BrianLee

Hrrmmm,,, did you just say that the cake is what the Surg Tech contributes to the equation? That you are the icing on the cake? With that logic is seems that the Scrub is building the house and the Circ is decorating it... Hrmm,,, just kidding by the way.

Also remember... some hospitals have Scrub Techs as circulators and circulators overseeing three rooms.

I understand where you are coming from,, but if you look up the definition of a nurse, you will find that more people are nurses than you may have previously figured. However, a Registered Nurse is quite a different thing. Nurse 1. somebody caring for patients: somebody trained to look after sick or injured people, especially somebody who works in a hospital or clinic, administering the care and treatment that a doctor prescribes

I find that many people in the OR in general are bossy, even the secretaries, equipment techs and Nurses Aides can be... it seems you have to have a strong personality to survive in the OR. In regards to your other comment. Any good scrub tech is also thinking about just as much as any good nurse. You might have to be dealing with 6 different people, this is true,,,, but the Scrub is dealing with the Surgeon,,, who in my opinion taks much greater presidence over any stressfull conversation that may be had between you and a floor nurse. Not to mention the Surgeon in general is way mor demanding. Oh,, and if we are going by numbers.... the Scrub is paying attention to the Surgeon, Assistant, Circulator, Anesthesia, Perfusionist and well,,, the patient... seems like those numbers are pretty even to me. God,, I wish we could just appreciate and respect each other.

The same could be said about being a Circulator that doesnt have a CST that is up to snuff. BTW, every scrub tech and nurse in the OR has worked with someone that was lazy and not up to snuff.

I would love it if the Nurses in the USA had this opportunity!

I love scrubbing too! I find it is a great break from the paperwork and politics of nursing. I def do not agree with the scrub tech you work with. I would never and never have referred to the RN's role as "easy",,,, unless I was obviously joking. I have always felt and stated that RNs in the OR schould be versatile as circs and scrubs. How are you suppose to be the "Patient Advocate" if you have very little idea of what is actually going on at the field? Please do not let one or a few CST's badmouthing speak for the majority of us. I will try to do the same in respect to nurses that bad mouth my techs.

I agree. Knowing both roles does lead to being a better OR Nurse. Thats why I advocate nurses taking a formal Srug Tech class and hopefully the Scrubs will do on to be nurses some day too. That would be great. I do admitt that there are some cases that can be very routine and slow,,, but the same can be said for circulating those cases. But to elaborate on what you just said about many of the cases being so routine that they could be done with eyes closed.... I am curious, with your high opinion of an all nursing staff and low opinion of scrubs, dosent it seem to be a waist of Nursing staff to scrub cases then if it is soo mind numbing? Again, I do not like the inference that scrubbing most cases are mind numbing and boring. I happen to think that scrubbing is one of the more exciting things that I get to do with my job.

The situation that you speak of is very very similair to the OR that I work in. At my OR however, the RNs that are proficient scrubs are assigned to both roles with regularity. It is unfortunate that the Nruses that want to learn do not have the opportunity at the hospital where you work because of staffing constraints. However, they do have an opinion if they are truly that interested in learning how to scrub and in turn increase their likelihood that they will get to scrub....... they can go to Surgical Technology school and formally learn how to do the job that they are interested in filling. You would have to do the same if you were interested being a Nurse. I had to do the same to get my CFA.

FYI, After three months of being a Registered Nurse with 13 years of Surgical Tech background, not only was I given a position but I was also offered and then accepted a positon as General, Vascular and Thoracic Surgical Charge Nurse. We are both entitled to our opinions. And I too will not change mine. Surgical Techs are a integral team member in the Operating room and deserve to be treated with respect as the professionals that they are. At my hospital we hire CST's because they are trained specifically for their job role..... not because we are desperate. As a nurse with scrub skills I have plenty of opportunity to scrub cases. The Nurses that I work with are welcome to scrub as well, so long as they have the proper training and they can competently cover he scrubbed role. I appreciate and commend you on your great ferver. However, in the USA most of the OR's have developed a great deal of respect for the CST's whom we work with. Your opinion of them as a fill in during desperate times is insulting to someone like me.

