I started out looking for first assistant info and ran across this info, the part I questioned I put in bold. I always thought circulators had to be RN's or does the RN requirement only come into play with medicare/medicade reimbursement? if so, I would imagine it would be hard for a hospital to run if it excluded these groups. any ideas or opinions? I have nothing against surgical techs, just wanted to make that clear.
http://www.ast.org the following info is taken from the ast website. type in first assistant in their search box & this & other info shows up.
who are surgical technologists?
surgical technologists (formerly called operating room technicians) perform many different responsibilities in the operating room. they act as the scrub person, as the circulator,
and as the first assistant on the surgical team. surgical technologists' responsibilities involve preparing the operating room and instruments, equipment, and supplies that will be needed; positioning and preparing the patient for surgery; and passing instruments, sponges, and sutures to the surgeon. surgical technologists are the surgical team's expert in aseptic technique, being constantly vigilant for any break in the technique that could endanger
the sterile field so necessary to the successful outcome of the operation. those not familiar with the profession may assume surgical technologists are nurses or nursing assistants, which they are not. surgical technologists belong to a separate non-nursing profession of highly skilled, credentialed allied health professionals that possesses specialized education and training to work specifically in the operating room.
how can you support your constituents who are surgical technologists?
carefully scrutinize any purposed regulations that could restrict the use of surgical technologists.
there have been efforts made by nursing groups in many states to regulate the role of surgical technologists and restrict their full utilization, particularly in the first assistant and circulating roles. because hospital accreditation standards do not require an RN to circulate, nursing groups are attempting in some states to make this a legal or regulatory requirement at the state level. these effort will lead to hospitals having no choice in the provider they employ and could cost csts their jobs. if nursing groups are successful in their efforts to restrict this profession, it could result in your constituents who
Ask the same doc if he would rather have the nurse if she also had just as much experience scrubbing. Its not the scrub tech vs nurse thing, its a who knows how to scrub vs who doesnt.
Why would you ask a doc that in the first place. In the OR is not the time or place for this even at the scrub sink its still a no no. People will get upset if the answer isnt both. Thats how feelings get hurt and trouble starts in the OR. People want to talk smack here is one thing or after work with a margarita.
Let's just face it here, Surgical tech are the only person besides the surgeon in the room that has had formal training. The only person in the room that is considered OJT is the nurse. Nursing schools need to focus more on offering this course as a part of the program. Please do not say she has some nerves, be honest surgical techs have been educated just for this job. Surgery is a techinal field. I love nurses and yes they are needed in the operating room, yes they have an higher education so far as patient care is consider, and yes patient care is important in the Operating room, but you have two indiviual who with 12+ years education regarding that( surgeon+anthesia etc.). Please let's stop this Nurse vs. Tech. Because when it all boils down to it, the doctor really do not care who is in the room with him/her, just along as the case is ready when their ready and the person is capable of doing their job. He would not care if casper the ghost brought the patient in the room and woody woodpecker set the case up!!!! Nurses are great ,so are CST!!! we are a team.
As an OR nurse I have some observations. I'm not an ST or CST nor am I OJT. I was trained in school along with clinicals in patient focused care, which is what I provide in the OR. True, I had to learn specifics to the OR environment once there and would have had to do the same environment specific care in any area of nursing I chose to practice. The ST/CST was trained in specific instrumentation, sterile field/technique, procedure, etc. all of which are specific to the OR environment and truly not adaptable to another environment. The training is technique oriented for the most part. Which one is more important? You can't have one and not the other, the patient and surgical team require both. I would give my eye teeth for some of my techs, they are invaluable. The ones I wouldn't are those who have made it a point to tell me that in their mind the circulator is nothing more than a glorified typist and has no place in the OR, that there is nothing the circulator does that a tech can't do. Yet one of these same techs when I was concerned over a patient's low Na value stated she had no idea what that meant, I was talking Greek and furthermore, she didn't really care.
I make a point of thanking my techs personally, letting them know how much I value their expertise and input as well as how valuable they are to the team. The techs who have the above mentioned attitudes about circulators take that as 'acknowledgement of their superiority' in the OR setting and the lack of a need for a circulator. The techs who I find invaluable accept it with gratitude, acknowledge that we each contribute greatly to the patient's care and are both invaluable. The respect is mutual. I know they have knowledge of and can do things I have very little skill and likewise, they acknowledge I have knowledge and skills they lack. It isn't a competition. Furthermore, I am sure to let them know I appreciate their professionalism and teamwork. Those who are truly team members will go out of their way to help one another, tech or nurse.
