goes thru. At least that has happened wherever I worked with a tech that was transitioning.
To give you some idea on how long that it takes to train a a nurse for the OR, at last to AORN standards, approximately one year to have them feel comfortable in all areas and able to handle about anything.
You now become the boss. What happens on off-shifts when you are the one in charge?
Last edit by suzanne4 on Jun 5, '04
Jan 12, '05Should they, NO
When surgical tech's become legally responsible for what happens to the patient, not working under the RN's license, then sure..let em circulate.
Jan 12, '05Should OR Tech's be Circulators? My answer is No.
Granted I know many absolutely wonderful techs who are excellent team players and can work circles around some other people, HOWEVER, I must say that when it's ME in the position as a patient under anesthesia and with my body going through surgery I want an RN in there to watch over me. When in my life would I be more vulnerable than when I'm on an operating table??!! As I remember from nursing school, one of the main purposes of the nurse is to be a Patient Advocate and all the things we are taught in school prepare us to be advocates for our patients when they need us and our extensive knowledge and critical thinking skills the most.
I don't want to hurt any feelings around here; just adding my 2 cent answer to the original post question....
Jan 12, '05I would not agree with a surgical tech taking over the position of a circulating nurse. Would it shock me if hospitals started to allow this to save them money....NO....I would not put anything past those who have turned the healthcare field into nothing but profits thats can make upper mng and administators rich.
Jan 14, '05I am a student in a surg tech program. As I have stated in another thread on this site,
I am a little worried about the war between RNs and CSTs. I DO NOT think that CSTs should circulate in the OR if they are working under the RNs license and are NOT qualified to do so. In the same breath..I do not intend on be some RNs "gofer" as stated before. I want to be trained to do the job of a CST, not take over the RNs job. I am not going to stop at just getting certified as a ST and will continue my education. But reading all of the threads has somewhat deflated my excitement of getting into the Medical field. Yes, I will be proud to be a CST. Even if I will be considered "cheaper help", I will be doing something that hopefully , I will love. I would rather pass instruments and watch the procedure being done, than watch machines and do paperwork(not to mention everything else a circulator does). If I did, I would have gone to school to be a nurse. So all of you 10-30 year vets give us newbies a break ..because everyone has to start somewhere. Who knows, may love the OR and want to advance , go back to school. UNTIL then, I intend on doing a CSTs job, not an RNs!Last edit by sharij1 on Jan 14, '05
Jan 14, '05I agree.....A couple of things have shocked me here...For one, I can't believe a Lpn is in a operating room,why??? And I also would like to know why a RN in an OR would not have ACLS?(this was a previous thread)Quote from stevieraeLonman, I will say this again: Patient assessment cannot be delegated to an operating room technician--whether he is certified or not. We are not talking here about doing paperwork, opening laps , adding suture, counting--we are talking about NURSING DIAGNOSIS and NURSING ASSESSMENTS. Nursing responsibilities cannot be delegated. Most nursing responsibilites, if not all, in an operating room setting, are RN responsibilities. Would I feel comfortable delegating insertion of a Foley to an LVN (LPN?) Sure, if she was experienced in the procedure.
Would I feel comfortable delegating nursing assessments and nursing diagnosis to an LVN or LPN ? Probably not--the patients we deal with really are best dealt with by RNs. They have multi-system problems and, worse yet, potential problems.
Anyway, my professional organization, AORN, has standards that state that patient assessment/diagnosis is an RN responsibility. Standards, as opposed to guidelines, are essentially bare bones, written in stone, do not cross this line RULES. You cannot attempt to change those rules that dictate OR policy and procedure to suit your own needs or interpretations. They dictate minimum standard of care. Who are you to challenge what constitutes minimum standard of care for a surgical patient?
LIke it or not, the circulating nurse is in charge of the room. Surprised? Don't believe me? Ask your boss.