I was taught to save the hair for several reasons. For funeral and hair piece purposes, religious and personal preferences, sentimental reasons. I am aware that there are several religions which put spiritual significance on the burial or burning of hair that has been shaved. I have even heard of patients requesting other products of surgical intervention, like the torn and destryed clothes they were wearing during a trauma, removed orthopedic implants, gallstones, organs, ect. But to my knowledge they need to go through a bunch of red tape with the Pathology department for requests like that.

Thank you for your response. You have proven my points with every sentence that you typed. While there is no question that the RN is the ST's superior in sense of the definition which concerns rank and station..... it is not always the case that they are superior in the sense of the definition which concerns grade and quality. And Vice Versa, every team member, ST, RN, ect can take something from this point. Now you on the other hand embody another form of the definition, which describes a person whom feels he is better than or above someone simply as a result of rank. Look up the definion and see which one suits you best. There is a remarkable resemblance to a few obtuse Surgeons I have worked with in the past. I have often offered to my peers the idea that " A lion dose not have to roar for everyone to know he is the King of the Jungle". If one is superior in quality and merit, one does not have to "act out" or "demonstrate" his/her superiority. That quality is obvious upon inspection of his work ethic. It must be very frustrating to be in a position of a Superior when one does not present adequate knowledge, communication and leadership skills to capture the respect of the team without resorting to tactics like " Becuase I said so!" Regarding your comments on the present and future roles of Surgical Technologists...... below, I have quoted a report from the Fl State Senate which details the role of surgical personel. I have also included a link for your benefit should you choose to educate yourself on the facts instead of letting your emotions demonstrate your ignorance. You stated that ST's would never, blah blah blah, ect ect... If I were you, I would ,,,well,,, never say never. I personally, see the benefits of the flexibility that it would provide considering the Nursing shortages we have been enduring, but have a GREAT appreciation for the essential importance of a RN presence and hope that we are able to maintain that level and build upon that which we are functioning at now. http://www.flsenate.gov/data/session/2006/House/bills/analysis/pdf/h0483a.HCR.pdf "State Regulations State governments regulate all occupations and professions, and it is within the power of state governments to ensure patient safety through the regulation of occupations. 15 According to a report by the Association of periOperative Registered Nurses (AORN): 20 states require RNs to circulate, 37 states require RNs to supervise in the OR but do not specifically mention the role of circulating nurse, 8 states explicitly follow Health Care Financing Administration’s conditions of participation for surgical services, and 7 states have no specific staffing requirements. Currently, Florida is one of seven states that have no nurse staffing requirements for hospital operating rooms (ORs). The other states are Georgia, Louisiana, Maryland, Ohio, Washington, and West Virginia. Of the 20 states that require an RN to circulate, California, Idaho, Maine, and Nevada require adequate staffing so that each RN does not circulate for more than one operating room. Hawaii, Oklahoma, Utah, and Wyoming mandate that licensed practical nurses (LPNs) and surgical technologists cannot function as the circulating nurse in the operating room. In Indiana, Nebraska, New Mexico, and Wisconsin, LPNs and surgical technologists may function as assistants under the direct supervision of a qualified RN. 16 The eight states (i.e., Alabama, Indiana, Iowa, Massachusetts, Montana, North Dakota, New York, and Texas) that explicitly follow Health Care Financing Administration rule governing surgical services also mandate that LPNs and surgical technologists may assist in circulatory duties under the direct supervision of a qualified RN, who is immediately available to respond to emergencies." For the record, I have not once said anything negative about Nurses as a whole, I simply have my reservations about those like yourself, whom are drunk with POWER! Anyways, thats my 300099487790434 cents worth! - be the change!

shodobe, i respect that you have a right to your opinion. although, i couldn't disagree more concerning your assessment of the value of the surgical technologist. oh, and if you are interested in learning about the differences in roles between a certified surgical technician and a certified first assistant i encourage you to visit the national board of surgical technology and surgical assisting (nbstsa) @ "lcc-st.org". if your idea of first assisting is solely based on whether or not someone has the ability and capability to sew in a drain, then i am lead to believe that your practice as a first assistant was very limited and lacking formal training. sewing in a drain is not even the beginning of it. a good first assistant will benefit the surgical team and the patient in countless ways. what i was implying when mentioning the "double doors" in the operating room was that some of the nurses in this blog have egos, that in my humble opinion, have swollen to a point that which only the use of a pair of double doors would permit access.

