Circulators

[StudentSandra]

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

are surgical technologists losing their jobs.

[CSTCFA]

Then its not OJT it is part of there clinicals or are you talking about the 3 month orientation. You must be part of a University hospital school where there are a lot of students.

[ewattsjt]

i am a cst returning to school for asn

wow! the hostility toward techs. the claim of being uneducated. well, i have enrolled into a pre-nursing program and all my prerequisites are met from my associate of science in surgical technology. i only need the core nur classes. to think how much less i would have needed if i had been educated better. i had to do a year in clinical surgery rotation.

is it any wonder we become so bitter with such disrespect?

the rn is the patient advocate? that statement should have been, "the rn is one of the patient advocates. i was taught it was a team effort until i was around nurses and found what a grand stand job they did by themselves.

sorry about the vent but i get tired of hearing the same, "we are better than you and you must fall under us" stuff. it is about the patient. it is the surgical "team" that treats the patient.

as for surgical assisting, there are several programs that one can attend of which the least time in class is 9mths. some require one being a cst first (which i think all should). the people here really should start checking out fact before knocking down another in the healthcare profession.

i do my job for the patient just as much as the rn. when i become an rn, i pray i show more respect to my peers than what i see being shown to me currently.

it is a team effort to give the patient the best quality and service one could expect.

[ortess1971]

i am a cst returning to school for asn

wow! the hostility toward techs. the claim of being uneducated. well, i have enrolled into a pre-nursing program and all my prerequisites are met from my associate of science in surgical technology. i only need the core nur classes. to think how much less i would have needed if i had been educated better. i had to do a year in clinical surgery rotation.

is it any wonder we become so bitter with such disrespect?

the rn is the patient advocate? that statement should have been, "the rn is one of the patient advocates. i was taught it was a team effort until i was around nurses and found what a grand stand job they did by themselves.

sorry about the vent but i get tired of hearing the same, "we are better than you and you must fall under us" stuff. it is about the patient. it is the surgical "team" that treats the patient.

as for surgical assisting, there are several programs that one can attend of which the least time in class is 9mths. some require one being a cst first (which i think all should). the people here really should start checking out fact before knocking down another in the healthcare profession.

i do my job for the patient just as much as the rn. when i become an rn, i pray i show more respect to my peers than what i see being shown to me currently.

it is a team effort to give the patient the best quality and service one could expect.

ok, i lied. i'm not quite done...the hostility that was present on this thread was aimed towards rn's. most people here feel that techs have a place in the or and i personally did not say they were uneducated, just that they receive a different education than rn's, one that is procedure focused, rather than focused on the patient as a whole. and in many or's in the country, there are techs who have been "grandfathered" in-they had no formal schooling and learned on the job. i also find it amusing that my post was seen as "immature" by a certain person, when all i did was point out that their posts had a disrespectful tone. ironic that this person didn't start bringing up the teamwork concept until i mentioned it. like marie said, respect goes both ways and patients aren't going to be helped by someone whose ego is their first concern. i didn't see any of us here stating that we think we are "better" than techs. but the fact remains that for now at least, we have separate roles. i work with some techs who run around all day whining about respect while giving no basic human courtesy to others. i only ask a small favor. if you are going to respond to something i have written, at least read it thouroghly and don't put words in my mouth.

[ortess1971]

I am sorry if i sounded snippy it was not my intention. I dont see why any one would get upset with what i said. Unless it was true. With 4 states already having CFA's to get Licensure or Registration and more to come, I hate to tell you it is not the end of story. As AST is pushing foward with higher education for CST's and CFA's, I see this discussion is just starting. Which by the way no CST within the past 10+ years has been On The Job Trained. With the nursing shortage rising, health care costs also rising, and most states with no laws saying that a RN and ONLY RN Must Circulate. I see why AORN is up in arms about this. Like you said MOST of the post were respectfull. What fuels and starts OR wars is comments, discussion boards, and articles like these. Keep the politics out of the work place. Troll feeding get a life. This is the reason why nurses are fighting to get respect in the OR. People like you who can not have a disscussion with out name calling or being immature. Nothing i said was worng.

Beg to differ on that...My hospital has two techs that were trained on the job(one was 3 years ago, the other was 5). Did you actually reread what you posted and the tone of the posts? Maybe you don't mean to be snippy but I'm not alone in feeling that that is how they come across-usually when someone has very few posts, and then chooses to make their first posts negative and confrontational in nature, that person in engaging in troll-like behavior. If you look at my first post in response to you, it was very calm and rational. You chose to respond in a confrontational manner. You then proceeded to back off some of your statements when it appeared that you were getting called on some of your comments. Again, I'm not the only person to notice this. Ok, now I really am done. Marie's right. This thread is becoming tiresome, because you can't have a rational discussion with someone who has a huge chip on their shoulder.