As an OR nurse I have some observations. I'm not an ST or CST nor am I OJT. I was formally trained in school along with clinicals in patient focused care, which is what I provide in the OR. True, I had to learn specifics to the OR environment once there and would have had to do the same environment specific care in any area of nursing I chose to practice. The ST/CST was trained in specific instrumentation, sterile field/technique, procedure, etc. all of which are specific to the OR environment and truly not adaptable to another environment. The training is technique oriented for the most part. Which one is more important? You can't have one and not the other, the patient and surgical team require both. I would give my eye teeth for some of my techs, they are invaluable. The ones I wouldn't are those who have made it a point to tell me that in their mind the circulator is nothing more than a glorified typist and has no place in the OR, that there is nothing the circulator does that a tech can't do. Yet one of these same techs when I was concerned over a patient's low Na value stated she had no idea what that meant, I was talking Greek and furthermore, she didn't really care.
I make a point of thanking my techs personally, letting them know how much I value their expertise and input as well as how valuable they are to the team. The techs who have the above mentioned attitudes about circulators take that as 'acknowledgement of their superiority' in the OR setting and the lack of a need for a circulator. The techs who I find invaluable accept it with gratitude, acknowledge that we each contribute greatly to the patient's care and are both invaluable. The respect is mutual. I know they have knowledge of and can do things I have very little skill and likewise, they acknowledge I have knowledge and skills they lack. It isn't a competition. Furthermore, I am sure to let them know I appreciate their professionalism and teamwork. Those who are truly team members will go out of their way to help one another, tech or nurse.
That it surely is. But you can't come into a nursing forum and try to tell nurses their job is easily replaced or that their job can be done by anyone. Anytime someone goes to school or training to become something, and then you tell them they can be easily replaced by someone else, you're guaranteed to get into a highly intense discussion.
As an OR nurse I have some observations. I'm not an ST or CST nor am I OJT. I was formally trained in school along with clinicals in patient focused care, which is what I provide in the OR. True, I had to learn specifics to the OR environment once there and would have had to do the same environment specific care in any area of nursing I chose to practice. The ST/CST was trained in specific instrumentation, sterile field/technique, procedure, etc. all of which are specific to the OR environment and truly not adaptable to another environment. The training is technique oriented for the most part. Which one is more important? You can't have one and not the other, the patient and surgical team require both. I would give my eye teeth for some of my techs, they are invaluable. The ones I wouldn't are those who have made it a point to tell me that in their mind the circulator is nothing more than a glorified typist and has no place in the OR, that there is nothing the circulator does that a tech can't do. Yet one of these same techs when I was concerned over a patient's low Na value stated she had no idea what that meant, I was talking Greek and furthermore, she didn't really care.
I make a point of thanking my techs personally, letting them know how much I value their expertise and input as well as how valuable they are to the team. The techs who have the above mentioned attitudes about circulators take that as 'acknowledgement of their superiority' in the OR setting and the lack of a need for a circulator. The techs who I find invaluable accept it with gratitude, acknowledge that we each contribute greatly to the patient's care and are both invaluable. The respect is mutual. I know they have knowledge of and can do things I have very little skill and likewise, they acknowledge I have knowledge and skills they lack. It isn't a competition. Furthermore, I am sure to let them know I appreciate their professionalism and teamwork. Those who are truly team members will go out of their way to help one another, tech or nurse.
Thank you so much. I agree with you. I never played the nurse vs. tech game, until now. I got caught up in this mess. This is not me. See you are the kind of nurse I use to work with everyday and enjoyed every minute of it. You are not caught up in a title. I so agree with you, we are a team, techs and nurses are both needed. Please lets STOP This. Yeah some techs think their the most important person in the room and their are some nurses who think their the most important person. We are not ,the patient is!! LET'S JUST GET ALONG!!!
That it surely is. But you can't come into a nursing forum and try to tell nurses their job is easily replaced or that their job can be done by anyone. Anytime someone goes to school or training to become something, and then you tell them they can be easily replaced by someone else, you're guaranteed to get into a highly intense discussion.
