Surgical Technology: The Profession and the Professional

Historical Origins of the Surgical Technology Profession

  • Surgical technology is recognized as an allied health profession with a distinct historical trajectory.

  • Period Before World War II (WWII):   * The Registered Nurse (RN) traditionally filled the role of the surgical assistant.   * The primary duty of nursing personnel in the operating room was focused on instrument preparation.   * Nurses were also responsible for assisting with the administration of ether (anesthesia).

  • Period After World War II (WWII):   * There was a significant increase in the clinical demand for Operating Room (OR) personnel.   * A severe nursing shortage occurred during this post-war expansion.   * As a solution, corpsmen were trained specifically to assist in surgical interventions.

  • The Era of the Korean War:   * The nursing shortage continued to persist throughout this conflict.   * Professional roles shifted such that corpsmen often circulated while nurses performed the scrub role.   * The Association of Operating Room Technicians (AORT) was developed during this period.   * Formalized training programs for the profession began to be established during this time.

Evolution of the Surgical Technology Profession and Leadership

  • In 19681968, the Association of Operating Room Nurses (AORN) founded the Association of Operating Room Technicians (AORT).

  • Key developmental agencies involved in the profession's growth included:   * The Liaison Council on Certification for the Surgical Technologist (LCC-ST).   * The Joint Review Committee on Education.

  • In 19701970, the first professional certifying examination was officially administered.

  • In 19731973, the AORT transitioned into its modern identity as the Association of Surgical Technologists (AST).   * During this transition, the title for practitioners changed from "certified technician" to "certified surgical technologist" (CST).

Roles and Primary Responsibilities of the Surgical Technologist

  • Scrub Role (Surgical Technologist Scrub Role - STSR):   * The STSR is a member of the sterile team and functions as a scrubbed, gowned, and gloved participant in surgery.   * This role delivers direct surgical care.   * Core tasks include the establishment and preparation of the sterile field.   * The STSR prepares and passes instruments, supplies, medications, and equipment during the surgical procedure.   * The STSR is responsible for the protection and active maintenance of the sterile field.

  • Circulator or Assistant Circulator Role:   * This position is defined as a "nonsterile" team member.   * The surgical technologist (ST) shares some, but not all, responsibilities of the Registered Nurse (RN), and these responsibilities vary based on individual state regulations.   * Specific tasks may include:     * Delivering and preparing nonsterile equipment.     * Distributing and opening sterile supplies to members of the sterile team.     * Assisting with the transfer and positioning of the patient.     * Performing urinary catheterization.     * Performing the surgical skin preparation.

  • Second Assistant Responsibilities:   * Specific tasks often performed include tissue retraction.   * Performing suctioning to maintain visibility.   * Maintaining hemostasis.   * Assembling and placing wound suction devices at the closure of the procedure.   * Applying final wound dressings.

  • Other Perioperative Responsibilities:   * Performing emergency duty as required.   * Detailed preparation of surgical instruments and specialized equipment.   * Engagement in direct patient care.   * Taking on leadership and management roles within the facility.   * Serving as a Preceptor (teacher/mentor) for new staff or students.

Professional Organizations and Accrediting Agencies

  • Association of Surgical Technologists (AST):   * This organization provides the professional Code of Ethics, Standards of Practice, and the Code of Conduct.

  • ARC/STSA (Accreditation Review Council on Education in Surgical Technology and Surgical Assisting):   * This council recommends the accreditation of surgical technology educational programs.

  • CAAHEP (Commission on Accreditation of Allied Health Education Programs):   * This agency is responsible for officially granting program accreditation.

  • ABHES (Accrediting Bureau of Health Education Schools):   * This body is a nonprofit accrediting group recognized by the U.S. Department of Education.

  • NBSTSA (National Board of Surgical Technology and Surgical Assisting):   * This is the official certifying body for the vocation of surgical technology.

Education, Certification, and Continuing Studies

  • Educational Pathways:   * Short certificate programs typically last between 99 and 1212 months.   * Two-year (22-year) college degree programs are also available.

  • Professional Certification:   * Certification is obtained through the NBSTSA.   * To sit for the exam, candidates must meet specific eligibility requirements.

  • Continuing Education (CE):   * CE credits must be consistently earned to maintain professional certification status.   * All CE credit activities and regulatory information are documented on the official AST website.

Professional Behavior, Characteristics, and Career Opportunities

  • The Concept of a Professional:   * Professionals exhibit specific behaviors that others recognize and respect.   * Becoming a professional is a standardized process that all health care providers undergo.

  • Characteristics of a Professional:   * Integrity and Truthfulness.   * Self-regulation and Perspective.   * Commitment and Politeness.   * Tact and discretion.   * Strict attention to personal hygiene and physical appearance.   * Respect for rules, regulations, and legislative laws.

  • Career Opportunities for the Certified Surgical Technologist (CST):   * Facility-based technologist.   * Military service practitioner.   * Specialty surgical practices.   * Certified Surgical Technologist–Certified First Assistant (CST-CFA).   * Educator and clinical instructor.   * Medical industry representative.   * Materials processing management.

Ethics in Surgical Practice and Employment Preparation

  • Professional Ethics for Health Care Workers:   * Respecting human individuality and the uniqueness of every patient.   * Practicing the profession with empathy.   * Practicing and upholding equal rights for all individuals.   * Respecting all confidences entrusted to the practitioner by the patient.   * Respecting the free will of the patient.   * Adhering to the principle of "Do no harm."   * The cultivation and maintenance of a Surgical Conscience.

  • Ethical Challenges and Workplace Dilemmas:   * Impairment in the workplace: Healthcare professionals have a legal and ethical responsibility to report suspected impairment of a coworker or to seek treatment themselves.   * Refusal to perform assigned tasks or refusal to work with specific individuals.   * Ethical Dilemma Definition: A personal conflict arising from the need to make a decision based on choices that are not completely acceptable.

  • Preparation for Employment:   * Steps for success include preparing a professional resume, researching prospective employers, and listing professional references.   * Practitioners should practice applying for jobs and prepare extensively for the interview process.

Questions & Discussion

  • This section serves as a prompt for interaction and clarification regarding Lesson 1.11.1 (The Surgical Technologist) and Lesson 1.21.2 (Becoming a Surgical Technologist).