Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients in a variety of settings. Surgical technologists work under medical supervision to facilitate the safe and effective conduct of invasive surgical procedures. Surgical technologists work under the supervision of a nurse or surgeon to ensure that the operating room or environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures.[1]
Employment of surgical technologists is expected to grow much faster than the average for all occupations. Job opportunities will be best for technologists who are certified. In fact, according to the Bureau for Labor Statistics,[2] employment of surgical technologists is expected to grow 24 percent between 2006 and 2016, much faster than the average for all occupations, as the volume of surgeries increases. The number of surgical procedures is expected to rise as the population grows and ages. Older people, including the baby boom generation, who generally require more surgical procedures, will account for a larger portion of the general population. In addition, technological advances, such as fiber optics and laser technology, will permit an increasing number of new surgical procedures to be performed and also will allow surgical technologists to assist with a greater number of procedures.[2]
Surgical technologists held about 86,690 jobs in 2006. About 75 percent of jobs for surgical technologists were in hospitals, mainly in operating and delivery rooms. Other jobs were in offices of physicians or dentists who perform outpatient surgery and in outpatient care centers, including ambulatory surgery centers. A few technologists, known as private scrubs, are employed directly by surgeons who have special surgical teams, like those for liver transplants.[2]
[edit] History
The role of the Surgical Technologist began on the battlefields in World War I and World War II when the Army used "Medics" to work under the direct supervision of the Surgeon. Concurrently, medical "Corpsman" were used in the Navy aboard combat ships. Nurses were not allowed on the battlefield or aboard combat ships at the time. This led to a new profession within the military called Operating Room Technicians (ORTs).
On the home front they were all going overseas or performing duties in military hospitals. An accelerated nursing program with emphasis only on operating room technology was set up as an on-the-job training of nursing assistants who worked in the surgery department. These individuals studied sterilization of instruments and how to care for the patient in the operating room. Techniques, sutures, draping and instrumentation were emphasized; they also had to do clinical time in labor and delivery and the Emergency Room.
After the Korean War there were shortages of operating room nurses. Operating room supervisors began to recruit ex-medics and ex-corpsmen to work in civilian hospitals. These ex-military men functioned as circulators in the operating room while the scrub role or “instrument nurse” role was performed by the Registered Nurse. It wasn’t until 1965 that these roles were reversed.
In 1967 the Association of periOperative Registered Nurses (AORN) published a book titled Teaching the Operating Room Technician. In 1968 the AORN Board of Directors created the Association of Operation Room Technicians (AORT). The AORT formed two committees in 1969, The Liaison Council on Certification for the Surgical Technologist or LCC-ST (now known as the National Board of Surgical Technology and Surgical Assisting or NBSTSA) and the Joint Committee on Education. The first certification examination was given in 1970, and those that passed the certification examination were given a new title: Certified Operating Room Technician (CORT).
In 1973 AORT became independent of AORN and changed the title of the position to what it is today, Surgical Technologist. The AORT also changed their name to the Association of Surgical Technologists (AST). In 1974 an accreditation body was needed to ensure quality education of the ORT. The programs accredited by ARC/STSA (Accreditation Review Committee for Surgical Technology and Surgical Assisting) (formerly ARC-ST)are monitored for compliance with the standards. The ARC/STSA and AST board of directors recommends the Associates Degree as entry level surgical technology education.
AST has worked diligently since 1973 to promote excellence in surgical technology profession. Today Surgical Technologists taking and passing the national certification examination designed by the National Board of Surgical Technologists and Surgical Assistants (NBSTSA)earn the title of Certified Surgical Technologist (CST).[1] Certification can be renewed by contact hours or re-examination.
The following description of the surgical technologist has been approved by the American College of Surgeons[3] and the Association of Surgical Technologists:[1]
Scrub Surgical Technologist
The scrub surgical technologist handles the instruments, supplies, and equipment necessary during the surgical procedure. He/she has an understanding of the procedure being performed and anticipates the needs of the surgeon. He/she has the necessary knowledge and ability to ensure quality patient care during the operative procedure and is constantly on vigil for maintenance of the sterile field. Duties are as follows:
- Checks supplies and equipment needed for surgical procedure
- Scrubs, gowns, and gloves
- Sets up sterile table with instruments, supplies, equipment, and medications/solutions needed for procedure
- Performs appropriate counts with circulator prior to the operation and before incision is closed
- Gowns and gloves surgeon and assistants
- Helps in draping sterile field
- Passes instruments, etc., to surgeon during procedure
- Maintains highest standard of sterile technique during procedure
- Prepares sterile dressings
- Cleans and prepares instruments for terminal sterilization
- Assists other members of team with terminal cleaning of room
- Assists in prepping room for the next patient
Circulating Surgical Technologist
The surgical technologist assisting in circulating obtains additional instruments, supplies, and equipment necessary while the surgical procedure is in progress. He/she monitors conditions in the operating room and constantly assesses the needs of the patient and surgical team. Duties are as follows:
- Obtains appropriate sterile and unsterile items needed for procedure
- Opens sterile supplies
- Checks patient’s chart, identifies patient, verifies surgery to be performed with consent forms, and brings patient to assigned operating room
