Scrub Surgical Technologist

The first type of ST, the scrub surgical technologist, is sometimes called the surgical technologist in the scrub role. In this scrub role, the surgical technologist is a member of the “sterile team,” working collaboratively with the registered nurse (RN), who functions in the circulator role. This circulating nurse coordinates the activities of the surgical team. To provide optimal care to the patient, the circulating nurse maintains mobility outside the sterile field to monitor the patient’s condition throughout the surgical experience, from pre-op to post-op, and thus provides invaluable direction to the surgical technologist.

In the scrub role, the surgical technologist will assemble the instruments and supplies needed to facilitate a safe and efficient surgery and maintain the sterility of the surgical field throughout the procedure. Basic working knowledge of a wide variety of supplies, sterile techniques, and equipment is crucial for patient safety. With experience over time, each tenured surgical technologist comes to rely on a mental checklist when preparing to set up for a procedure; this is built over time and with each new experience. The fundamentals do not change with surgical specialties; they are instead uniform to each procedure.

Circulating Surgical Technologist

Sometimes the surgical technologist assists in circulating, by retrieving additional supplies, equipment, or instruments during the surgical procedure itself. In contrast to the scrub role, circulating requires working outside the sterile field. The circulating surgical technologist also monitors OR conditions and anticipates patient and surgical team needs. In the circulating role, the surgical technologist can assist in transporting and positioning the patient, assisting anesthesia personnel, securing dressings, keeping accurate records throughout the entire operation, and a variety of other duties outside the sterile field.

Second Assisting Technologist

In this more advanced role, the surgical technologist still performs in the scrub role but is also able to perform additional tasks to assist the first assistant or surgeon. These additional tasks may include any of the following, among other responsibilities: holding instruments as directed by the surgeon, performing suctioning or sponging at the operative site, applying dressings, helping to provide aid in exposure and hemostasis, connecting drains to suction apparatus, and cutting suture material as directed by the surgeon.

Hospital Surgical Suites

Surgical technologists are most commonly utilized in main operating rooms in large and small hospitals. They may function as part of a specialized team for a specific surgical service or function in all procedures the operating room performs. In some facilities there is a career advancement ladder for the surgical technologist, usually ranging from two to four different levels based on the needs of the facility and the education and training of the surgical technology staff. This advancement model encourages the surgical technologist to achieve additional training and education for additional recognition.

Labor and Delivery Departments

Surgical technologists are well equipped to specialize in this demanding department, both as the scrub in a cesarean section and as an assistant to the team in a vaginal delivery.

Ambulatory Surgical Centers

Less complex surgeries are being performed more often in ambulatory surgical centers. These outpatient centers offer the surgical technologist the opportunity to work in a facility specializing in minimally invasive surgery as well as short-term–stay patients. Most often these patients arrive the day of surgery and leave within 23 hours. As modern surgery has become more specialized with the advancement of minimal incision techniques and the implementation of robotic surgery, the perioperative team needs to increase their level of training. Thus, in these ambulatory surgery settings, the surgical technologist has the opportunity to expand skill sets to function in multiple specialties and highly advanced procedural changes, without the call and shift requirements of a hospital setting.

Private Surgeon’s Scrub

Functioning as a private scrub technologist for a specific surgeon or group of surgeons provides the surgical technologist the ability to gain expert knowledge in a surgical specialty and function at a higher level. This career choice will present the opportunity for the surgical technologist to have more hands-on, direct patient care than working as part of a traditional hospital staff and often requires advancement to the position of surgical first assistant. Additional education and advanced knowledge of knot tying and suturing techniques are required to function as a first assistant. The private scrub may interact with the patient preoperatively and do rounds with the surgeon postoperatively. They may be involved in procedures done in the surgeon’s office, and will work with the surgeon in several hospitals, requiring the surgical technologist to be credentialed in several facilities.

Sterile Processing and Decontamination Department

The experience and expertise the surgical technologist brings to surgical patient care settings can also be utilized in the sterile processing and decontamination departments. In addition to focusing on sterilization techniques, an advanced understanding of specific surgical instruments and their functionality plays an important role in the safe and efficient processing of specialized sets. Some facilities utilize surgical technologists as group leaders or coordinators in this department.

Certification

The most widely accepted certification for surgical technologists is offered through the National Board for Surgical Technology and Surgical Assisting (NBSTSA). The title of Certified Surgical Technologist (CST) is a registered trademark of the NBSTSA. The outcomes-indicator for surgical technology programs is the CST exam, which can be taken before graduation or any time after graduation from an accredited program. Students are not denied graduation if they are unsuccessful at passing the exam and may retake it twice more in a year’s time in an effort to attain certification. Once certified, the Certified Surgical Technologist will have 4 years to complete 60 continuing education (CE) credits to maintain certification or retest; however, the preferred method of maintaining currency and professional competency is through continuing education. These credits can be obtained in a number of ways: through meetings at the state or national level, hospital educational in-services, journal article post-tests, and qualifying college courses.

Preoperative Phase

Before surgery, the surgical team relies on the surgical technologist to prepare the OR, create a sterile field, and gather and count all necessary equipment and supplies. This last responsibility is no small matter: checking to be sure all the correct supplies, equipment, and instruments are available is paramount to achieving quality outcomes for the patient. It is impossible to anticipate every aspect of the surgical procedure; however, the more prepared you are for the unexpected, the better the flow of the surgical procedure.