Unlicensed surgery tech working under my RN licence?

[philip8614]

Hi,

I have just graduated nursing school and am busy studying for my boards but I recently interviewed at an outpatient surgery center in town for a circulating RN position in their OR. It sounds like a good position but they are asking that their 2 surgery techs are to "work under my licence" and they are "trained but not licensed". I told my GF (long time OB nurse) and she is thinking there might be some issues regarding liability especially because I am not trained in the area and the whole thing seems strange. Any thoughts about this?

I would like to take the position but not at the risk of jeopardizing my licence.

OR staff include; surgeon, CRNA, 2 surgery techs, one circulating nurse. Oregon

[JustBeachyNurse, LPN]

No one can work "under your license" but you in any state . However to proficiently delegate to unlicensed assistive personnel you need to understand the position responsibilities of both the UAP & nursing staff, be reasonably knowledgable about the tech's level of training and proficiency at the task delegated as well as any BoN guidelines for delegation.

Most surgical technicians are not licensed they may be trained in house or have a surgical tech certification.

[JustBeachyNurse, LPN]

Delegation to UAP info:

Delegating without doubts - American Nurse Today

https://www.ncsbn.org/Delegation_joint_statement_NCSBN-ANA.pdf

[TheCommuter, BSN, RN]

Thread has been moved to our Operating Room Nursing forum to increase the number of responses from nurses who work in this specialty area. Good luck to you.

[Argo]

You are just graduating, have never been in an OR and they are trying to get you to work straight into an OR that has zero ability to train with another nurse? Sounds like your asking to get into trouble. IF you were a scrub prior i could understand this move but, given the fact that you posted this in a gereral forum to start and the content of your post, I doubt that is the case.

The biggest problem is that you wont know what you dont know, I am sure that is why they want someone that has no clue, it is probably an unsafe environment and cant keep someone that does know.

[springchick1, ADN, RN]

You are just graduating, have never been in an OR and they are trying to get you to work straight into an OR that has zero ability to train with another nurse?

The biggest problem is that you wont know what you dont know, I am sure that is why they want someone that has no clue, it is probably an unsafe environment and cant keep someone that does know.

OP never said they wouldn't be able to train her. I think what Beachy said is right. They won't be working under your license, you will just be responsible for delegating. Experienced scrubs are a huge asset to have!

[WhoDatWhoDare, BSN, RN]

In my experience, the surgical techs I have worked with do not perform any actions that would endanger my RN license... They don't administer meds, don't perform incisions, don't start IV's, don't start foleys, don't inject local, etc. unless they are also Surgical First Assists, and in that case they are working under the surgeon, not the RN. I could be wrong, but it the potential new employer you interviewed with is indicating they would be under your license, i would wonder if the surgical techs are working outside their scope of practice. I would ask for clarification on this point before you decide whether you accept the position if said position is offered.

[offlabel]

With rural critical access hospitals, this type of thing is the tip of the ice burg. A little off the original intent of the thread, but these types of places are not really for new grads if they can be avoided. Having practiced in this setting, I'm very aware that it's not uncommon for even the surgeon to get out of his depth with regard to what the facility is actually capable of managing.

[Texan girl]

No such thing as someone working under your licence. It sounds like these techs have no qualifications whatsoever so to ensure that in the event of an adverse incident the clinic is covered by throwing you under the bus as the only qualified certified nurse there. THe hope is that you will just let both of them do the job while you learn. The bigger hope is that they do not screw up. If they do your licence is on the line........................... good luck

[Izaak]

From the Association of Surgical Technologists

[Texan girl]

I was once in very similar situation. Went to interview in another country for the position of RN OR. The interviewer told me I would be the only qualified nurse in the OR, and my staff would be orderlies......... yes orderlies would scrub, and maybe circulate but I would be overseeing the lot of them. I ran for the hills

[11blade, RN]

Izaak ( 7 years experience...at what, exactly) has posted a statement from the AST. Nice, but the original poster of this thread noted that the people she would work with would be 'experienced' but not 'licensed'.

I have worked with licensed and unlicensed operating room techs in my career. I much prefer to work with a tech who has been through a formal program, and, who did the extra step of obtaining a certification. In traveling work around the country I have found many less techs without certification grandfathered in the states that now require certification. There are still places that will train their own techs in states that don't require certification. The problem comes when you have the 2nd or 3rd generation of these, who only know how to do something 'because so and so taught me this way'....no critical thinking skills, limited understanding of sterile technique, etc..

And back to the AST position-they may 'believe' they do not practice the circulating RN in the room, state law and hospital policies say otherwise.