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Just about all of us can recall an encounter with someone working in a professional capacity—a healthcare provider, a college professor—who impressed you with his or her competence, courtesy, and kindness. Most of us, unfortunately, have also dealt with someone who left us feeling uninformed, ignored, or even insulted. As medical professionals, we must make a conscious effort to do our jobs to the best of our ability and inspire confidence in and foster a rapport with our patients.
In this chapter, we’ll cover a wide range of topics that you will need to understand not only for your certification examination but also to do your job well and in accordance with the law.
Credentialing
Demonstrating Competence
There are several ways of exhibiting competence in your field:
• Certification: Becoming certified in surgical technology by passing a certification examination (i.e., the NBSTSA or NCCT assessment for which you’re using this text to study) is a voluntary demonstration of competency and the least restrictive of the three methods discussed here.
• Licensure: Attaining licensure by fulfilling a state’s requirements in regard to education, competence, and practice is the most restrictive of the three means of demonstrating competence.
Professional Organizations
Many different organizations work to ensure safety in healthcare and among the American public. Joining the appropriate groups can help you stay up to date on the most recent developments and reassure patients, family members, and co-workers that you care about doing the best job possible.
• Association of Surgical Technologists. The AST, a professional membership organization, is devoted to ensuring that surgical technologists are up to date on the latest skills and techniques.
• National Board of Surgical Technology and Surgical Assisting. As you know, the NBSTSA is a certification body for surgical technology and surgical assisting.
• Council on Surgical and Perioperative Safety. The CSPS seeks to ensure that patients receive the safest surgical care possible.
• American College of Surgeons. The ACS is the main American representative body for surgeons.
• Association of Perioperative Nurses. The APN is an organization representing nurses who work in a perioperative role.
• Centers for Disease Control and Prevention. This federal agency, better known as the CDC, is a division of the U.S. Department of Health and Human Services (HHS). It is responsible for educating the public on health topics and also monitors and works to prevent and contain disease outbreaks.
• Food and Drug Administration. The FDA, another division of the HHS, approves and regulates medical devices and medications.
• The Joint Commission. This organization sets standards for health care quality and conducts assessments of participating facilities to ensure compliance.
• Occupational Safety and Health Administration. This division of the U.S. Department of Labor, better known as OSHA, monitors and enforces workplace safety.
• Commission on Accreditation of Allied Health Educational Programs. The CAAHEP is an accreditation body for educational programs in health care.
• Accreditation Review Council on Education in Surgical Technology and Surgical Assisting. ARC-STSA is a committee on accreditation that reports and makes accreditation recommendations to CAAHEP.
• Accrediting Bureau of Health Education Schools. The ABHES accredits surgical technology programs; once a program has gained approval, its graduates may sit the CST exam.
Communication in the Workplace
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No matter how good your surgical technology skills, if you are not an effective communicator, you will not be able do your job well.
Effective and Ineffective Communication
Ineffective modes of communication include:
• False reassurance: telling someone that things will be fine when, in fact, they may not
• Defensiveness: reacting angrily when one feels that one is being blamed
• Judgmental behavior: judging others’ appearance, clothes, and behaviors
• Inhibition of communication: making it difficult to communicate productively with others
An effective communicator:
• Asks open-ended questions (rather than yes-or-no questions) to elicit more information and help the other person express him- or herself
• Engages in active listening, giving the speaker his or her full attention
• Asks for clarification when something is not clear or it is necessary to ensure that all parties are on the same page
• Is accepting of input from others
• Practices conflict-management skills: negotiating, bargaining, collaboration
• Engages in cooperative behaviors such as open communication
• Knows how to differentiate message (any communication containing information) and meaning (the intention behind the message [reading between the lines])
• Is able to recognize and interpret verbal (spoken) and nonverbal (body language, eye contact) communication
Leadership Styles
The surgical technologist who also functions as a leader has several options for managing people in the workplace. Each leadership style has its benefits and drawbacks, and not every style of leading is appropriate in every situation.
• Autocratic. There’s just one leader, and everyone does things in that person’s way.
• Democratic. The members of the team work together to make decisions.
• Laissez-faire. The leader exerts little or no control, leaving the team members to their own devices.
Surgical Conscience
In addition to solid job skills and the ability to communicate well, professionalism requires the surgical technologist to have what is known as surgical conscience. This “conscience” involves:
• Strict adherence to sterile technique
• Accountability, honesty, and integrity in the delivery of quality patient care (including the capacity to speak up if you compromise the sterile field) (Fig. 6.1)
• The understanding that one must advocate for the patient and quality of care, including controlling costs where possible. For instance, it’s crucial for the surgical technologist to review the surgeon’s preference card before a procedure and refrain from opening supplies that might not be called for during the surgery.
Emotional Development of the Surgical Patient
Always be mindful that a person scheduled for surgery is a member of a special population. Whatever the surgery might be—therapeutic, reconstructive, or cosmetic—the patient will not be the same after surgery. Take, for example, a woman who is to undergo mastectomy. Making the decision to have this surgery is difficult. The surgery and its aftereffects will influence her self-esteem, her sex drive, and how she feels about herself as a woman. It is the obligation of the surgical technologist to treat all surgical patients with compassion and to serve as an advocate on their behalf.
The members of certain populations are more vulnerable and often have special needs as they face surgery:
• Pediatric patients
• Geriatric patients
• Immunocompromised patients
• Diabetic patients
• Pregnant women
• Trauma patients
• Bariatric patients
• Physically or mentally challenged patients
• People who are isolated
• Patients with substance abuse issues
Anyone responsible for advocating for patients or working closely with others must understand what makes people tick, especially in stressful environments such as the operating room.
Pioneering psychologist Abraham Maslow boiled this information down into what has become known as Maslow’s Hierarchy of Needs (Fig. 6.2):
• Physiological. This includes things needed for survival (e.g., oxygen, water, homeostasis, shelter).
• Safety. We seek freedom from danger and poverty.
• Love and belonging. Almost everyone desires a feeling of acceptance in social groups.
• Esteem. We want to be respected by others and to respect ourselves as well.
• Self-actualization. We have the desire or need to achieve our full potential, especially after a life-changing event such as surgery.
Another renowned psychologist, Erik Erikson, formulated with his wife, Joan Erikson, what they called psychosocial stages, in which a person must fulfill tasks of development over his or her lifespan. Success or failure in dealing with these tasks can help explain a person’s behavior.
FIG. 6.2 Maslow’s hierarchy of needs as related to surgical patient needs during perioperative care. (From Phillips N: Berry & Kohn’s operating room technique, ed 13, St Louis, 2017, Elsevier.)
• Infancy (Birth–1 Year): Trust Versus Mistrust
• The infant depends on its mother for nurture, sustenance, and love and ideally begins to experience a sense of trust and hope regarding its place in the world. An infant who is not nurtured and loved and does not develop trust and hope may have trouble learning to trust and love others.
• Early Childhood (1–3 Years): Autonomy Versus Shame and Doubt
• Toddlers begin to develop control over their body functions, as well as some degree of autonomy, and they experience conflict when told no, shamed, embarrassed, or forced to be dependent. A toddler who successfully navigates this stage will emerge with budding willpower and self-control. Failure can result in low self-esteem and too much dependence on others.
• Preschool (3–6 Years): Initiative Versus Guilt
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