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Discussion

Will circulators be RNs in the future?

Just wanted peoples feedback. With the nursing shortage predictions getting worse over the next ten years what are people's feelings about the thought that RN circulators may be replaced by unlicensed personnel. Does anyone know AORN stand on this? Do people see something like this happening in the future? What is it about the circulator's job that requires an RN license?

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The circulator role requires a licensed person because there are assessments that the nurse carries out pre-op and in the room,there are positioning issues, medication that get distributed onto the sterile field and the R.N. is first and foremost the patient's advocate. I know that AORN would fight the idea that circulator's don't have to be R.N.'s and with good reason. I am an OR tech and I know that techs vary with the amount of training and education they receive. There are those of us who have a college degree in Surgical Technology and are certified, but there are others who have very little in the way of education or training. I think this hurts the profession as a whole,and it's one of the main reasons that I am in nursing school. Techs unfortunately don't get paid well and I got tired of not only showing certain R.N.'s how to scrub but how to do their job as well(new grads, etc). I wouldn't want to circulate( as a tech )anyway-it's a lot of responsibility and most techs get crappy pay. I kick myself because I should have gone to Nursing school earlier.:crying2:

what are people's feelings about the thought that RN circulators may be replaced by unlicensed personnel. Does anyone know AORN stand on this?

The circulator should always be an RN.

As for the AORN stand, it wouldn't fly, they've made their opinion quite clear on anything that's less than an RN, no matter what the role.:uhoh3:

The circulator role requires a licensed person because there are assessments that the nurse carries out pre-op and in the room,there are positioning issues, medication that get distributed onto the sterile field and the R.N. is first and foremost the patient's advocate. I know that AORN would fight the idea that circulator's don't have to be R.N.'s and with good reason. I am an OR tech and I know that techs vary with the amount of training and education they receive. There are those of us who have a college degree in Surgical Technology and are certified, but there are others who have very little in the way of education or training. I think this hurts the profession as a whole,and it's one of the main reasons that I am in nursing school. Techs unfortunately don't get paid well and I got tired of not only showing certain R.N.'s how to scrub but how to do their job as well(new grads, etc). I wouldn't want to circulate( as a tech )anyway-it's a lot of responsibility and most techs get crappy pay. I kick myself because I should have gone to Nursing school earlier.:crying2:

For the record, AORN is and has been adamant that the circulator be a RN. They feel so strongly about this that they have been instrumental in a couple of states (Texas is one of them) passing bills that the circulator in every OR room be a RN.

There should be an RN in every OR room. If it's not the circulator then there won't be one at all. Nursing training brings a totally different skillset and knowledge base than medical school or surg tech school. I think it's to the patient's benefit that an RN be in the room.

we discussed this at length at our last aorn chapter meeting. there are 25 states that do not have a law requiring an rn as circulator in each or room. hopefully, after some letter-writing campaigns, we'll get that changed. it's not about money or job security - with the shortage, we all have job security - it's about patient safety.

:rolleyes: just a thought why does the circulator have to be a rn? why can't an lpn circulate. i cannot think of anything done in the circulator role that would be out of their scope of practice. Certainly they are licensed nurses as well. And its not like we ever get to start ivs or give drugs in the or. In fact at my institutio paperwork is such abig focus thats all they seem to care about.Just wondering

" i cannot think of anything done in the circulator role that would be out of their scope of practice. "

It depends on the state rules. Some states have plenty that LPNs aren't permitted to do.

And I would appreciate it, if just once, in this section of the forum, when other people answer why someone other than an RN can't circulate, that they don't take it as an opportunity to insult and degrade other positions in the OR, like past discussions have.

California law requires that the circulator be an RN. This will not change. I know many OR techs think circulating can be done by anyone. They just don't know what RN's really do! As a former OR tech, it was not until nursing school that I found out how little I really knew. Memorizing instruments and surgical procedures is such a tiny part of OR nursing.

I would never want that responsibility!!!!!! Within my scope of practice or not , Im not qualified at all for that...:eek: Truth being there are some IV drugs LVN's cannot push and you wouldnt want any limitations when you are in the OR...

:rolleyes: just a thought why does the circulator have to be a rn? why can't an lpn circulate. i cannot think of anything done in the circulator role that would be out of their scope of practice. Certainly they are licensed nurses as well. And its not like we ever get to start ivs or give drugs in the or. In fact at my institutio paperwork is such abig focus thats all they seem to care about.Just wondering
  • Experts

There are actually many times when the RN will need to start an IV in the OR. If anesthesia is having issues with the patient, and they need another line, or you are doing a case that there is no anesthesia person in the room, and they do come up.

Even with peds cases, anesthesia will be maksing the child, and the circulator will start the IV.

The RN is also responsible for doing the assessment on the patient, and this is an RN skill as per the BON. An assessment by an LPN would need to be signed off by an RN.

I'm a Circulating RN in the OR and we start IV's quite frequently. Especially in pediatric cases where anethesia is masking the patient. We also may start them if two IV's are necessary, anethesia starting one on one side and us starting one on the other.

We almost always have an OR Tech in the room with us as 2nd circulator. They are wonderful. The knowledge that they have regarding anticipation of the scrubs needs is greatly needed. However, any of my techs will admit that they do not have the education to do assessments or notice if there is a problem going on. They have the basic education which focused mainly on the anatomy of the body and the instruments they'll scrub with. With the exception of a scrub who was a previous CNA, they don't understand many disease processes, effects of medication, F&E balances, ect. I think these are really important things for the circulator to understand.

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