Surgical Technologists Taking Over Nursing Roles?

BrianLee · Jan 29, 2009

In my area ST's are not utilized in the OR anymore. Only small towns it appears use them. We have one St left and when she retires we will hire no more. The legality of it all is really getting strong. Even though ST's are good at what they do some are not always that efficient and it is the RN's license on the line. We hire all the time and some love it some don't but again they are all nurses. New and long time workers.

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.

shodobe · Jan 30, 2009

In a perfect world, as it was once was, there were no scrub techs just RNs who knew how to do it all. I am fortunate enough to work with a total RN, except one token tech, staff who can do it all. As I have always said before, Techs are not necessary in the OR, except that mangement has decided this is a cost cutting notion. Every patient deserves the best care they can get and only an RN, IMHO can give this. Techs are here to stay and we have to live with them. I work with some very good techs and also some pretty subpar ones. There are a few RNs that have alot to be desired. If I had my way there would be no techs in an OR and thestaff would be all RNs. This won't happen. The problem with most ORs is that they hire Techs to scrub and RNs to circ, so the RN can't do without a Tech. Kind of pitiful! The one nice thing about this whole debate is, you can't run an OR without RNs but you can run it without Techs.

BrianLee · Jan 31, 2009

In a perfect world, as it was once was, there were no scrub techs just RNs who knew how to do it all. I am fortunate enough to work with a total RN, except one token tech, staff who can do it all. As I have always said before, Techs are not necessary in the OR, except that mangement has decided this is a cost cutting notion. Every patient deserves the best care they can get and only an RN, IMHO can give this. Techs are here to stay and we have to live with them. I work with some very good techs and also some pretty subpar ones. There are a few RNs that have alot to be desired. If I had my way there would be no techs in an OR and thestaff would be all RNs. This won't happen. The problem with most ORs is that they hire Techs to scrub and RNs to circ, so the RN can't do without a Tech. Kind of pitiful! The one nice thing about this whole debate is, you can't run an OR without RNs but you can run it without Techs.

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.

jdg0719 · Sep 1, 2010

Healthcare has gone a through a long trend of job titles. Get used to it. CRNAs now make up a long majority of Anesthesia Providers than Anesthesiologists compared to 20 years ago. In many states NPs are the Primary Care Providers, Orthopedic surgeons do less foot surgeries due to the growing field of Podiatry. Sorry to break to you folks, new fields and specialties are going to be growing in all areas of healthcare. Who would have ever guessed that “nurses” would be administering anesthetics, writing prescriptions, etc? People that say they would rather have an RN scrub over an ST (who has gone through specialty training and met competency requirements) would be like saying “I don’t want an advanced practice nurse giving me medicines without a doctor’s supervision since she didn’t go to medical school.” Yes, having an ST over an RN is cheaper just like going to an NP over an MD. Why don’t we focus more on the patient and less of our egos?

brian132 · Feb 21, 2011

Wow! some of you are really out there!

Whats wrong with you people? Do you think we're that stupid? Im a tech and I know you didnt get any education in nursing school for the OR. Everything you know about your job you learned on the job and admit, it some of what you learned was from a surg tech. As far as your "nursing" duties in the OR I dont know why you need a license to ask a patient his name and then spend the next four to seven hours doing data imput on the computer. And do you really dont think we can handle that? Please! Besides most of you are ASN's In the next few years no one will be hiring those anymore. Counting supervision? are you kidding? There are places where one RN supervises up to four rooms of techs both circ and scrubbing. What your really afraid of is losing your jobs.

TakeTwoAspirin, MSN, RN, APRN · Feb 21, 2011

Wow! some of you are really out there!
Whats wrong with you people? Do you think we're that stupid? Im a tech and I know you didnt get any education in nursing school for the OR. Everything you know about your job you learned on the job and admit, it some of what you learned was from a surg tech. As far as your "nursing" duties in the OR I dont know why you need a license to ask a patient his name and then spend the next four to seven hours doing data imput on the computer. And do you really dont think we can handle that? Please! Besides most of you are ASN's In the next few years no one will be hiring those anymore. Counting supervision? are you kidding? There are places where one RN supervises up to four rooms of techs both circ and scrubbing. What your really afraid of is losing your jobs.

I wouldn't dream of calling you stupid, but if you are going to start throwing out generalizations then I am sure you understand people will jump in and correct you.

Not all, but some nursing schools do have have clinicals in the OR. My school was one of them. I actually spend an entire 4 month semester in the OR while I was in NS. Many do not have this as a clinical, but you are wrong to state that this does not happen.

