jamiebell

It has been difficult to address this issue. 90% of the staff have only worked at this one facility and don’t know any different, they don’t want anything to change. They do a great job but I know it’s a legal liability. I have made some staff and even some of the doctors upset with me, but I believe in in doing the right thing, striving for excellence, continued growth, and education. Do your job for the patients and staff that trust you, ask the difficult questions, and stand up for there best interest.

Georgia, I have also looked up scope of practice for CSTs in GA. It reads almost word for word as California CST. Only with advanced education/first assistant programs are the CSTs able to suture, place Instruments, cut tissue, or permanently alter tissue. I simply asked management to clarify and put in writing that the scrub Tech‘s are allowed to perform first assisting tasks without advanced education. I’m not just talking about holding retractors or maybe cauterizing tissue. I’m talking about making incisions and placing trochars in the abdomen. Apparently, legal would not put that in writing and risk management has addressed some of the issues that were taking place. I am the patient advocate and I wanted to make sure I was covered legally. Nowhere else I’ve ever worked was this an acceptable practice. I never made a formal complaint or wrote anyone up. I just asked for clarification in writing.

As a the circulating RN in an operating room, it is your duty to ask questions and voice any concerns you may have. You are the patient advocate. Once they go to sleep they cannot speak for themselves. They trust you as the nurse “the gate keeper” of the operating room to make sure they are safe. Yes, it is my job to know everyone’s scope of practice in the operating room!

I ?% agree. I have informed my manager that the CSTs are acting as first assist/RNFA/PA/NP with out the proper education and this is a legal liability. I do not work with certain scrub techs because they know I have spoken up about this issue. Management has done nothing to my knowledge besides me not working with those scrubs. Other RNs and staff have said, nothing will change and all you’re going to do is make it harder on yourself by pushing the issue.

I have been an RN in the OR for 16yrs. I was a surgical tech for 6 years while putting myself through nursing school. As a scrub tech at a teaching hospital, your scope of practice was cut and dry. I am now currently in school for my RNFA. About a year ago, I got married and moved. I now work at a much smaller hospital. 90% of the staff (CST & RN) have ONLY worked in that operating room. I find myself struggling with the CST/STs that practice outside of their scope. (Suturing, making incision, putting in ports, stapling across bowel) Just to mention a few things. I have spoken to the OR manager about the scope of practice for a CST/ST. I get no answers from them as to why the scrub techs are practicing as a first assist without proper training or credentialing. I have informed the manager these behaviors are still happening. The response I have gotten, “Under direct supervision of the surgeon“. Do the surgeons know that the scrubs are not qualified to execute these tasks? Or have they just done whatever they had to, to get through the surgeries? None of the CST/ST have first assist training. I know there is legal liability when staff are working out of there scope of practice. I have been there over a year and nothing has changed! The other RNs say you have to pick your battles and nothing is going to change because of poor management. Any suggestions???