I am hoping that my future-fellow nurses will help me out here. I am writing a persuasive paper for my leadership class and want to persuade people that OR nurses should be trained to scrub. That it should be included in their orientation to the OR. The OR that I have been as an ST for the past 12 years does not include much, if any, scrubbing. The nurses may get one or two days and that is all. What I am looking for are your comments and opinions about why you, as a circulating nurse believe you should or should not be trained to scrub. Please also let me know if you are CNOR.
Thank you from a future OR nurse!! :balloons:
I appreciate so many great replies, but lets try not to slam the surg tech shall we? I have been a scrub tech for 15 years total, I have an associates degree, not a 9 month certificate. I am a Level III scrub tech. (We have a competency leveling system that determines the what we are able to do in the OR and also puts us at a higher pay scale.) I am a Laser Officer, I have been through a course in wound closure offered by our surgeons and the suture company. I serve as a preceptor for tech sturdents and new employees. When a new RN comes off orientation they always assign us together to help the room operate smoothly. The days that I am not assigned to scrub in a room, I will help with turnovers and starting cases. My RN's appreciate that I take the initiative to help position the patient, offer to do the prep, plug in equipment as the case gets started, etc. I could go on but won't. So let's remember the question and not slam the tech. Thanks. By the way it will be my many years of scrubbing that will make me an awesome OR nurse.
What does the initials "ADST" stand for? I have heard of ST, CST and just plain SA but not those. Education is nice but unless it is appropriate to the job you are doing it is meaningless. That said and all, it is still the responsibility of the "RN" to mix ALL drugs and unless I am mistaken it is NOT within your scope of practice to do this EVEN if the surgeon is standing right on top of you. I think you are the one who got off of the subject and made it quite plain that you felt superior to the RNs that were working with you. Sorry, that is just my perception.
I HAVE BEEN READING ALL OF THESE THREADS, I THINK IT IS ASSOCIATE IN SURGICAL TECHNOLOGY.
I AGREE WITH SHODOBE, TECHS HAVE THERE PLACE MOST OF THEM JUST DONT'T KNOW WHERE IT IS. I TO WORK WITH SOME REALLY GREAT TECHS, BUT THEY ALL TO OFTEN FORGET THAT THEY ARE BEING DIRECTLY SUPERVISED BY ME. I FILL ALOT OF DIFFERENT JOB ROLES, I SCRUB,CIRCULATE, FIRST ASSIST, AND HELP MANAGE 18 ORS,AND SOON TO BE 25. I HAVE BEEN A NURSE (RN) FOR 31 YEARS, AND HAVE WORKED IN THE OR ALL OF THESE. I AM A FIRM BELIEVER OF WORKING WITHIN YOUR SCOPE OF PRACTICE. IF FACILITIES ARE ALLOWING TECHS TO MIX AND ADMINISTER DRUGS THAN THEY ARE JUST AS RESPONSIBLE AS THESE DRS THE TECH IS TALKING ABOUT. EVERYBODY IS HELD ACCOUNTABLE. I VALUE MY LICENSE TO MUCH . IF I KNOWINGLY ALLOWED THIS I AM JUST AS RESPONSIBLE.
My own personal opinion... keep that in mind when u read this. I am a very open-minded person.. i take everyones opinions to heart and read them right, i hope anywayz...
When I start in the OR I will be the Scrub Tech. I will do my job as a Scrub take and only that. I will not circulate or anything like that because I do think that I will not be qualified. I agree with that! But when I do go back eventually and get my RN.. I will not complain about the ST UNLESS they just are complete uh, rude?!? I will never make anyone feel inferior to myself because I am a RN. I will help anyone that needs help and will surely ask questions if I need help. There is always something to learn in the medical field. My first priority is for the patient. That is why we are there, not to put someone down, not to make anyone feel 1/2 inches tall and not cause drama. (which all go into the same category) That is about all....
as a new rn in the or, i have to say quite definitively: rns must know the scrub role intimately. i agree with stevierae that listening and supporting the scrub is so important. you cannot possibly know what is necessary for the team if you have never scrubbed before. being in there, hands dirty, working fast, the order of a tie, using up floseal, etc. means you know what the next step in the process will require this, that, or the other thing.
i'm only just starting to get my organizational process down as a circulator. i'm begining my 8th month as an or nurse, and yesterday my scrub (who knew me back when i had just arrived in town) said to me, "you're so organized!" well, i do work hard. i do make sure there is blood available before a big liver case. i do know how to work the ultrasound...i actually studied the damn thing! (i'm such a techno-geek!) :chuckle
i want to be a contributing member of the team - it gives me supreme satisfaction to be knowledgeable and supportive to the team.
our preceptor program is considering a more stringent standard for the gns who come into the or, and one of those standards will be learning to scrub first. it's that important.
from what i've heard, the requirements for an rnfa are much more stringent than for a scrub/fa- anyone know if this is true??
last i heard, the rnfa has to have a bsn for certification. but i think taking a specific course for rnfa is the standard. i suppose it depends on how you wish to be compensated, independent or by hospital.
From what I've heard, the requirements for an RNFA are
much more stringent than for a scrub/FA- anyone know if this is true??[/QUOT
It is not hard to get into an accredited program for RNFA's although it should be.