No doubt!!:trout:
That's exactly why I detest working with a couple of our techs. Recently these same two folks spend half the case as well as breaks and lunches carping about the pay difference between nurses and techs, telling us how it's so unfair that we make more yada yada. Hello, I could've gone to school to be a CST (might have liked it more just because I like being in the blood and gore grits of things) or I could've chosen to persue any number of careers that pay much more than what I get now and require little to no schooling but I know I'd hate it. The fact of the matter is I chose nursing because it still gets me in the door to patient care, faster than med school-which was my true first desire, has better pay than a CST and still is something I love. I guess I could complain how make so much more than me and how it's unfair since I went to school and all but sheesh. I'm sorry, ok not really sorry, that they chose ST school instead of RN and now are paid less than I am. The pay difference has been what it is for much longer than they've been a tech so give it a rest, guess you should've chosen differently or at least be able to live with the choice.
Sorry, that was a rant that is not completely on topic. It is just another example of why I find it difficult to work with those couple of folks. It's gotten to the point where I'm having to get up and leave the break room or walk away from where ever else one of these folks are at just to get away from the caustic cloud perpetuated.
Well, I am new to the OR, so, as you may well know, the techs are invaluable to me. They simply know more than me right now. And I value them.However, if I were to scrub every day, I would become just as good as them....On the other hand, there are some of them who think the nurses are idiots, and they are the ones who really do any work, etc etc etc. There are also housekeepers who think that they work the hardest. I guess the point I am trying to make is, could the role of circulator be done by anybody with training? I must say, maybe so. Will it happen? I say absolutely not.... if for no other reason then to have someone with a LICENSE to take the heat if something goes bad. The OR was my choice, mainly, because I have no interest in "traditional" pt care, I like the technology and I like to be precise with things (counts, sterility etc). Techs are good at what they do, because they do it day in and day out. If a nurse (circulator) only scrubbed, she would be just as proficient. And I know quite a few who can do BOTH. The OR is a big world. The only really important person in the room, is the surgeon. The rest of us are just employees!!!!! Get over yourselves........Every patient deserves a RN. It doesnt even sound right.... to have a patient undergo SURGERY, without a nurse assigned to their care? It will never happen. Never.
That's exactly why I detest working with a couple of our techs. Recently these same two folks spend half the case as well as breaks and lunches carping about the pay difference between nurses and techs, telling us how it's so unfair that we make more yada yada. Hello, I could've gone to school to be a CST (might have liked it more just because I like being in the blood and gore grits of things) or I could've chosen to persue any number of careers that pay much more than what I get now and require little to no schooling but I know I'd hate it. The fact of the matter is I chose nursing because it still gets me in the door to patient care, faster than med school-which was my true first desire, has better pay than a CST and still is something I love. I guess I could complain how make so much more than me and how it's unfair since I went to school and all but sheesh. I'm sorry, ok not really sorry, that they chose ST school instead of RN and now are paid less than I am. The pay difference has been what it is for much longer than they've been a tech so give it a rest, guess you should've chosen differently or at least be able to live with the choice.
Sorry, that was a rant that is not completely on topic. It is just another example of why I find it difficult to work with those couple of folks. It's gotten to the point where I'm having to get up and leave the break room or walk away from where ever else one of these folks are at just to get away from the caustic cloud perpetuated.
Right!!! I always say, its a free country, you can go to school to be a nurse just like the rest of us.... just like I could have gone to school to be a md, crna,lawyer,
heck, some days I admire the shuttle bus drivers job!!!! But, I chose what I chose.
Again, I chose what I chose. An orchestra does not perfrom based only on the soloist(the surgeon), but rather on the team as a whole. I am a CST. I am only as good as the team I scrub with, including my circulator and anesthesia if things go poorly, but I am also the one (among many) that can make things go well. I can appreciate variances in a CBC, and know what it means for me, as well as my circ, surgeon, and PATIENT. We are not out for each others jobs, and for the most part respect what each member of the team bring to the procedure. If we do not cooperate with each other, and what we can provide to our patient, the result is chaos.
Sigh. Same ol', same ol.' This is deja vu all over again--it's just like the old "Who's better---A.A. RNs or BSN RNs." It never stops.
This discussion has been had ad nauseum on this BB, if anyone cares to do a search. (Or just ask shodobe or me.)
We are O.R. nurses who scrub AND circulate, and always have. We trained that way, and we expect other RNs to take the time and trouble to learn to scrub--all one needs to do is ASK to backscrub someone a few times, or take call--that's one way to get thrown into situations where you learn to be very proficient in a variety of scrub (and circulating) situations very fast.
