Do most OR's use scrub tech's?

[galenanurse]

Hello everyone,

I was wondering if your OR uses scrub tech's, or RN'S scrub and circulate? I just had a phone interview with a large hospital in Chicago, and they said their OR RN's scrub 50% and circulate the other 50%. They say you do one half the day, and switch for the other half of the day so their nurses are always scrubbing and circulating. Are there any nurses out there working this kind of schedule in the OR? Do you also have scrub tech's or only RN's?

Thanks

Jen

[Scrubby]

it's too late. your jobs have all ready been taken over by non nursing staff. your career in the management and delegation of these trained professionals has, however, advanced. have you considered how much of a floor nurses job is done by ancillary staff like phlebotomists, pct's, pt's, rt's, environmental services, ect, ect, ect. i'm sure some nurse way back when probably said, "the last thing i want to see happen to my country is see some non nursing trained staff member drawl blood on my patients." now, i am confident that they are happy to see they staff because they are so over loaded.

hmmm i don't think you really know much about nursing in australia do you? i've never met a surg tech in my life, we don't have them in most hospitals in my state. in the eastern states of australia they are few and far between. we have rn's at my hospital (called jelco nurses) who put in iv,s same in other hospitals. i never even heard of a phlebotomist until i came to allnurses.

rn's are still being trained to scrub, but they have to want it and seek that training like any person who has a career goal. they don't just give it to you because you have a rn on your badge. if there were more interest in the field of nursing and nurses in general did not have a history of eating their young there would not be as much of a need for unlicensed personnel as there is in today's climate. i have yet to meet a nurse, who excelled in his/her position as a circulator, that has not had the opportunity to learn to scrub. rn's are not trained in school to fully understand even the basics of working in the operating room, that is why it is so important to seek out a quality surgical internship. one with surgical scrubbing included if possible. personally, i think it is incredibly important for a nurse to be competent and able to perform the scrub role. the rn is the patients' primary advocate, a role that is hard to fill if he/she does not know what is going on.

i agree that every nurse in the or should be able to scrub not just circulate. if the scrub (whether it was a nurse or tech) was to pass out or be severly injured then someone has to be able to step in and take over straight away for patient safety. i have just read comments by rn's here on allnurses that they aren't even trained to scrub anymore. i feel that this is a shame, as traditionally nurses have done both roles.

and as for your comments about rn's not being trained in or nursing while at university well your 100% wrong there. i don't know how rn's are trained in the us, whether they have the option to do a specialty course. i undertook a perioperative specialisation which taught me the basics of working in the or and was given the opportunity to scrub, circulate and the anaesthetic nurses role while being a student nurse. i am currently studying for my graduate diploma in perioperative nursing.

perhaps the comment 'the last thing i want to see in this country' wasn't 100% thought out. i will rephrase this and say that it is the last thing i want to see happen to perioperative nursing in this country.

[shodobe]

I agree with scrubby that RNs in the OR should look out for their jobs and protect it from non-licensed personnel. I have been around a very long time and plan on staying around for a few more years. I started out when RNs were the only ones allowed to work in the OR. We didn't get our first Tech until about 6-7 years ago. I do have a strong opinion on whether Techs should even be in the OR and make no apologies about it. Face it, the only reason Techs are even in the OR is for financial reason, cheap labor. I am lucky in the fact that we have an all RN staff, except for one token Tech, and each and everyone of us scrub and circ. Very rare in today's modern OR. Patient's deserve the best care they can get and an RN is the best choice. There is really no difference between what a CST can do or a FA or whatever. The only thing I don't do is suture, big deal! Up to around 15 years ago all of us did suture things like drains and such. Not much of a skill level needed. To wrap things up, Techs are really not needed in ORs and wouldn't be missed. RNs are needed by law in all states for patient care and I am glad I work in a state that doesn't allow sloppy nursing rules. We have openings for staff but won't fill them until an RN applies for it. The Tech we have was out of desperation for a warm body. I like her very much and she is fairly good at what she does, but we all would have rather had an RN, much more versatile. Staffing with an all RN is much easier. Also, not sure what you meant by "double doors"? Enlighten us, please.

