Operating Room

linda2097 · Nov 11, 2008

Surgical Assistant: Most likely refers to a surgical technologist, which is not a nurse. Her job is to hand instruments to the surgeon. Most have only a year of training, or are trained on the job.

Surgical First Assistant: Registered Nurse First Assistants are RN's who are trained to do the same a job a physician first assistant would do during surgery.... mainly retracting, suctioning, and suturing skin.

Operating Room Nurse: An RN who circulates and/or scrubs.

Circulator Nurse: an RN managing one operating room suite, checking in the patient, positioning and prepping, getting supplies, documenting, problem-solving, etc.

Scrub Nurse: An RN doing the same job that a surgical technologist does.

Surgical Tech: same thing as surgical technologist.

Fun2, BSN, RN · Nov 12, 2008

The scrub nurse could be an LVN or RN, but the circulator (I think) must be an RN.

linda2097 · Nov 12, 2008

Anyone can scrub. You don't need any kind of nursing degree. All you need is some training. Circulating on the other hand requires an RN license.

Fun2, BSN, RN · Nov 12, 2008

Anyone can scrub. You don't need any kind of nursing degree. All you need is some training. Circulating on the other hand requires an RN license.

Right, but a scrub "nurse" could be either an LVN or RN...that was what I was referring to. :)

MichiganChris · Nov 12, 2008

Thank you all. Great info.

core0 · Nov 16, 2008

Surgical Assistant: Most likely refers to a surgical technologist, which is not a nurse. Her job is to hand instruments to the surgeon. Most have only a year of training, or are trained on the job.
Surgical First Assistant: Registered Nurse First Assistants are RN's who are trained to do the same a job a physician first assistant would do during surgery.... mainly retracting, suctioning, and suturing skin.
Operating Room Nurse: An RN who circulates and/or scrubs.
Circulator Nurse: an RN managing one operating room suite, checking in the patient, positioning and prepping, getting supplies, documenting, problem-solving, etc.
Scrub Nurse: An RN doing the same job that a surgical technologist does.
Surgical Tech: same thing as surgical technologist.

I would generally agree except for the first two. Surgical assistant and surgical first assistant are pretty much the same job. There are multiple pathways. There are those who were trained on the job and are usually referred to as surgical assistants. There are those who were CSTs and then got additional training are known as CST/FAs. Then there are those who are RNs who are certified who are known as RNFAs. They usually all get lumped under the SA or FA title (at least where I've worked).

David Carpenter, PA-C

ewattsjt · Nov 16, 2008

As coreO stated, the Surgical Assistant and Surgical First Assistant are the same term. It is the position in the field. Surgeons, NPs, PAs, RNs, CSTs and LPN/LVN can all perform this role. There are some states that have regulation on the practice of assisting while others have nothing. So check with state law and facility policy.

The only assisting titles for the CST that is recognized by the Association of Surgical Technologists (AST) are the CFA (by the NBSTSA) and CSA (by the NSAA). If someone calls themselves a CST/FA or CST/SA their professional organization does not officially recognize it.

To be a CRNFA an RN has to hold a bachelor degree (in anything since Aug of this year), passed and maintain CNOR, assisted in 2000 documented case hours, and of course passed the certification exam (by the CCI).

The RNFA has attended the program but does not meet ALL of the above requirements. CNOR eligibility is typically required for the admissions and most require CNOR pass by completion of the program.

LPN and LVN are also eligible for the CFA or CSA exams if they attended a CAAHEP program which typically requires a couple of years in the OR.

In certain areas of the country such as mine, not anyone can scrub. All the facilities around me have policies that require new hires for the scrub role to be RN, LPN/LVN with 2 years proven OR experience or a CST (pass exam within a year). I think South Carolina just passed a law that requires one to be a CST for entry to the profession.

GadgetRN71, ASN, RN · Nov 17, 2008

Anyone can scrub. You don't need any kind of nursing degree. All you need is some training. Circulating on the other hand requires an RN license.

Around here, they do not train STs on the job anymore. You have to go through a formal program and many places won't even look at you if you're not certified. To be certified, you have to pass an exam and have graduated from an accredited program. I was a tech before I was a nurse, and I have an associate's degree in surgical technology. I'm not sure I agree that anyone can scrub..it's not easy. To be a good one, you have to be able to anticipate what the physician needs. Some of them just hold out their hand, and the tech is expected to give him/her the proper instrument without being told. It takes many years and nerves of steel to be a good tech. And trust me, as circulator it's very obvious when you don't have a good one..techs can make or break the case.

Like you mentioned, in my area only RNs can circulate.

linda2097 · Nov 17, 2008

I'm not sure I agree that anyone can scrub..it's not easy. To be a good one, you have to be able to anticipate what the physician needs.

That's not what I meant. I meant that anyone can scrub without going to scrub tech school first. At least in some states.

GadgetRN71, ASN, RN · Nov 17, 2008

That's not what I meant. I meant that anyone can scrub without going to scrub tech school first. At least in some states.

Gotcha.. although, the days of OTJ training for techs are going away. I'm of the opinion that they need to make the requirements the same across the country for techs..they can get away with paying them less now, because some places still do the OTJ training. I also think they should be licensed. This would give them more clout and probably a better paycheck.

I loved being a tech, but they don't always get the respect and compensation they deserve. Although, we nurses hardly do either.. :rolleyes:

ewattsjt · Nov 18, 2008

I don’t think techs should be licensed to give them more clout or bigger paychecks. They should be licensed to hold them to a high standard that is enforceable and regulated for the safety of the patients. Right now a tech can screw up in one state and move to another (sometimes a different area of a state) and begin practicing again. This should be stopped. The way to hold them more accountable and to the high standard is through licensure.

The AORN in some states are lending support to make sure the techs have to attend a formal accredited program and to have the CST certification (mandatory for entry level for scrub).

I feel that licensing the techs does not take away from the RN any more than a LPN/LVN does (even though some states do need to bolster their current laws in regard to what the RN does in surgery). It simply holds the techs to a regulatory body that oversees that profession.