Should Surgical Technicians Circulate - page 7

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

  1. by   Marie_LPN, RN
    As for circ yes that is an RN job currently.
    And i sure as heck don't see that changing anytime soon, for very good reasons.
  2. by   Marie_LPN, RN
    To demean your fellow employee is detrimental to the workings of a well-oiled department.
    And this should apply to everyone.
  3. by   stevierae
    Quote from MtnMan
    Is 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.
    I did my OR tech training in the military, during Vietnam. I did it in CA, and the community college in the city in which I did it offered a fair number of units--can't recall how many, but it was substantial--as credit toward an A.A.
  4. by   Fiona59
    When I did my LPN, the military were sending groups of Medics through our college to obtain LPN certification, so they could acquire the OR Technicican education. Some were pretty ticked at having to work LTC, but found that the civilian qualification came in pretty handy in supplementing their incomes at local hospitals.

    Whys shouldn't an LPN who has obtained OR Tech. credentials be in an OR?

    My scope of practice REQUIRES me to be capable of assessing a patient, there is a big difference between assessment and diagnosis (which I believe RN's arent allowed to do either).

    Perhaps part of the problems with healthcare today is the fact that RN's appear to be hostile to others with different training being employed in positions that they have traditionally held. Makes sense to use an OR Tech at $21/hour (with 5+years experience) than an RN (new grad) at $28/hour.
  5. by   Marie_LPN, RN
    Perhaps part of the problems with healthcare today is the fact that RN's appear to be hostile to others with different training being employed in positions that they have traditionally held.

    I really agree with this statement, except for the fact that i don't think the hostility is just from RNs. It can be from anyone (i've learned that here, that's for sure).
  6. by   madmad
    Quote from Lonman
    Actually,for those who felt threatened, the Illinois bill that goes in effect in July is not intended to "replace existing RN's". It is actually the 1st attempt to get more regulation in this field that many of you love to phrase, "unlicensed professionals". Isn't it about time that surgical technologist become licensed?? As you the RN's love to say, don't you wnat the best qualified help??

    As for the main issue on this thread about circulating, in the accredited programs we are taught the role of circulating except the paperwork involved. Surgical Technologist love what they do and could care less about doing paperwork. We believe in the concept of TEAMWORK and that the patient is our number one priority in OUR DOMAIN, the operating room. OUR DOMAIN, refers that we are specialist. We are trained for the operating room setting. Not the Registered Nurse who is a jack of all trades. RN's get OJT when it comes to the operating room. They also get OJT when it comes to the RN's scrubbing procedures, doing what the trained specialist is trained to do.

    The bottom line regarding should we circulate should be this. If there is a need for institutions to utilize CST's then yes, as for the paperwork involved, that what OJT is for..Right? Some hospitals make it work and it works for them just fine. For others, the need may not be there.
    There should be more emphysis on teamwork in the OR then the "in charge" mentality that I routinely see regarding RN's and CST's.

    I can honestly say that after 14 years at my workplace, our CST's and RN's, and SA's all work together and there isn't just 'ONE' in charge. We don't have that mentality. I also don't see that in other hospitals in this area.

    Do I circulate, yes, do I do the paperwork and documentation? No, not when the need is not there. Do I have the skills? Yes, I have learned OJT from the many talented staff that I work with. Sounds familiar doesn't it??

    RN's, a cut above the rest??? Not hardly.
    My husband is a CST, and CFA, and an LVN. He has to tell his new RNs and New Circulators how to and what to ALL THE TIME (thats what working together is all about) isn't it? But when you say CST can't and shouldn't cir. because they have NOTHING TO LOSE, makes me wonder what kind of NURSE you must be to work with. I have been an LVN for over 25 years working ER and ICU, and I spend time TEACHING RNs basic/advanced nursing skills, (how to draw ABGS, start IVs, clear lines, read monitors,etc.), and they inturn TEACH ME THE WHYS and WHAT FORS. So I agree every department has room to LEARN AND WORK TOGETHER, pitch in when needed, learn all you can OTJ and hope you don't run into the RN WALL that tries to keep all others beneath them. Glad to know there are RNs out there that KNOW WHAT THE REAL WORLD IS LIKE, and enjoy working with SKILLED Co-WORKERS (certified, licensed, or REGISTERED)! Just had to speak up, sorry if I offend, my husband is in this fight now with our STATE ASSOCIATION, getting the Scrub Techs Licensed, so they aren't UNDER THE RN, but THE DR. !!!!!!!!!!!!!!!!!!! That way the RN isn't CARRYING the unlicensed.
  7. by   stevierae
    Quote from Fiona59
    My scope of practice REQUIRES me to be capable of assessing a patient, there is a big difference between assessment and diagnosis (which I believe RN's arent allowed to do either).
    As shodobe pointed out earlier, nursing scope of practice varies according to state law.