[falika35]

Of course RN's will act superior to ST's because THEY ARE SUPERIOR!!!! It is because of ST's like you that we as RN's have to demonstrate our superiority. While a RN who is able to circulate can be taught how to scrub and do both, a ST will never be able to legally perform the role of a circulator in most, if not all , states. Just my :twocents.

[BrianLee]

it's too late. your jobs have all ready been taken over by non nursing staff. your career in the management and delegation of these trained professionals has, however, advanced. have you considered how much of a floor nurses job is done by ancillary staff like phlebotomists, pct's, pt's, rt's, environmental services, ect, ect, ect. i'm sure some nurse way back when probably said, "the last thing i want to see happen to my country is see some non nursing trained staff member drawl blood on my patients." now, i am confident that they are happy to see they staff because they are so over loaded.

hmmm i don't think you really know much about nursing in australia do you? i've never met a surg tech in my life, we don't have them in most hospitals in my state. in the eastern states of australia they are few and far between. we have rn's at my hospital (called jelco nurses) who put in iv,s same in other hospitals. i never even heard of a phlebotomist until i came to allnurses.

rn's are still being trained to scrub, but they have to want it and seek that training like any person who has a career goal. they don't just give it to you because you have a rn on your badge. if there were more interest in the field of nursing and nurses in general did not have a history of eating their young there would not be as much of a need for unlicensed personnel as there is in today's climate. i have yet to meet a nurse, who excelled in his/her position as a circulator, that has not had the opportunity to learn to scrub. rn's are not trained in school to fully understand even the basics of working in the operating room, that is why it is so important to seek out a quality surgical internship. one with surgical scrubbing included if possible. personally, i think it is incredibly important for a nurse to be competent and able to perform the scrub role. the rn is the patients' primary advocate, a role that is hard to fill if he/she does not know what is going on.

i agree that every nurse in the or should be able to scrub not just circulate. if the scrub (whether it was a nurse or tech) was to pass out or be severly injured then someone has to be able to step in and take over straight away for patient safety. i have just read comments by rn's here on allnurses that they aren't even trained to scrub anymore. i feel that this is a shame, as traditionally nurses have done both roles.

and as for your comments about rn's not being trained in or nursing while at university well your 100% wrong there. i don't know how rn's are trained in the us, whether they have the option to do a specialty course. i undertook a perioperative specialisation which taught me the basics of working in the or and was given the opportunity to scrub, circulate and the anaesthetic nurses role while being a student nurse. i am currently studying for my graduate diploma in perioperative nursing.

perhaps the comment 'the last thing i want to see in this country' wasn't 100% thought out. i will rephrase this and say that it is the last thing i want to see happen to perioperative nursing in this country.

scrubby,

i was, of course basing my responses based upon the nursing profession in the united states of america, not australia. i never professed to know how healthcare in a country on the opposite side of the world functions. each country obviously has very different situations and solutions to those situations. btw, in the usa we have iv team nurses (jelco nurses) too. a phlebotomist, is as i stated, is a allied health professional that draws blood for lab work. everything i stated to you refers to healthcare in the usa not australia. so, when you stated i was 100% wrong, well actually it was you who was 100% confusing the perspective of my comment.- brian lee

[BrianLee]

Where I work now, we have a lot of scrub techs. I did work at one hosptial, and it was mainly RN's who did the scrubbing. I loved scrubbing. My current facility, I haven't got to scrub yet and I've been there since April.

Im sorry to hear that as a result of the Nursing shortage you have not had the opportunity to scrub. I know how rewarding scrubbing is and I hate to see someone deprived of the opportunity. ((HUGS))

[BrianLee]

In Australia RNs scrub and we have ENs or AINs circulate (we even have orderlies who circulate now due to the Nursing shortages!)

