Should Surgical Technicians Circulate - page 8

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

  1. by   shodobe
    I am back after a good nights sleep. I agree with stevierae that certain programs are lucky to have people like your hubby. I guess what I was really getting at was I have worked with some very good, competent Techs, at another facility, and I have learned a few things from them. I only get to scrub about half the time so I like to see how others do their cases. We can all learn from each other and shouldn't put ourselves above another. There are rules set out to guide and unfortunately some try to circumvent these by setting their own. States are probably the worst ones because they allow stuff to happen without monitoring them. I am not new to this game and still like to reflect back to the "good old days" when only RNs worked in the OR, but that isn't the case anymore. The situation has changed dramatically over the past 10-20 years especially with the severe nursing shortage where hospitals need to come up with alternatives. The Scrub Tech role has been a god-send to the OR because of the new training that has been initiated over the past few years. Techs are not just taught, "this is a kelly", DUH! Their programs are more intense and longer now. I do see one day where states will licsense(?) and not just give certs to these programs. I am getting towards my twilight years, not for at least 15 years, and realize change is in the air, why fight or worry about it. I will stay in the OR for many years to come and do realize that my role will be one of directing and leadership. I think most OR RNs will have to realize that and stop fighting the changes that are coming. I still hear grumblings from RNs about Techs scrubbing certain cases but they have to realize that staffing constraints only allow them to scrub and nothing else, so what to you do with them? I myself sometimes gets irked when I read or hear someone expounding on how great they are or they can do this or that and can't understand all of these rules. That's the problem, not understanding their role in the scheme of things. I'll stop now, just rambling but I think you get what I am trying to say.I have another 24 hours of call to get through, wish me luck! Hi, stevierae. Mike
  2. by   stevierae
    Quote from shodobe
    I have another 24 hours of call to get through, wish me luck! Hi, stevierae. Mike
    Hi, Mike--I'm tellin' ya, this call stuff is going to kill you one of these days. Let the young folks take the call while you do fun stuff like play with your dogs and take your wife cool places.
  3. by   shodobe
    Today isn't so bad, so far! I have a case scheduled later today for an exlap. Patient ate so we can't do it for awhile. Being so far away from home I really don't have anything else to do but take call. I think this will be my last year down here and I will start to look closer towards home. Eight years is a long time. The call isn't as bad as it looks because we do a majority of cases during the day and hardly ever come out after 11pm. It does seem to me that the weekends I am on we do alot and the other weekends they do very little. I guess I am just a magnet for punishment. Take care, talk to you later. Mike
  4. by   clare lewis
    Quote from carcha
    Wow, you lot, I bet none of u have worked in a theatre in the UK. I can only imagine your reaction. I have worked in places where health care aides, with less then a few week experience have been circulating for me. Do I agree with it, heck no but it happens and more then you would believe. However looking at both sides of the coin, I do not think it would be fair on the tech as their role limits them to basic duties and as circulator you have to have access to all domains of the room. And as you say all patients have the right to a qualified nurse managing their care. Im laughing here trying to imagine you lot in an english theatre,.
    I'm too laughing with carcha on this one. Things are done a lot different here in England. Our Rn's and ODP's are usually scrubbed and the role of circulating assistant is often that of a non-registered nurse (HCA). However, most of our HCA's have many years experience and are very compitant at this role. Many of you may disagree with this, but I would much rather reley on an experienced HCA or ODP than a newly qualified RN any day. Three years training does not make you an expert at something, but continual training, development and experience can, even if your not registered.
  5. by   solarflare
    No.
  6. by   subee
    Quote from shodobe
    Absolutely NOT!!! Not even qualified. I did have a very long answer to this, but decided my answer would be taken wrong by a few out there. So, instead a very short NO. Mike
    Please allow me to disagree. I've been a CRNA for 25 years and believe that RN's in the OR are generally a waste of taxpayers money. Why do people work in the OR? No one comes TO the OR. They're running AWAY from the floor. People come to here from the floor and they have no idea what they're in for because no one does an OR rotation in school anymore (because its not nursing!). When I did my neuro rotation at Columbia (very long, very complicated procedures)all scrubs were techs and they were sharp. I've told my anesthesia pals that if I have a bad accident on the way home, please make sure that I have an army tech in the room. What nursing diagnosis could you possible make about a patient in the OR that only a nurse could do? "Help relieve apprehension." "The OR is a cold environment. Keep the patient warm." Are these the higher order decisions of nursing? I think not. I think that we need a compromise - the Operating Room Nurse. They would have two year associate degree training. The first year would be spent learning the scrub role along with freshman prerequisites and the science courses that the RN students take. The second year would be honing your scrub skills and learning to circulate. The internship would take place where the student would like to be employed. When the student graduates on Fri., that person can come to work on Monday and be familiar with that hospital's OR and be ready to take call. I've seen a depressing number of RN's come down here for orientation only to get pregnant or "move" (now that we've spend the time and money orienting them). I see nurses spending precious little time with the patients. They're doing paper work, trouble shooting VCR's and gophering. The circulator is a very expensive gopher. When a lawsuit comes out of patient positioning, it is anesthesia that gets sued, rarely the nurse. I've worked with very few OR nurses that didn't embarress the profession as a whole. Didn't even know that there were hospitals that used techs who weren't certified. That's a liability. A lot of the RN's like to scrub but why should the hospital pay the RN's salary to do a tech's job? Of course, I understand that small rural hospitals are different and the OR nurse might have to work PACU which is a different can of worms. The AORN is one big closed union that's making itself obselete since they are so resistent to using another license to circulate. The OR nurses are getting pretty old. Who do they think is going to keep the OR's running in the future when the pool of nurses is even smaller to recruit from?
  7. by   madmad
    I TOTALLY ARGREE with the last post!!!
  8. by   solarflare
    Quote from madmad
    I TOTALLY ARGREE with the last post!!!
    Yeah, me too. Why can't we all be gophers? Then the fight would be: "I'm a registered gopher" or, "I'm a certified surgical gopher" or, "I'm a licensed vocational gopher", or, "I'm a medical gopher", etc.,etc.,etc. Whatever we, (the O.R. team), are called, the patient is really the one we "gopher" for. So why don't we get things really heated up and talk about the different payscales for the "gophers"?