    In CA, where he and I both practice nursing, LVNs are not allowed to assess patients--period. It is not within their scope of practice. They have their own regulatory body; we have our own--the CA Board of Registered Nursing. LVNs also cannot be used to fulfill the minimum safe staffing ratios mandated by CA law (AB 394.) Those are strictly RN to patient ratios.

    Re: diagnosis--no, RNs do not diagnose MEDICAL conditions. What we DO--every day--is assess, then form a NURSING diagnosis based on those assessments so that we can create an individualized care plan for each and every patient we have--and understand how to intervene and evaluate whether that care plan and those interventions resulted in a positive outcome. If we assessed and planned correctly, and continually modified our care plan and interventions, there is no reason that the outcome should be anything BUT positive. It's a dynamic--constantly changing based on the patient's changing condition--and our continual assessment of the patient's condition, and the formation of NEW nursing diagnoses based on those changes-- and the patient's individual needs.
    Last edit by stevierae on Jan 15, '05
  8. by   madmad
    Quote from CIRQL8
    I don't believe that Techs will replace RN circulators in Illinois.


    Yes, Techs shouls follow and learn the circulating role, as well as RNs should follow and learn the scrub role.

    We are a TEAM.

    And, in short, NO - under no circumstance should a surg tech circulate.
    All patients deserve an RN.

    I will not get into it, because it would be hard to be diplomatic and also would be lengthy, but just for one little thing, what kind of education and understanding do techs have about proper positioning, nerve protection, and ulceration prevention??

    -Dave
    My husband is a CST, and CFA, and an LVN. He has to tell his new RNs and New Circulators how to and what to ALL THE TIME (thats what working together is all about) isn't it? But when you say CST can't and shouldn't cir. because they have NOTHING TO LOSE, makes me wonder what kind of NURSE you must be to work with. I have been an LVN for over 25 years working ER and ICU, and I spend time TEACHING RNs basic/advanced nursing skills, (how to draw ABGS, start IVs, clear lines, read monitors,etc.), and they inturn TEACH ME THE WHYS and WHAT FORS. So I agree every department has room to LEARN AND WORK TOGETHER, pitch in when needed, learn all you can OTJ and hope you don't run into the RN WALL that tries to keep all others beneath them. Glad to know there are RNs out there that KNOW WHAT THE REAL WORLD IS LIKE, and enjoy working with SKILLED Co-WORKERS (certified, licensed, or REGISTERED)! Just had to speak up, sorry if I offend, my husband is in this fight now with our STATE ASSOCIATION, getting the Scrub Techs Licensed, so they aren't UNDER THE RN, but THE DR. !!!!!!!!!!!!!!!!!!! That way the RN isn't CARRYING the unlicensed.
  9. by   Fiona59
    Well, I guess we require a lot out of our LPNs up here in the Great White North. I know that training and scope of practice varies greatly from province to province.

    We are trained to do physical and neurovital assessments, write careplans (reams and reams of them while training), evaluate our outcomes, be knowledgeable enough about our meds to be able to evaluate them and discuss them with the Dr.'s in LTC or the charge in Acute. About the only thing I haven't been able to do (that I was trained to do) is hang IV meds and ng insertions.

    I'll say it again, the healthcare dollar is stretched to the limit and the appropriately trained healthcare worker has to be fully utilized for the taxpayer and the insurer's (never sure how to spell that word) benefit.
  10. by   stevierae
    Quote from madmad
    My husband is a CST, and CFA, and an LVN. He has to tell his new RNs and New Circulators how to and what to ALL THE TIME (thats what working together is all about) isn't it?
    I don't want to start a fight here--I can, and DO, work with anybody, and I am far from territorial--but if your husband is an LVN, then he works in CA. Now, CA has some of the savviest operating room nurse in the nation (hey, just look at shodobe and me, LOL!!)

    All kidding aside, I have always found that those ORTs and even--(what did you call him--a CFA?--I am sorry, but in the operating rooms in which I have worked all over CA, I have never encountered a CFA--everywhere I have worked we have either PAs or RNFAs--) CFAs or ORTs who tell people that they "have to tell the RNs what to do" tend to be legends in their own minds.