As far as most of "us" being ASN nurses, again, not entirely correct. According to the 2010 AORN survey the breakout for OR nursing is as follows:

Diploma nurses: 11.9%

Associate Degree nurses: 25.5%

BSN: 37.8%

BS in another field: 7.6%

MSN: 8.0%

Masters in another field: 6.9%

As far as being concerned about losing my job, if it ever happens that RNs are no longer needed in the OR (and I think we all know that that is never going to happen, even if it's painful to accept) I can work in practically any other department in a hospital, or even in private practice. Trust me, I'm not worried about losing my job.

And, before you jump on me for bashing techs, 1) I'm just putting some of the actual facts out there rather than generalizing my own perception of reality, and 2) I'm not just a BSN but a CST (with an AS in Surgical Technology) so I am speaking from many years of experience in the OR, both as a tech and a RN. Trust me, from someone who has been through both educational programs and had a career in both fields, by implying that nurses just don't do anything other than ask a couple of questions and then sit doing paperwork it is you that is putting down the other person. I can tell you from experience, you don't know what you don't know if you haven't walked a day in the other person's shoes you should refrain from making sweeping generalizations. Now, bash away!

CTORnurse · Feb 21, 2011

interesting posts..some of them unprofessional. I work in a BIG city , in a BIG hospital with 27 ORs and we have lots of STs and they are an invaluable member of the TEAM..yes, TEAM..something some of you are missing here. I do more than check Patients IDs and input computer work, I am the captain of the ship... I am not worried about my job in the OR( Ct. mandates that 1 RN is present per OR room)..and ,unlike a ST, I can get a job anywhere in the hospital. But, this shouldnt be the point here- I am ashamed at the attitude of some of the nurses who think that Sts aren't capable(they have had more training than I have). As for counts...every hospital has a policy and procedure to follow -regardless of who is on the team. My counting isint better than my partners (ST)

What makes an OR a bad place to work? the attitude that any of is better than the other. I respect all of my colleagues. Poor attitudes and better than you attitudes compromises patient safety. :nurse:

canesdukegirl, BSN, RN · Feb 22, 2011

wow! some of you are really out there!
whats wrong with you people? do you think we're that stupid? nobody is saying that anyone is stupid. let's not project. im a tech and i know you didnt get any education in nursing school for the or. you know this and will actually write this on a post without knowing what kind of training the nurses on this forum received in nursing school? as another poster stated, or rotations are offered in many nursing schools, and mine was focused on the or for an entire semester. everything you know about your job you learned on the job and admit, it some of what you learned was from a surg tech. again, this is a very sweeping generalization. not everything i know about my job came from on the job training. i honed my skills in the or as an employee, yes. and i had many wonderful sts help me learn. i am forever grateful to them for their skills and patience in teaching me in a focused manner. i continue to be grateful for the sts that i work with that know their stuff. it is a godsend. as far as your "nursing" duties in the or i dont know why you need a license to ask a patient his name and then spend the next four to seven hours doing data imput on the computer. ok, let's back up on that yellow brick road, dorothy! understand that the documentation that we must do while in a case is protecting the st's as well. everything that we do, every intervention and every implementation must be documented as if we are testifying in court. this "data input" is a legal record and unfortunately, only an rn can do this. believe me when i say that it is the bane of our existence and it is redundant and tedious. however, it is necessary in order to prove that we all did our jobs correctly. and do you really dont think we can handle that? i have no doubt that sts can handle it, but the laws that govern nurses prohibit anyone but an rn to document in the or setting. i would love for sts to document! please! besides most of you are asn's really? how do you know this? where is the research proving this point? in the next few years no one will be hiring those anymore. counting supervision? are you kidding? there are places where one rn supervises up to four rooms of techs both circ and scrubbing. can you clarify this statement? you mean that only one rn is circulating and documenting on 4 rooms at a time? i am unsure of what you mean, because as far as i know, only an rn can circulate. your statement read "of techs both circ and scrubbing." do you mean that an rn is supervising counts on a team consisting of a circ and a scrub? what your really afraid of is losing your jobs.

i don't know of too many or rns who are afraid of losing their jobs. i encourage you to think through such generalizations when debating points that are inflammatory to the reader. everyone loves a good debate, and that is encouraged on this site, however it would be wise to have facts that back your argument up instead of assumptions on the responsibilities of another team member's job and what those responsibilities entail.

Scrubby · Feb 22, 2011

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.