    Greg, Registered gopher, 3-11
  9. by   CrunchRN
    I wish you only the best, but after reading your posts in several different threads I really have to wonder why you seem to despise associate degree nurses especially, but all nurses to some degree. I see that you are a nurse with advanced education, but how can you be so out of touch. I understand that a minority of nurses and humans are idiots, but I feel such antipathy and scorn for nurses when I read your posts. Do you mean to be communicating these types of feelings, are you even aware of how your posts read to nurses in the trenches?

    You had one post in the Nursing Shortage thread (I think) that literally was the worse writings I have ever read by one nurse about other nurses.

    No flaming, just generally interested to try to understand where you are coming from.
  10. by   subee
    Quote from carcha
    Well, well, well Subee, how delightful to have such an unbiased post on this thread. So I guess somewhere in that totally , how do I put it?, oh yeah, STUPID, rant you forgot to state how the same principal applies to CRNA'S. I guess you too can be replaced by a 2 year associate degree trainee who has never done a days training other then the OR in his or her life?. Actually here in London your job Subee is performed by the most junior doctor and very few hospitals here would pay an RN to hold retractors ect. It is embarrassing for me to know that every day you work in the OR and every day you fail to see the work we do. Or do you simply take delight in putting us down. I have worked in the OR for many years both in the states and europe . I am a perioperative nurse which means I am aware of each aspect of my patients journey throughout the OR. I am also a midwife so in the event of pregnant women coming to the OR my training and experience provides a safe journey for both of those patients. I assess my list, according to the cases, personnel, type of patient and instrumentation available. I consult with the surgical team including the units, blood bank, surgeon and anaesthetist. I continually monitor my patient's progress throughout the case, as well as mentoring students and teaching and assessing new grads. I feel that your lack of knowledge stems from the fact that you now work in an environment where your autonomy is limited by your boss who calls the shots. My boss is the patient whose best interests are my sole concern. And that my friend is why all ORS should have RN's .
    Well, Carcha, you and your other UK colleague are sort of proving my point when you point out that RN's do not scrub in your OR's. Don't be so sensitive. I"ve already listed the qualities that the person who works in the OR should have and I don't remember stupid or subservient being any of them. I'm only saying that we have no new OR nurses coming down the line. The average age of the OR nurse in the states is 48 and the source of new OR nurses is becoming increasingly smaller. Very few hospitals in the states have OR training programs because they can't afford that education position in the OR. Is is so awful that the associate degree educated person should not assume this job (for all you folks who think I'm putting down associate degrees)? Is it so much for the hospital to ask to have a new employee who can come to work and not go through six or eight months of training before taking call? All of your work is necessary and you seem like the kind of person I'd love to have working with me. I'm just saying you don't have to be an RN - you could be something else. By the say, CRNA's in the states do not have to be supervised by an anesthesiologist so I'm certainly not ranting out of any feelings of powerless. I do not dislike nurses - we are the hardest working, kindest people I know. No, I do not think an assoc, degree would be
    appropriate for CRNA. I meant for my question to be provocative and get folks to think outside the box.
  11. by   Marie_LPN, RN
    the source of new OR nurses is becoming increasingly smaller.
    I could see why lol. And i wouldn't say it's all because of long work hours, ******** sugeons, or techs.
  12. by   Nurse Ratched
    Closed for cooling off/clean up.

close