Even in an all RN OR, where the scrub AND circulator are both RNs, the circulator is in charge of the room. The circulator is the patient's advocate. The circulator must anticipate, and respond appropriately to, in a timely fashin, when seconds count, anything that could possibly go wrong with that patient. Can you honestly say you have that capability? Didn't think so.
We have a slogan out here, widely televised and on billboards: "Every Surgcial patient Deserves An RN."
It is not media a hype. It is not publicity. It is a FACT, distributed in the interest of safe patient care.
Oh, and excuse me--I can scrub virtually any specialty,proficiently, and have done so for 30 years--as opposed to some techs who can "only do GYN' or "only do ENT" or "can't scrub a crani, or a spine." Bunch of da** prima donnas.
Wherever I have worked, it was required--one cannot take scrub call, especially trauma scrub call, without being able to scrub whatever comes crashing through the doors.
Jan 14, '05For one, I can't believe a Lpn is in a operating room,why???
Jan 14, '05Quote from sharij1I am a student in a surg tech program. As I have stated in another thread on this site,
I am a little worried about the war between RNs and CSTs. I DO NOT think that CSTs should circulate in the OR if they are working under the RNs license and are NOT qualified to do so. In the same breath..I do not intend on be some RNs "gofer" as stated before. I want to be trained to do the job of a CST, not take over the RNs job. I am not going to stop at just getting certified as a ST and will continue my education. But reading all of the threads has somewhat deflated my excitement of getting into the Medical field. Yes, I will be proud to be a CST. Even if I will be considered "cheaper help", I will be doing something that hopefully , I will love. I would rather pass instruments and watch the procedure being done, than watch machines and do paperwork(not to mention everything else a circulator does). If I did, I would have gone to school to be a nurse. So all of you 10-30 year vets give us newbies a break ..because everyone has to start somewhere. Who knows, may love the OR and want to advance , go back to school. UNTIL then, I intend on doing a CSTs job, not an RNs!
OMG... I honestly do not believe i could have said it better myself!!! Preach it on.... Exactly what I would say and what I think! Ill second that one... "as a rule!!"
Jan 15, '05The problem with this whole thread is the one thing that is completely missing. States dictate what each individuals scope of practice is. Everybody would love to "think" what they should or shouldn't do but should be constantly reminded of what reality is. This is why I am glad I work in the state of California and have not only a powerful union, the CNA, but also the the AORN to keep everything in check. There are states out there who don't care about the welfare and safety of patients and will basically give carte blanche to almost any individual with a little or no education. The CNA, on the other hand, protects patient's rights to have an RN as their advocate. Other states will for the sake of a few dollars, allow non-liscensed individuals to give care in certain dangerous conditions. I feel sorry for these patients and also fear for their safety. The ultimate responsibility lies on the shoulders of the RN and no one else. You may feel responsible as a nursing auxillary staff but it is the RN who assigns and directs your assignments so don't feel like you are flying solo. All members of the OR, from housekeeping all the way up to the Director need to know their jobs and what is expected of them. To demean your fellow employee is detrimental to the workings of a well-oiled department. I guess what I am saying is I have people who work "with" me but also know I am in charge and the one who will get called on the carpet if anything goes wrong. It may not be my fault or I might not even know it happened but I am still responsible, the RN not the ST or the Rad Tech or whoever. It's a little bit more than watching monitors or doing paperwork, you ask any veteran OR nurse. MikeLast edit by shodobe on Jan 15, '05
Jan 15, '05Is it me or are the colleges just starting to offer ST program's. My school just started one and I think it is great. Compared to the minimal training that military tech's get, The students at my school are sitting next to us in all the advanced sciences (2 A&P 4 credit course and a 4 cr micro) and have a very intense clinical rotation yes as busy and varied as the RN students. As a new grad and doing first assist I waould rather ine of them than an RN. As for circ yes that is an RN job currently. New better training is going to up their game and I beleive they are headed toward licensure of some sort. Compared to my grandmother who was OJT exclusively and was a high school dropout I think ST's are headed nowhere but up.