Their prerequisites make it far to easy to get in. It takes years of experience of scrubbing cases,and first assisting to acquire the knowledge and expertise that every patient deserves. First you have to be licensed as a RN, have a min of 2 years in the OR, be certified( CNOR). When I went thru my program they told me that you had to demonstrate scrub proficiency in any area that you would be first assisting in. That was not a problem for me. I was taught from day one some 30 years ago how to scrub and circulate. I do believe it is important that nurses know how to scrub, some are just not cut out for this. Some can barely manage their circulating duties much less anything else. Most drs. that use a scrub/fa is because they are cheaper. The RNFA's are more marketable because they usually are independent. can bill the insurance co. for their services, the surgeons like it because they also can help with pt care pre, intra, and postop. rounds, drg changes, discharge...etc.
FYI, I am a full time employed OR nurse in a large trauma center, I do work privately, part time as a RNFA for one of the surgeons. I love it, I love my work. I also think that my patients deserve the very best.
last i heard, the rnfa has to have a bsn for certification. but i think taking a specific course for rnfa is the standard. i suppose it depends on how you wish to be compensated, independent or by hospital.
your are most certainly correct,but certification is not required to practice.
it is something that will be necessary one of these days, for the independent rnfa who needs to bill medicare/medicaid. some are privately employed and there physcians pay there salaries. pending legislation if passed will provide for third party reimbursment, and at present depending on where you are at (state)
most rnfa's are recognized by several insurance co. as healthcare providers.
enough said, if you have any questions, feel free to ask.
The purpose of orientating a RN to the scrub role is multifaceted, and none of it has to do with the Surgical Technologist. First in order to understand and function in a proactive vs. reactive role the RN must have a working knowledge of the principles of surgery. The circulator should be able to stand away from the field and understand what is going on during the case and anticipate the changing needs of the rest of the team. These principles are well-developed in theories of adult learning and organizational development. If surgery were scripted and never varied then the process would be well defined, but the surgical process has many variables, therefore only staff which has experienced many surgeries can be agile enough to make lemonade from lemons.
Another reason to have the RN able to scrub is purely a staffing issue. If all the staff in an OR are single role personnel, then the staffing becomes more complex. On the other hand, if a Surg Tech can scrub and first assist; and the RN can circulate, scrub and first assist the narrow avenues we put ourselves in become much wider and like constrictive.
By the way I am a CNOR, can scrub, circulate and first assist.
BL
I am hoping that my future-fellow nurses will help me out here. I am writing a persuasive paper for my leadership class and want to persuade people that OR nurses should be trained to scrub. That it should be included in their orientation to the OR. The OR that I have been as an ST for the past 12 years does not include much, if any, scrubbing. The nurses may get one or two days and that is all. What I am looking for are your comments and opinions about why you, as a circulating nurse believe you should or should not be trained to scrub. Please also let me know if you are CNOR.
Thank you from a future OR nurse!! :balloons:
I appreciate so many great replies, but lets try not to slam the surg tech shall we? I have been a scrub tech for 15 years total, I have an associates degree, not a 9 month certificate. I am a Level III scrub tech. (We have a competency leveling system that determines the what we are able to do in the OR and also puts us at a higher pay scale.) I am a Laser Officer, I have been through a course in wound closure offered by our surgeons and the suture company. I serve as a preceptor for tech sturdents and new employees. When a new RN comes off orientation they always assign us together to help the room operate smoothly. The days that I am not assigned to scrub in a room, I will help with turnovers and starting cases. My RN's appreciate that I take the initiative to help position the patient, offer to do the prep, plug in equipment as the case gets started, etc. I could go on but won't. So let's remember the question and not slam the tech. Thanks. By the way it will be my many years of scrubbing that will make me an awesome OR nurse.
callbabe
50 Posts
I HAVE BEEN READING ALL OF THESE THREADS, I THINK IT IS ASSOCIATE IN SURGICAL TECHNOLOGY.
I AGREE WITH SHODOBE, TECHS HAVE THERE PLACE MOST OF THEM JUST DONT'T KNOW WHERE IT IS. I TO WORK WITH SOME REALLY GREAT TECHS, BUT THEY ALL TO OFTEN FORGET THAT THEY ARE BEING DIRECTLY SUPERVISED BY ME. I FILL ALOT OF DIFFERENT JOB ROLES, I SCRUB,CIRCULATE, FIRST ASSIST, AND HELP MANAGE 18 ORS,AND SOON TO BE 25. I HAVE BEEN A NURSE (RN) FOR 31 YEARS, AND HAVE WORKED IN THE OR ALL OF THESE. I AM A FIRM BELIEVER OF WORKING WITHIN YOUR SCOPE OF PRACTICE. IF FACILITIES ARE ALLOWING TECHS TO MIX AND ADMINISTER DRUGS THAN THEY ARE JUST AS RESPONSIBLE AS THESE DRS THE TECH IS TALKING ABOUT. EVERYBODY IS HELD ACCOUNTABLE. I VALUE MY LICENSE TO MUCH . IF I KNOWINGLY ALLOWED THIS I AM JUST AS RESPONSIBLE.
WHICH I WOULD NEVER DO. ENOUGH SAID.