One way to stagnate is to refuse to learn to scrub--or to confine yourself to only one specialty area--refusing to do trauma, ortho, or neuro; instead sticking with eyes or plastics--you know, the easy, predictable, non-challenging stuff.
Don't be so sure that OR RNs have very little training as scrubs. I learned to scrub as a Navy corpsman, in Navy O.R. tech school, during the Vietnam era.
When I got out and went to nursing school, and went back to the O.R., ALL the RNs with whom I worked scrubbed--and very proficiently.
By the way--what IS the difference between an ORT and an ST? I was not aware there was one. In the '70s and '80s, techs were called OR techs---even though many of them took a national certification exam.
Then, in the '90s, the terms ST and CST suddenly appeared.
What's the difference? I do realize that the "C" stands for "certified," and that STs who have the "C" prefix have taken a national certification exam." But, to me, the name change--from "operating room technician" to "surgical technologist" makes about as much sense as the name change from "housekeeper" to "environmental engineer--" people doing the same job, but with a fancy new title. What's the point? I don't care about calling myself an "operating room nurse" or even a "perioperative Registered Nurse." I usually introduce myself to patients, families and new staff simply as "the nurse in the room." (And when I was in Navy O.R. tech school, and graduated, I referred to myself as a "tech" or "scrub tech" or "O.R. tech--" as did the more experienced techs, even those who HAD taken the national certification exam.)
I think if one is confident in his or her skills and knowledge base, one does not have to insist on being recognized by a long, alphabet soup of titles after one's name.
One thing I will comment on---more and more, I am wondering what people are being taught in "CST" programs--because, more and more, I see this pattern---scrubs putting damned near their entire back tables up on their Mayo stands, rather than working from the minimum needed at any given time, and putting things in water in their soak pans once they are no longer needed.
What's up with that? I swear, I've started (and finished) big bowel resections and colostomy takedowns, Whipples, liver and kidney transplants, AAAs, etc. with scrubs who put an entire stringer of vascular clamps--plus every size of loaded hemoclip applier--plus long instruments--plus long ties loaded on deep passers---up on their Mayo at the beginning of the case--- an hour or more before they will be needed!
3, 4 or 5 hours into the case--or, even when we are getting ready to close----said vascular clamps, Hemoclip appliers, long instruments, long ties, etc. are STILL up on their Mayos (but by now coated with dried blood--could have been avoided by putting them in water to soak hours before.)
One last thing: For those OR techs---forgive me, STs, CSTs, whatever--who'd like more autonomy--I suggest you go back to school--either to become (first) RNs, then RNFAs or PAs--particularly if you want to first assist.
Like it or not, you are working under the state licensure of your RN circulator--YOU ARE NOT LICENSED---even if you are certified. He (or she) is in charge of the room--and he (or she) is the designated patient advocate---by virtue of the ANA and the corresponding state's Nurse Practice Act.
By becoming a CST and taking the examination a person proves that they have attended a CAHEEP or ABHES accredited program. Attending a program with this type of accreditation helps to assure that students are taught using a 'standardized" curriculum. The curriculum is based on the Core Curriculum for Surgical Technology, 5th ed.The Core is published by AST. AORN and ASA had a great deal of input.
Many at AST support a move to require licensure of surgical technologist. As it stands now, if a tech messes up, they often are just fired and move on to another job. It DOES not mean that the licensed tech ignores the important role of the RN as cheif patient advocate or places themselves 'above' the nurse.
IMHO, bad techs, needed to be taken OUT of the show Permanently. Pulling a required license assures that.
As a Certified Surgical Tech I have NEVER disrespected any nurse (RN or LVN). We are a team. I know for a fact that my professional success depends on the RN in that room.
I also don't care what folks call me. ORT, cool. ST, Fine. CST, okay too. Just plan 'ole tech, is hunky dorey. To be honest I prefer folks just call me by name. I don't like alphabet soup. I much prefer Chicken noodle.
Nurses are great ,so are CST!!! we are a team.
CSTCFA
16 Posts
Why would you ask a doc that in the first place. In the OR is not the time or place for this even at the scrub sink its still a no no. People will get upset if the answer isnt both. Thats how feelings get hurt and trouble starts in the OR. People want to talk smack here is one thing or after work with a margarita.