Maybe you should talk to Scrubby. She has the idea that this sort of thing dosnt happen in Australia.

Im sorry to hear that as a result of the Nursing shortage you have not had the opportunity to scrub. I know how rewarding scrubbing is and I hate to see someone deprived of the opportunity. ((HUGS))

scrubby, i was, of course basing my responses based upon the nursing profession in the united states of america, not australia. i never professed to know how healthcare in a country on the opposite side of the world functions. each country obviously has very different situations and solutions to those situations. btw, in the usa we have iv team nurses (jelco nurses) too. a phlebotomist, is as i stated, is a allied health professional that draws blood for lab work. everything i stated to you refers to healthcare in the usa not australia. so, when you stated i was 100% wrong, well actually it was you who was 100% confusing the perspective of my comment.- brian lee

IMHO? There is nothing humble about your opinion. Obviously, the field of Surgical Technology is a positive influence because it has flourished and patients have benefited from their skills. If it provided inferior patient care it would not be so successful. It must really burn you up that a "lowly" Scrub Tech can replace you at the sterile field and likely surpass you for that matter. If I could I would challenge you to a Scrub Off. If I had it my way, Nurses entering the OR would have to take a Surgical Technology course before they could be considered for a position in the Operating Room. Atleast that way they would have to be held up to at least the same standard of surgical training as Scrub Techs whom are trained SPECIFICALLY to work in the Operating Room. The one nice thing about the debate from my end is that Nurses whom share your point of view will be extinct in the OR a decade from now and they will be replaced with RN's that are more concerned with the cohesiveness and effectiveness of the surgical team than their glory days and ego's. There are new Generations of Surgical Nurses evolving... Many who have had 5 or 10 years of experience as Surgical Technologists. Oh,,, Now I see whats got you so worked up. Someday some Scrub Tech you though was inadequate might be signing your annual evaluation.

it's too late. your jobs have all ready been taken over by non nursing staff. your career in the management and delegation of these trained professionals has, however, advanced. have you considered how much of a floor nurses job is done by ancillary staff like phlebotomists, pct's, pt's, rt's, environmental services, ect, ect, ect. i'm sure some nurse way back when probably said, "the last thing i want to see happen to my country is see some non nursing trained staff member drawl blood on my patients." now, i am confident that they are happy to see they staff because they are so over loaded. in my opinion the best way to protect one's job security is furthering the advancement of your professions training, not stifling that of another. rn's are not excluded from evolving with the times and adjusting to meet the new needs of the patient and community. rn's are still being trained to scrub, but they have to want it and seek that training like any person who has a career goal. they don't just give it to you because you have a rn on your badge. if there were more interest in the field of nursing and nurses in general did not have a history of eating their young there would not be as much of a need for unlicensed personnel as there is in today’s climate. i have yet to meet a nurse, who excelled in his/her position as a circulator, that has not had the opportunity to learn to scrub. rn's are not trained in school to fully understand even the basics of working in the operating room, that is why it is so important to seek out a quality surgical internship. one with surgical scrubbing included if possible. personally, i think it is incredibly important for a nurse to be competent and able to perform the scrub role. the rn is the patients’ primary advocate, a role that is hard to fill if he/she does not know what is going on. many circulators that are trying to delegate orders to the surg. tech's do not have the experience to understand the basics of what they are doing let alone the instrumentation. many of the best circulators were initially trained as surg. techs. so, i can understand why some in the nursing profession would be intimidated. furthermore, if that skill is so important to someone, perhaps they should consider a surg. tech program where they teach you the specifics of the art of surgical technology. i'm sure after careful thought you can think of a list of other things that are higher up on the priority list of what you wouldn't want to happen in your country than this. perhaps the fact that if the nursing crisis keeps heading where it is forecasted that someday you may be supervising two or three o.r. rooms staffed entirely by non nursing trained staff. similar to how floor nursing has become. so, encourage others to attend nursing school, encourage those talented trained staff members to further their education. we need more nurses, but until that happens we need to learn to work with and appreciate each other. be thankful that you have this auxiliary staff instead of resentful. it is a load that the nursing profession itself can not carry on its own.