:lol2:

I seriously doubt anyone who just knows the scrub role would be able to challenge an experienced OR RN who can scrub and circulate. For starters a tech only understand how to scrub, they do not circulate and therefore do not have an understanding of the bigger picture. The best scrub nurses I've seen are the ones who are very good at circulating because they can anticipate from both sides of the table.

shodobe · Feb 26, 2011

I haven't been in on a debate for awhile, but any Tech who thinks they "might" just be signing my eval one day is really living in a dream world. When it comes down to who to lay off because staffing is an issue, it will be the Tech no matter how many years of experience they might have. Anyone with any management experience knows with contracts and state issues, only RNs have to be constantly present. You can run hospitals without a majority of people, pray this doesn't happen, but you CANNOT run the place without RNs. Anyone can pay a "tech" school for the education but that doesn't make them a necessity for an OR department. It still boils down to dollars, cheap labor! Nursing managers aren't always looking for the best for their department so when they are filling positions an ST is a nice option. The reason that most RNs don't look at the OR as an option is because there are so many other nursing areas to choose from. An ST "only" has one option and that is the OR. Simply one-sided and replaceable. No more IMHO!And, yes, I still have an "old" ego that longs for the days when techs were a nuisance and unnecessary. Hospitals simply do not want to train their "nre" RNs to scrub because of the cost. Why do that when you can call the local tech school and get one of their "fresh" off the assembly line models. Come on, this is an old issue that won't go away and even I have accepted it. I just want the techs out there to know that they won't be taking my job, or doing my eval or any of that silly stuff, or running departments or whatever. Remember we are all here to do a job for the patient and personality conflicts are a detriment to patient care. Can't we all just get along?

RNPinkShoes · Mar 5, 2011

I do understand both sides of the story.

I don't think that some scrub techs understand the big picture of what nurses are there for. We went to school specifically to study the care and monitoring of patients. We were trained in extensive anatomy and physiology, medicine, disease processes, and assessment. We learned to be patient advocates. We learned how to talk to patients and their families. We never really trained in ANY specific area of nursing during school. We were trained patient care across the board. After school we went on to the floor that we chose... and learned specific things pertaining to the floor we were on whether it was ICU, ER, or Operating Room.

As nurses in the operating room, we know everything about our patient, and are on constant awarenness of what may happen. Where I work we bring our patients back and talk with them... answer any questions, ease their nervers and are contantly assessing their status.

To be a good nurse you can't rely just on anesthesia to assess patient status. YOu have to be aware of what may happen and be able to jump in and know what is going on if something is wrong and anticipate what the patient may need.

Scrub techs go to school specifically for the operating room only... they are trained in the set up and safe handling of instruments. And yes, I agree, they were mainly hired because it is quick training and cost effective. They don't have much responsiblity when it comes to patient care... they are to be supervised by the RN and the RN is accountable for them.

That doesn't mean they don't have any value in the operating room. I may have came to the OR knowing patient care.... but running the OR, instruments, and procedures I learned mostly from scrub techs... THANK YOU

But that doesn't mean I don't agree that hospitals should hire all RN staff.... I guess I wouldn't mind it. I think they are pluses and minuses to each side.

I do believe, however, that all RNs should know how to scrub.... it should be required.... I think in order to supervise a scrub tech they need to know how to be one ) I have been an OR nurse for five years and fought my way into scrubbing... now I do it all the time... love it, love it, love it. It has made me a much better operating room nurse.

canesdukegirl, BSN, RN · Mar 5, 2011

I do understand both sides of the story.
I don't think that some scrub techs understand the big picture of what nurses are there for. We went to school specifically to study the care and monitoring of patients. We were trained in extensive anatomy and physiology, medicine, disease processes, and assessment. We learned to be patient advocates. We learned how to talk to patients and their families. We never really trained in ANY specific area of nursing during school. We were trained patient care across the board. After school we went on to the floor that we chose... and learned specific things pertaining to the floor we were on whether it was ICU, ER, or Operating Room.
As nurses in the operating room, we know everything about our patient, and are on constant awarenness of what may happen. Where I work we bring our patients back and talk with them... answer any questions, ease their nervers and are contantly assessing their status.
To be a good nurse you can't rely just on anesthesia to assess patient status. YOu have to be aware of what may happen and be able to jump in and know what is going on if something is wrong and anticipate what the patient may need.
Scrub techs go to school specifically for the operating room only... they are trained in the set up and safe handling of instruments. And yes, I agree, they were mainly hired because it is quick training and cost effective. They don't have much responsiblity when it comes to patient care... they are to be supervised by the RN and the RN is accountable for them.
That doesn't mean they don't have any value in the operating room. I may have came to the OR knowing patient care.... but running the OR, instruments, and procedures I learned mostly from scrub techs... THANK YOU
But that doesn't mean I don't agree that hospitals should hire all RN staff.... I guess I wouldn't mind it. I think they are pluses and minuses to each side.
I do believe, however, that all RNs should know how to scrub.... it should be required.... I think in order to supervise a scrub tech they need to know how to be one ) I have been an OR nurse for five years and fought my way into scrubbing... now I do it all the time... love it, love it, love it. It has made me a much better operating room nurse.

That was very nicely stated, Pink.