[RNOTODAY, BSN, RN]

So what you are saying is only a nurse can check lab values, consents, orders ect. This is a way for nurses to justify there numbers in the OR. I dont want to slam nurses either but come on. Im not saying nurses shouldnt be in the OR. What would a tech do for a conscience sedation case, or a code? Nurses are needed in the OR just not in large numbers. By the way if the Tech school you went to didnt teach basic ekg or labs then shame on that school and the student.

Yes, they can *check* the lab values, consents, orders, etc..... but without the knowledge of a nurse, what can they do with that information? And if the consent is wrong, for example, and the procedure is done, is a tech legally responsible, like an RN would be? ....No, they are not. I am not saying that to be an RN in the OR you do these highly complex things that nobody else can do, but what I am saying is that there are legalities. You can delegate to someone, for example, on the floor a cna can take your vitals, do your I&o's, but they cant sign the chart that this was done. A *licensed* person needs to do this. Same with the OR. Something simple like "checking a consent" has big implications, and nurses are taught to advocate for the patient. Techs, valuable as they are, are not taught that. It is not their scope of practice. All OR's need a RN circulator.

[RNOTODAY, BSN, RN]

Well then we know, someone who is OJT is not A CST!

NO. I work with a tech, who, 12 years ago, became a tech, with ojt. Just recently, she took the exam that certifies her. Now , she is a bonafied *C*ST.....

[ewattsjt]

yes, there are on the job techs but there are not any on the job csts. one has to graduate a school accredited by the caahep or abhes. this is the only way someone within the last 10 years can sit for the national board of surgical technologists and surgical assistants (formerly the lcc-st) certification. this is one of the reasons that the ast is pushing for legislation for licensure of the cst. it would mandate the certification and hospitals would not be able to train or use on the job trained techs.

there is an area where techs pre ???? (i am not for sure of the exact date) can sit because of grandfather clause. one would have to have been a tech for at least 10 years, maybe more. anyone that is within 10 years has to be from a caahep or abhes accredited program.

[RNOTODAY, BSN, RN]

Do any CST or ST bulletin boards exist on the net?

[ewattsjt]

by the way ortess1971, my comment about the education, etc... was aimed more toward attitudes like that of orjunkie on page one. it is a general attitude that is seen in most ors nation wide. i was just becoming familar with the posting design and has not found the quote button when i first posted.

just some added info, not only is the training 9 month diploma to 2 years associates (kind of like nursing lpn, lvn, asn) but the exam is difficult. here is the results of the previous year:

[color=#333333]in 2005, 3,762 candidates attempted the nbstsa’s national certification exam for surgical technologists. of these, 2,475 passed and 1,287 failed. pass rate: 66%

i worked hard for my certification. it took me 2 years and a drive of 1 hour away for my core classes and clinical site. i "worked for free" during my training in clinical.

as i said before, i am returning to school to become a nurse. getting back to the topic, csts do not have proper training to be the sole circulator. there has to be an rn. while a tech could be trained on lab values, etc... they are not currently trained and most states do not allow them to do things such as start an iv. because of this, most programs do not teach it. this goes with scope of practice issues.

some facilities use the charge as the rn that the csts are circulating under but the problem with this is patient safety. what happens when the is a code in two rooms at the same time or one room needs a blood transfusion stat and a code proceeds in another room. tooooo much room for error. as a patient advocate i can not go along with this type of practice.

[ewattsjt]

Do any CST or ST bulletin boards exist on the net?

Yes they do.

[ewattsjt]

This is off the main topic again but within the general posts. Have you ever noticed that there is a general concensus among techs that they have to become defensive about their education and role in surgery? Although you personally may not have made them feel that way, they did not come out of school with that attitude!

[SOCALDAN]

NO. I work with a tech, who, 12 years ago, became a tech, with ojt. Just recently, she took the exam that certifies her. Now , she is a bonafied *C*ST.....

This might help this argument.

NBSTSA - LCC-ST – Certification in Surgical Assisting

OJT personell can take an exam, but they cannot label themselves CST..YOU must go to an accredited program to get that tagline.

I am a retired Navy corpsman 20 yrs active duty and 15 yrs as certified surgical tech.

I've been on both side of the coin here, I've circulated many, many case in my days, and yes a tech with the right training can circulate cases.

Techs can find out lab values and can even understand them, and act if the values are not in the normal ranges/values. Thats easy with the right training. Really how many people NURSES or techs can go to an O.R. without some type of training.

Nurses are valuable in the O.R. not all want to scrub, and not all tech want to circulate. I've known many really bad techs, and many really great techs, and the same goes for nurses.

Truly what it all boils down to is the root of all evil...MONEY. Techs believe they should be making more money. IMHO

Both professions are unique. A nursing job in the O.R. is stressful and the tech is right ther with HER/HIM. I believe the nurses job in the O.R. is more stressful, with all the paperwork and limb holding, scrub prepping, running around ,suture finding, instrument flashing....I CAN GO ON FOREVER.

We all value our professions, and want to stick up for what we do.

I'll bet even a ditch digger can say their job is more important, because without ditch diggers their would be no foundations laid for any hospitals, and without hospitals, this makes us UNEMPLOYED..

rant over.