Protect your jobs from what exactly? It's a good thing that O.R.'s come equipped with double doors.

Every O.R. I have worked in the last decade uses Surgical Technologist as their primary scrubbed team member.

Most of the Urologist I work with say not to inflate the balloon because of the ribs irritating the urethra. I can understand and appreciate that opinion. The thing is that you are not only testing the balloon to ensure that it does not have a leak...... you are also testing it to ensure that it deflates. If the balloon has a leak it will just fall out, true, but if for some reason it does not deflate, you have to get a Urologist to come in and deflate it by use of a scope and urethratome. Back in the day, some nurses would just take some mayo scissors and cut the hub to let the foley down and they found that sometimes this actualy would not work and instead keep the foley from deflating. I have seen this happen... no doubt.

We do the same where I am at. Unless it is absolutely impossible we will read it. In fact, one time, on a multi-procedure case, (crani, tib/fib, and closed humerus) someone in the E.R. splinted the wrong arm and it was the consent discreprancy which alerted us to double check the x-rays. It saved the patient and us from a serious problem.

Not all Nurses are able to scrub as well as Circulate. Many of the O.R. Nurses I have known througout the years barely know how to put on a gown without contaminating themselves let alone scrub a case on their own. As far as efficiency and turnover goes, that is very dependant on the individual RN and CST. There are just as many RN's as CST's that are proficient at dragging their feet esp. around shift change.

i have been a certified surgical technologist and certified first assistant for over 13 years. i am now finishing up my last term in nursing school with honors and plan to return to my home, the operating room. eventually, it is my goal to get some experience on a tele or med/surg floor. in the years that i have spent in the o.r., i have always had a great respect and cohesiveness with the nurses in my unit, barring the occasional rude and condescending one. it was incredibly ignorant and disrespectful for the surg. tech and surgeon to have made the comments that they did. it is also however, equally disrespectful for those of you whom have chosen to use it as an excuse to belittle and subjugate the value of the surgical technology profession as a whole. without reservation, i can state that i have learned as much about patient care from the nurses as they have learned from me. in fact, almost every nurse that i have known in those years has learned to scrub in on cases and become proficient as a result of a surgical technologist that has graciously shared those skills. this sort of dialog is hurtful and back-biting to the entire surgical team. for any of us to say that we would be better off without the other is ignorant and obtuse. i guarantee that if you sat down a surg. tech and a nurse with identical o.r. years of experience and challenged them to pass the others exam… that they each would have a difficult time at it. i suggest that instead of making broad statements about the entire profession because of a few ignorant individuals. perhaps take an assessment of all the good experiences that you have had as well. you, rn, are not the only one doing the counting and so called saving the surgeons behind. you are not the only one, preparing and planning ahead to assure that the case goes smoothly and that patient safety is ensured. you are not the only one subject to the ignorant remarks of small minds. have you considered the disrespectful things that are said from your side of the sterile field? i have heard on many occasions an rn say, “oh, he’s just a scrub tech.” oh, and using your licensure as a tool to disrespect the cst and pct’s is no different from some of the dr’s so many of you complain about. let’s practice what we preach. since i have been on the floor, i have heard on several occasions floor nurses stating that o.r. nurses aren’t “real” nurses. each and every time i have politely put them in their place by demonstrating the skills and incite that i have learned by way of working side by side with circulating nurses in the o.r. i have different and enlightened perspective coming from a surg. tech background. i wish we could all treat each other with the same respect and compassion we hope to deliver to our patients.