I think they have just started teaching EN's to scrub now too there just has to be a RN in the room (Aneasthetics or Circulating)

We currently do not have scrub techs, although I have asked our Nursing Unit Manager if we would employ an USA trained Scrub Tech as my aunt is a ST and wishes to move here, I found that she would have no problems being hired.

Maybe you should talk to Scrubby. She has the idea that this sort of thing dosnt happen in Australia.

[BrianLee]

i agree with scrubby that rns in the or should look out for their jobs and protect it from non-licensed personnel. i have been around a very long time and plan on staying around for a few more years. i started out when rns were the only ones allowed to work in the or. we didn't get our first tech until about 6-7 years ago. i do have a strong opinion on whether techs should even be in the or and make no apologies about it. face it, the only reason techs are even in the or is for financial reason, cheap labor. i am lucky in the fact that we have an all rn staff, except for one token tech, and each and everyone of us scrub and circ. very rare in today's modern or. patient's deserve the best care they can get and an rn is the best choice. there is really no difference between what a cst can do or a fa or whatever. the only thing i don't do is suture, big deal! up to around 15 years ago all of us did suture things like drains and such. not much of a skill level needed. to wrap things up, techs are really not needed in ors and wouldn't be missed. rns are needed by law in all states for patient care and i am glad i work in a state that doesn't allow sloppy nursing rules. we have openings for staff but won't fill them until an rn applies for it. the tech we have was out of desperation for a warm body. i like her very much and she is fairly good at what she does, but we all would have rather had an rn, much more versatile. staffing with an all rn is much easier. also, not sure what you meant by "double doors"? enlighten us, please.

shodobe,

i respect that you have a right to your opinion. although, i couldn't disagree more concerning your assessment of the value of the surgical technologist. oh, and if you are interested in learning about the differences in roles between a certified surgical technician and a certified first assistant i encourage you to visit the national board of surgical technology and surgical assisting (nbstsa) @ "lcc-st.org".

if your idea of first assisting is solely based on whether or not someone has the ability and capability to sew in a drain, then i am lead to believe that your practice as a first assistant was very limited and lacking formal training. sewing in a drain is not even the beginning of it. a good first assistant will benefit the surgical team and the patient in countless ways.

what i was implying when mentioning the "double doors" in the operating room was that some of the nurses in this blog have egos, that in my humble opinion, have swollen to a point that which only the use of a pair of double doors would permit access.

[BrianLee]

Of course RN's will act superior to ST's because THEY ARE SUPERIOR!!!! It is because of ST's like you that we as RN's have to demonstrate our superiority. While a RN who is able to circulate can be taught how to scrub and do both, a ST will never be able to legally perform the role of a circulator in most, if not all , states. Just my :twocents.

Thank you for your response. You have proven my points with every sentence that you typed. While there is no question that the RN is the ST's superior in sense of the definition which concerns rank and station..... it is not always the case that they are superior in the sense of the definition which concerns grade and quality. And Vice Versa, every team member, ST, RN, ect can take something from this point. Now you on the other hand embody another form of the definition, which describes a person whom feels he is better than or above someone simply as a result of rank. Look up the definion and see which one suits you best. There is a remarkable resemblance to a few obtuse Surgeons I have worked with in the past.

I have often offered to my peers the idea that " A lion dose not have to roar for everyone to know he is the King of the Jungle". If one is superior in quality and merit, one does not have to "act out" or "demonstrate" his/her superiority. That quality is obvious upon inspection of his work ethic.

It must be very frustrating to be in a position of a Superior when one does not present adequate knowledge, communication and leadership skills to capture the respect of the team without resorting to tactics like " Becuase I said so!"

Regarding your comments on the present and future roles of Surgical Technologists...... below, I have quoted a report from the Fl State Senate which details the role of surgical personel. I have also included a link for your benefit should you choose to educate yourself on the facts instead of letting your emotions demonstrate your ignorance.

