Can a surg. tech. "circulate" a case -give medications?

Specialties Operating Room

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At the hospital where I currently practice we sometimes have 2-RNs and 1-Surg. Tech in a room (on good days). In some cases the Surg. Tech. is allowed to "ciculate" the room with one of the RNs. My question is when a surg tech "ciculates" can they spike IV bags or give medications to the scrub RN for the surgical field? I have refused to allow the ST to spike IV bags or give me drugs when I am scrubbed because I think that this exceeds her scope of practice but I am not sure. I have asked this question to AORN without results but I think this question goes beyond AORN into the Board of Nursing Practice Act. Please help me to bring some clarity to this situation.

Ok RN2BE, lets go around again . This post regarding OR RNs and CST, and STs is an old topic which rears its ugly head all the time and to be honest I love it because what I was unable to say in a politically correct climate of the work environment I can freely state here. I feel qualified to state my point because 1, I have worked in the OR, for almost 20 years, 2, I have worked with both STs, CSTs and RNs. I do not want to work with STs ect because simply put they are of little value or support to me in assessing, planning , implementing and evaluating patient care. They are trained to scrub and do so for the most part very well but hey I'm no mean scrubber myself, actually I consider myself a brilliant scrub nurse and I dont care who knows it. Now RN2BE, however I am also excellent at anaesthetics, circulating, post operative care and managing the room dealing with conflict, reps, rotas ect ect. In an emergency I am capable of hanging fluids, drawing up drugs organizing who does what, on the nursing staff, dealing with infected cases, orderlies, does anyone want me to stop. My fellow RNs understand all of these duties for which we take responsibility for and are accountable for if called to account. With other RNs at my side my job is a dream. We work together, challange each other, support each other, we rotate duties, no one person scrubs just because thats all they can do, we all rotate, in one day I may scrub for a laparotomy, do anaesthetics for a neonate, circulate for an aneurysm and recover a craniotomy. We are multi skilled peri operative nurses. I do not need anyone in the room who can do no less then I can. I want someone to share responsibilities with, to pool thoughts. Surly you can understand that. As I have previously said STs and CSTs may be brilliant at scrubbing but thats not good enough. And as for recognizing the whole team, ect ect. I am well aware of the whole team but I am as aware for the need to provide each patient with the best possible team. That to me is a team of highly skilled, knowledgable, dedicated RNs. STs and CSTs are not a requirement in the OR, and are only tolerated because to say otherwise is politically incorrect. In my present employment each and every patient is cared for in every aspect of their perioperative journey by and rn.

Carcha

I am also excellent at anaesthetics

I'm just curious...are regular RN's allowed to do anesthesia in the UK? It's an extra two years of school here post-bac. (master's degree)

Carcha

I'm just curious...are regular RN's allowed to do anesthesia in the UK? It's an extra two years of school here post-bac. (master's degree)

I think carcha is referring to conscious sedation, which American nurses do frequently. I don't, because I refuse to do an anesthesia provider's job on a nurse's salary, especially when it done only to keep cases moving. It sometimes seems HERE as if "the desk" wants to "head 'em (surgical patients) up and herd 'em out" like cattle, and I won't deliver patient care that way.

Carcha will clarify, however--I am curious about the extent of RN involvement with neonates in the UK--we just start the IV while the anesthesia provider masks, or vice versa. We may also give IM or IV drugs while the anesthesia provider's hands are tied up, masking.

Thanks for the input, Stevierae. :) I've seen rn's do conscious sedation in the er, but as you mentioned, I wasn't sure to what extent (in regards to anesthesia) Carcha was referring to.

I have to agree.....I am so very tired of Nurses and STs feeling hostility....the whole philosophyof the Operating Room is teamwork....how can that be accomplished if there are those that insist that there is competition on the same team!!!

I originally had a pretty sharp response to the attitude displayed by Mike...until I read the link posted above (Should ST's circulate?). Now I'm just simply curious....what exactly has spawned such an intense (and I do mean intense, from some of the posts I've read) hatred of ST's? I mean, some of the people got downright nasty! I would think that with the amount of condescending comments RN's receive from doctors because the rn's didn't attend four years of medical school, they would think twice before passing the s**t down a level. (Overheard from a doctor once: "There's no way I could have been JUST an RN. I had to be something more than that." I'm not an RN (yet!) but that comment pissed me off just the same.)