    Operating room RNs in CA tend to know their stuff--we HAVE to, as we are required to keep up a fair amount of continuing ed just to maintain CA RN licenses--and, truthfully, most of us were scrubbing and circulating before most ORTs and those who first assist--regardless of the "alphabet soup" surrounding their names--were BORN.
    Last edit by stevierae on Jan 16, '05
  11. by   madmad
    Quote from stevierae
    I don't want to start a fight here--I can, and DO, work with anybody, and I am far from territorial--but if your husband is an LVN, then he works in CA. Now, CA has some of the savviest operating room nurse in the nation (hey, just look at shodobe and me, LOL!!)

    All kidding aside, I have always found that those ORTs and even--(what did you call him--a CFA?--I am sorry, but in the operating rooms in which I have worked all over CA, I have never encountered a CFA--everywhere I have worked we have either PAs or RNFAs--) CFAs tend to be legends in their own minds.

    Operating room RNs in CA tend to know their stuff--we HAVE to, as we are required to keep up a fair amount of continuing ed just to maintain CA RN licenses--and, truthfully, most of us were scrubbing and circulating before most ORTs and those who first assist--regardless of the "alphabet soup" surrounding their names--were BORN.
    ... He is working in Texas. Texas LVN Certified First Asst.)/Certified Scrub Tech. Who is also an Instructor at local College, program to certify scrub techs. He is a lead preceptor at the OR where he still works PRN CALL for heart room. He is ACLS and CPR Instructor. I think I could trust ANY SURGICAL PT under his care, as circulator, scrub or first asst. He isn't an RN, and that still ruffles some of the "OLD HENS FEATHERS". I don't think he is an EXCEPTION either! I know most of the RNs, LVNs, CSTs,STs and Surgeons he works with ... they all work like EDUCATED PROFESSIONALS TOGETHER, and an LVN in Texas(ER,L&D,ICU,MED/SURG) can S.O.A.P. a patient without and RN in the bldg. as long as we have a Doctor to cover us. We too have to "know our stuff" and that includesEVERYTHING ABOUT OUR PT AND THEIR TOTAL HEALTH. Our responsabilty, NOT some other LVN or RN !! Is is that much different in other States? Or is it JUST RNs in the Operating Room??? Just asking an honest question? Hope i word this better than i did the last. I think better than i type. LOL :O)
    Last edit by madmad on Jan 16, '05
  12. by   shodobe
    The last time I looked, CFAs were not recognized in the state of California and probably won't be in the near future. I don't know about Texas but in California your hubby would be working under me as a CST and nothing more. I have only encountered one so-called FA and I wasn't sure what his job was and when I questioned this I was told, " that's the way it has been for a long time"! I really don't think what he was doing was legal, but hey what do I know! I think it is great he has all of these creds but still he works under the direction of an RN, at least in California. This debate will rage on and on for ages and there is no real answer to it. To each their own, but you still have to have order to any situation or anarchy reigns supreme! There are bosses and there are worker bees, I am a bee under my director and the CNAs and STs and others on my shift are the worker bees for me. It works out real well because when the s**t hits the fan I am it, the responsible person. Each state has their own "scope of practice" as they see fit and I personally would like to see it the same across the land. There would be no more squabbling over who's best at what and who has the better qualifications or education to do whatever. If the "scope of practice" was standardized throughout the nation there would really be nothing to argue about, but unfortunately there are too many states living in the past and this would be too much trouble. Got to go for now, just finished my 16 hours of call and I really need some sleep. Mike
    ps, I have been scrubbing for over 28 years and do come from a time when STs didn't even exist outside the military, so I do have a very strong opinion of their existence. I work at a facility where we are an AL RN staff, no techs( lucky us ).
  13. by   stevierae
    Quote from madmad
    ... He is working in Texas. Texas LVN Certified First Asst.)/Certified Scrub Tech. Who is also an Instructor at local College, program to certify scrub techs. He is a lead preceptor at the OR where he still works PRN CALL for heart room. He is ACLS and CPR Instructor.
    Well, he certainly sounds like he knows his stuff--and is, indeed, exceptional. As I've said in previous threads, I have worked with some outstanding OR techs, and I continue to learn new stuff from the young ones all the time--they often have clever ways of setting up their back tables that immediately make me think, when I see them, "Hey! That's the way I'm doing it from now on!" They tend to be whiz kids around spinal instrumentation and total joint systems, too--they are very mechanical.

    That's pretty cool that your husband teaches surgical technology, BLS and ACLS. Obviously he is a smart guy, and they--both the hospital where he works, and the college-- are lucky to have him.

    Did he by chance get any of his training in the military?

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