- Transfers patient to operating room table
- Assesses comfort and safety measures and provides verbal and tactile reassurance to the patient
- Assists anesthesia personnel
- Positions patient, using appropriate equipment
- Applies electrosurgical grounding pads, tourniquets, monitors, etc., before procedure begins
- Prepares the patient’s skin prior to draping by surgical team
- Performs appropriate counts with scrub person prior to the operation and before incision is closed
- Anticipates additional supplies needed during the procedure
- Keeps accurate records throughout the procedure
- Properly cares for specimens
- Secures dressings after incision closure
- Helps transport patient to recovery room
- Assists in cleaning of room and preparing for next patient
Second Assisting Technologist
The second assisting surgical technologist assists the surgeon and/or first assistant during the operative procedure by carrying out technical tasks other than cutting, clamping, and suturing of tissue. This role is distinct from that of the first assistant and may, in some circumstances, be performed at the same time as the scrub role. Duties include but are not exclusive to the following:
- Holds retractors or instruments as directed by the surgeon
- Sponges or suctions operative site
- Applies electrocautery to clamps on bleeders
- Cuts suture material as directed by the surgeon
- Connects drains to suction apparatus
- Applies dressings to closed wound
[edit] Training and certification
Educationally, surgical technologists graduate from surgical technology programs accredited through CAAHEP which relies on information on a program gathered by a collaborative effort of AST[1] and ACS,[4] by CAAHEP.[5] CAAHEP is a recognized accreditation agency of the Council for Higher Education Accreditation (CHEA).[6] In addition, surgical technology programs are located in educational institutions that are institutionally accredited by agencies recognized by the United States Department of Education (USDE) or The Joint Commission. The ARC/STSA is also a member of the Association of Specialized and Professional Accreditors (ASPA).
The following statement was developed by the American College of Surgeons’ Committee on Perioperative Care, and approved by the ACS Board of Regents at its June 2005 meeting. This statement was subsequently approved by the Association of Surgical Technologists, American Society of Anesthesiologists, American Association of Surgical Physician Assistants, American Association of Nurse Anesthetists, and American Society of PeriAnesthesia Nurses.
Surgical technologists are individuals with specialized education who function as members of the surgical team in the role of scrub person. With additional education and training, some surgical technologists function in the role of surgical first assistant. Surgical technology programs are inspected by the Accreditation Review Committee on Education in Surgical Technology—a collaborative effort of the Association of Surgical Technologists and the American College of Surgeons, under the auspices of the Commission on Accreditation of Allied Health Education Programs.[5] Accredited programs provide both didactic education and supervised clinical experience based on a core curriculum for surgical technology.
Accredited programs may be offered in community and junior colleges, vocational and technical schools, the military, universities, and structured hospital programs in surgical technology. The accredited programs vary from nine to 15 months for a diploma or certificate to two years for an associates degree, which is the preferred entry level.
Graduates of accredited surgical technology programs are eligible for certification by the National Board of Surgical Technology and Surgical Assisting[7] (NBSTSA), an administratively independent body from the Association of Surgical Technologists consisting of representative Certified Surgical Technologists, a surgeon, and the public.
The American College of Surgeons strongly supports adequate education and training of all surgical technologists, supports the accreditation of all surgical technology educational programs, and supports examination for certification of all graduates of accredited surgical technology educational programs.
[edit] Earnings
According to the Bureau for Labor Statistics, the median annual earnings of wage-and-salary surgical technologists were $36,080 in May 2006. The middle 50 percent earned between $30,300 and $43,560. The lowest 10 percent earned less than $25,490, and the highest 10 percent earned more than $51,140. Median annual earnings in the industries employing the largest numbers of surgical technologists were:
- Offices of physicians $37,500
- Outpatient care centers 37,290
- General medical and surgical hospitals 35,980
- Offices of dentists 37,080
Benefits provided by most employers include paid vacation and sick leave, health, medical, vision, dental insurance and life insurance, and retirement program. A few employers also provide tuition reimbursement and child care benefits.[2]
According to the Mayo Clinic’s School of Health Sciences, the median annual earnings of surgical technologists in 2006 were $44,077. Salaries ranged from $34,410 to $54,204.[8]
[edit] Professional organization
The professional organization for surgical technologists is the Association of Surgical Technologists (AST). Formed in 1969 with the support of the American College of Surgeons, American Medical Association (AMA), American Hospital Association (AHA), and Association of periOperative Registered Nurses (AORN), AST represents the interests of over 80,000 surgical technologists.
AST's primary purpose is to ensure that surgical technologists have the knowledge and skills to administer patient care of the highest quality and is the principal provider in conjunction with more than 40 state organizations of continuing education for surgical technologists. AST also works with ARC-ST and NBSTSA to set standards for education and certification and represents the profession at state and national levels to ensure graduation from an accredited program in surgical technology and that all surgical technologists attain the Certified Surgical Technologist credential as a condition of employment.
[edit] Work environments
- Operating rooms in hospitals.
- Central Sterile Processing in hospitals
- Dental and orthodontic offices
- Private surgical facilities
- Experienced surgical technologists may return to teach future technologists.
- Organ and Tissue donation organizations
- Veterinary clinics
- Military facilities
- Sales representatives in industry
