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.

[sunnyjohn]

Surgical techs and OR nurses are a team. This argument is foolish and only exists in the minds of people who can't understand that sucessful patient outcomes depend on the profesional success of EVERY member of that team.

(Nurse, Surgeon, X-ray tech, Surgical tech, lab, houskeeping, etc...)

[ewattsjt]

I agree with all of sunnyjohn's post except I do care what title I am called. I worked hard to earn the CST title. I deserve the same respect that I give the RNs who worked hard for their title.

[ewattsjt]

please read all of my post before jumping to conclusions.

this is somewhat off topic; it has to do more with the scrub role. while i believe that the role of circulator should not be replaced by a cst, i do believe that on the job training for scrub role should never be allowed (be it tech or nurse). it is just simply bad for the patient. a program for both (nurse and tech) should be the standard. the reason being is that bad habits are easily passed down and the “newbie” has no reason to question it. therefore, they learn bad practice and will pass it on to the next student.

the point is that the newer techs have specialized training dealing with instruments, aseptic techniques and procedure. the training ranges from 11 mth. as a diploma to 2 years as an associate degree. this training should never be misconstrued as sub standard or easy.

this same token can be applied to the circulator role; techs do not have proper patient care training to efficiently deal with the role of circulator. nurses go to school to specialize in patient care. they go 11 (12) mth as a diploma to 2 yrs as associate degree.

am i the only one who sees this? or am i totally getting it wrong? it is about the patient isn’t it?

[RNOTODAY, BSN, RN]

ejwatts says:

This same token can be applied to the circulator role; techs do not have proper patient care training to efficiently deal with the role of circulator. Nurses go to school to specialize in patient care. They go 11 (12) mth as a diploma to 2 yrs as associate degree.

A nurses educational requirement ranges from, according to you, from 12 months to 2 years? Its more like (for RN's) 2 years to 4 years.:uhoh21: A diploma program, by the way, is 3 years.:uhoh21:

[ewattsjt]

sorry to tell you but, here the diploma lpn (lvn) is 11 (12) mth. my sister-in-law just finished.:) the asn is 2 to 3 years depending what program one attends and how many hours are taken during the prerequisites (this is what i am doing):) . here there is also a lpn to asn transitional program 1 year diploma + 1 year transition (a co-worker is currently doing this):) . bsn is 4 years or 2 years then 2 to 3 years in an interrupted in a asn to bsn. at least that is how it is here.

the point was not the exact length of the programs; it was that each is trained for specific duties. one is trained specifically for patient care and the other specifically for the procedure and that the schooling is approximately the same length with general studies being the same until the core programs. i do not have to do prerequisites because all mine transferred into the nursing program:) :) :) .

[RNOTODAY, BSN, RN]

sorry to tell you but, here the diploma lpn (lvn) is 11 (12) mth. my sister-in-law just finished.:) the asn is 2 to 3 years depending what program one attends and how many hours are taken during the prerequisites (this is what i am doing):) . here there is also a lpn to asn transitional program 1 year diploma + 1 year transition (a co-worker is currently doing this):) . bsn is 4 years or 2 years then 2 to 3 years in an interrupted in a asn to bsn. at least that is how it is here.

the point was not the exact length of the programs; it was that each is trained for specific duties. one is trained specifically for patient care and the other specifically for the procedure and that the schooling is approximately the same length with general studies being the same until the core programs. i do not have to do prerequisites because all mine transferred into the nursing program:) :) :) .

ok, well i didnt think you were including lpn's in your estimation, and i include prerequisites as part of the total program.

[cwazycwissyRN, RN]

All this from a thread that was originally started 3-28-02......wow, it did not get much response then....why bring this thread back to life CSTCFA ???

The facts have changed quite a bit in the last 4---nearly 5 years.

[CSTCFA]

All this from a thread that was originally started 3-28-02......wow, it did not get much response then....why bring this thread back to life CSTCFA ???

The facts have changed quite a bit in the last 4---nearly 5 years.

I never looked at the date and if it that old why is the thread still posted and not archived. Yes quite a bit has changed but have people change also.

[Marie_LPN, RN, LPN, RN]

All this from a thread that was originally started 3-28-02......wow, it did not get much response then....why bring this thread back to life CSTCFA ???

The facts have changed quite a bit in the last 4---nearly 5 years.

Some things haven't changed though, as evidenced here.

[echaney]

At the risk of insulting many good CSTs, in 22 years of OR nursing, I've yet to find one who remotely had the amount of education equivalent to that of an RN. The scrub nurse role is primarily technical in nature and many an RN cannot do it well. However, the circulating role relies on an overall knowledge base that I would challenge a CST curriculum with showing proof of as a requirement. Any credentialing (ie., JCAHO) surveys I've gone through have always included the specific question regarding whether or not CSTs or RNs are circulators. While CSTs can circulate a room, they still MUST be under the direction of an RN and this RN should be readily able to respond to emergency. Someone tell me how that can be safely done if one RN is supervising several rooms and more than one room has an emergency. As for me or my family, give me an RN anyday. And while we are at it, I also want a second physician to serve as the assistant in surgery and not someone who has attended a two week first assist course somewhere and now has delusions of granduer that they are capable of troubleshooting and consulting during surgical cases. MEOW... I'm on a role...

I have to say that you are very one minded. I was trained as a Surgical Tech in the Navy and we were trained to circulate rooms. I have to say that while not all techs may have the "knowledge base" that you apparently have some do. I feel that I (and many techs I work with ) have a broarder and better knowledge base than many RN's I know. I think to just generally state that techs are "essentially not as good as RN's " is a poor choice. I think you need to rethink how the operating room works and look around you with your eyes open. I hope I wasn't on to much of a role (or roll).

[heather2084, BSN]

I would agree with this. As someone who just started as a new circulator in surgery and as a new nurse as well, I look up to everyone who is there, tech, nurse, or whatever. Everyone has been in surgery longer than me, so I feel that the tech's have a larger knowledge base than I do. While they may not have RN after their name, most of them would be able to circulate the room alone. I still feel a nurse should be in the room to be available for emergencies, but it should not be said that nurses are so much above techs. Techs in the OR are NOT the same as techs out on the floor. The schooling and training OR techs have done set them apart from the majority of other healthcare 'techs'

[NabiRN, BSN, RN]

I am writing a paper on labor relations and policy. Is anyone out there who work in states that do not require a RN circulator in the room for each procedure? If yes, what is your experience like?

Thanks so much.