You stated that ST's would never, blah blah blah, ect ect... If I were you, I would ,,,well,,, never say never. I personally, see the benefits of the flexibility that it would provide considering the Nursing shortages we have been enduring, but have a GREAT appreciation for the essential importance of a RN presence and hope that we are able to maintain that level and build upon that which we are functioning at now.

http://www.flsenate.gov/data/session/2006/House/bills/analysis/pdf/h0483a.HCR.pdf

"State Regulations

State governments regulate all occupations and professions, and it is within the power of state governments to ensure patient safety through the regulation of occupations.

15

According to a report by the Association of periOperative Registered Nurses (AORN):

20 states require RNs to circulate, 37 states require RNs to supervise in the OR but do not specifically mention the role of circulating nurse, 8 states explicitly follow Health Care Financing Administration’s conditions of participation for surgical services, and 7 states have no specific staffing requirements.

Currently, Florida is one of seven states that have no nurse staffing requirements for hospital operating rooms (ORs). The other states are Georgia, Louisiana, Maryland, Ohio, Washington, and West Virginia. Of the 20 states that require an RN to circulate, California, Idaho, Maine, and Nevada require adequate staffing so that each RN does not circulate for more than one operating room. Hawaii, Oklahoma, Utah, and Wyoming mandate that licensed practical nurses (LPNs) and surgical technologists cannot function as the circulating nurse in the operating room. In Indiana, Nebraska, New Mexico, and Wisconsin, LPNs and surgical technologists may function as assistants under the direct supervision of a qualified RN.

16

The eight states (i.e., Alabama, Indiana, Iowa, Massachusetts, Montana, North Dakota, New York, and Texas) that explicitly follow Health Care Financing Administration rule governing surgical services also mandate that LPNs and surgical technologists may assist in circulatory duties under the direct supervision of a qualified RN, who is immediately available to respond to emergencies."

For the record, I have not once said anything negative about Nurses as a whole, I simply have my reservations about those like yourself, whom are drunk with POWER!

Anyways, thats my 300099487790434 cents worth! - be the change!

[willitblend?]

Thanks for all the replies on this thread. It's most enlightening!

[Scrubby]

Scrubby,

I was, of course basing my responses based upon the Nursing profession in the United States of America, not Australia. I never professed to know how Healthcare in a country on the opposite side of the world functions. Each country obviously has very different situations and solutions to those situations. BTW, in the USA we have IV TEAM Nurses (JELCO Nurses) too. A Phlebotomist, is as I stated, is a allied health professional that draws blood for lab work. Everything I stated to you refers to Healthcare in the USA not AUSTRALIA. So, when you stated I was 100% wrong, well actually it was you who was 100% confusing the perspective of my comment.- brian lee

Perhaps you want to be a bit more careful when you throw around comments like 'your jobs are already been taken over'. :)

[Scrubby]

Maybe you should talk to Scrubby. She has the idea that this sort of thing dosnt happen in Australia.

You need READ my posts. I said it doesn't happen where I work. In fact I actually said:In the Eastern states of Australia they are few and far between. In my state scrub techs do not work at any of the major public hospitals, they are all nurses. In private well they have non liscenced staff only because they are desperate. In the eastern states I have heard of anaesthetic technicians, there may be some scrub techs but they still use nurses as scrubs there as well. We don't have the widespread problem of nurses no longer being prevented to scrub like you guys do in the US. I don't want to see this happen in Australia. If you don't like my opinion then that's just tough because I'm not changing.

If your not happy with your scope of power then feel free to become a nurse sometime. You may just learn how limited the scope of just being the scrub really is in relation to what else is actually happening in the OR.

[beccarner]

The Surgical Technologist role came about during wwII when nurses were overseas. Didn't need to learn how to care for pt's on the floor. Started with student nurses at first. Evolved with todays skilled scrub tech's. In the 60's RN's scrubbed the more difficult cases (at the time) eg. craniotomy, lum lam, carotids. There were only peripheral vascular cases, no such thing as open heart.

When traveling learned in some states like Virginia have trained on-the-job LPN's to scrub. The RN also scrubs when needed.