As a cst myself, I take a lot of pride in knowing my scope of practice and doing my job in a safe, proficient manner. Do I believe that st's should be the primary and sole circulator in an OR? No, we are neither licensed nor trained to do so (ie: pt assessment, dispensing of medications, etc.). I also agree with the posters that every patient should have an rn to help oversee their care. However, I do believe our skills can be valuable in a secondary position, working WITH the rn if we are not scrubbed in (ie: opening a room, helping with pt positioning and padding-- which we ARE taught in our 2-yr schooling--running for supplies so the rn doesn't have to leave the room, answering docs beepers, etc.). And as for when the s**t hits the fan...it happens quite often in L&D. Just because I'm a cst does not mean that I lose my head and start whimpering in a corner everytime there's an emergency section or a code on the table (neonatal or adult). I follow my scope (which is usually running during codes unless I'm scrubbed in) and do what I can to help in a quick and efficient manner. I fully realize that there are techs (as well as rn's) that are lazy, incompetent, and pretty much useless. I think every profession has a few of those, I believe it's due to one's work ethic, not whether you spent 2 years getting a st degree vs. 2 years getting an rn.

And I don't know about where all of the negative posters work, but here the rn's, techs, and doctors all work together to....OMFG, IMAGINE THIS....give the patient the best possible care, and make them as comfortable as we can while they are in the hospital.

A lot of the posters should be ashamed of the comments they wrote. I think we all (techs, rn's, doctors, lpn's...even housekeeping) have our specific role in the hospital...our little niche to work from. And I think it says a lot about one's character to belittle someone who isn't on your *perceived* level.

I can't remember who said it, but I believe this rough paraphrase fits this thread well:

"Judge a man not by how he treats his equals, but by how he treats those beneath him."

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I have to agree.....I am so very tired of Nurses and STs feeling hostility....the whole philosophyof the Operating Room is teamwork....how can that be accomplished if there are those that insist that there is competition on the same team!!!

Treating each other as human beings would be a start, though in some situations, the one who starts that stays as the Lone Ranger for a long time.

well i have a question.. i know this is a debate about circulating and such, but i wanted to know outside of the OR do some RN's or other OR staff have the same "attitude" toward the ST's. or is it just in the OR theater? I mean if its also outside of the OR that cant make for a very healthy work enviroment, can it??

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

At my job, the hostility is on the entire floor with just a few, thank goodness.

One of my preceptors is CONSTANTLY running her mouth about her opinions ("Only RNs belong in THIS dept., LPNs and techs are useless, and will stay that way, so i don't see why the hell they let you people in here."). Nothing like having a preceptor who puts your profession down with any intake of air, but, hey, it's her blood pressure lol.

And it's her opinion. Which she's entitled to think what she wants, but i have to laugh to myself when she talks about the hostile work enviroment. Hell, she's part of the problem she's whining about!

Why do i put up with it? Well for starters, it's a daily reminder of how NOT to be when i continue on with my education, or even now. And secondly, i enjoy a challenge and i'll be ****ed if she's going to be my reason for a complaint. She will not get to me that way, i won't give her the satisfaction.

i just want to make sure that when i do graduate, i wont find any hostility as soon as i walk in the door to a job interview.. I want to be treated fairly based on my personality and my skills as a ST. I dont want people to judge me based on my career. I could and my be the best ST that comes out of my class but if people or already aggrevated at even the thought of an ST, then I really have no chance at making a good working atmosphere for myself.. what to do ?

i just want to make sure that when i do graduate, i wont find any hostility as soon as i walk in the door to a job interview.. I want to be treated fairly based on my personality and my skills as a ST. I dont want people to judge me based on my career. I could and my be the best ST that comes out of my class but if people or already aggrevated at even the thought of an ST, then I really have no chance at making a good working atmosphere for myself.. what to do ?

Cristinak, most Surgery department RNs and Surg Techs do not have a problem, the problem lies with the few who do not or will not understand that Surg Techs are here to stay and so are RNs. Both are useful in the OR, we compliment each orthers strengths and weaknesses. It will be a very rare instance for an OR to be fully staffed by RNs, especially due to the nursing shortage. I have and do work with some excellent RNs, LVNs, and Techs, I have also worked with some very bad ones.

In my experience a problem is typically created because someone feels threatened, or if someone is incompetent. If you are competent and your co-workers are compent then there should be no problems.

Remember everyone in the OR is a TEAM, if the RN needs assistance and the Tech is capable and competent at the task then there should be no problems.

This discussion is pointless and this contribution is my last. While the RNs on this thread have focused on the professional aspect of the role of the RN compared to the task allocated to the st or cst, the non nurses on the thread have hidden behind such words as "hatred, competence, insecurity". I am a registered nurse and proud of it. I have studied and worked hard and continue to do so to this day. I have no personal feelings towards st or cst's . My beef is that they are taking the place of a registered nurse who is more knowledgable, more accountable and multi skilled. Scrubbing and handing instruments is only one aspect of peri operative care, no big deal. Give me an all around peri operative nurse capable of multi tasking, who is multi skilled and then I am impressed. ST's and CST'S are just filling gaps, sorry but thats how I feel.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Gee, what a confidence booster.

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