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Cover Story: A Leading Role

How the surgical tech plays an instrumental part of the OR team

By Don Sadler

There are few environments where teamwork is more important than in the operating room. Each individual on the OR team has specific skills and clearly defined individual roles.

This includes the surgical technologist, who is sometimes referred to as the surgeon’s right-hand person. In its recommended job description, the Association of Surgical Technologists describes the role of the surgical technologist as follows:

“Surgical technologists are allied health professionals who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety.”

Surgical Techs And Or Nurses
One of the key differences between the surgical technologist and the OR nurse is that the surgical tech scrubs in and works at the surgical field, explains Dr. Robert T. Grant, Plastic Surgeon-in-Chief at N.Y. Presbyterian/Columbia University Medical Center and Weill Cornell Medical Center.

“The OR nurse has a more global role as patient advocate, which includes responsibility for room preparation and equipment, ensuring that all pertinent policies and procedures are followed, and keeping the operating room schedule and cases running efficiently. The surgical technologist serves in a supporting role to the surgeon, which enables the tech to truly focus on the successful completion of the procedure. He or she is a knowledgeable, capable assistant who facilitates the flow and performance of the operation.”

“As surgical technologists, we are on the surgical field, sterile and assisting the surgeon,” adds Ruth Ferguson, a Surgical Tech II at The Mary Catherine Bunting Center at Mercy Medical Center in Baltimore, Md. “Surgical technologists set up the operating room with instruments and supplies, and surgeons rely on the knowledge of the surgical tech, who must anticipate the surgeon’s needs during surgery.”

According to the Association of Surgical Technologists (AST), the primary role of the surgical technologist is the first scrub role. In this role, the Certified Surgical Technologist (CSTTM) has the knowledge and technical skills needed to handle the surgical instruments, power equipment and supplies that are necessary for performing the specific surgical procedure. Therefore, the CST must have detailed knowledge of the surgical procedure in order to meet the needs of the surgeon.

As Ferguson noted, surgical technologists are expected to anticipate the needs of the surgeon during the procedure. The more the CST can anticipate the needs of the surgeon without the surgeon having to ask, the sooner the procedure can be completed and the patient brought out from under anesthesia.

Sandra Hart, CST, CSA, a Surgical First Assistant at Lakewood Hospital in Lakewood, Ohio, who has been certified since 1978, describes her role as “in effect, the surgeon’s other hands, eyes and voice. I must be prepared to voice my opinion in situations if the need arises.”

The surgical technologist must be willing to apply the principles of surgical conscience on a daily basis, according to the AST. This includes being another pair of eyes to professionally self-correct, or correct others, in breaks in sterile technique, and being able to recognize potentially dangerous patient circumstances, such as dark blood on the sterile field that could indicate an emergency patient situation.

Perhaps the most important role of the surgical technologist is maintaining a high standard of sterile technique during the procedure. The surgical tech must be ever vigilant in making sure everyone in the OR maintains sterile technique. He or she must immediately point out breaks in sterile technique, such as a tear in a glove or a sterile item touching a non-sterile surface.

History Of Surgical Technology
According to the AST, the profession of surgical technology dates all the way back to 16th century England, where surgical techs were called surgery beadles. As time progressed, the role of the surgery beadle evolved from one of peripheral patient care duties to directly assisting the surgeon during the surgical procedure. One of the most famous surgery beadles is Mr. Rampley, who worked at the London Hospital in the late 1800s and invented a needleholder that bears his name.

The surgical technology profession became solidified during the wars of the 20th century. When the military medical technicians who learned on-the-job how to work in the first scrub role in the OR were discharged, they were more than eager to continue to provide their skills in civilian hospitals.

The profession advanced from hospitals individually providing on-the-job training to formal educational programs that are offered by colleges, community colleges, technical schools and the military. The role of the surgical technologist has greatly expanded, and there are now 462 accredited surgical technology programs in the U.S., according to the AST.

To become a Certified Surgical Technologist today, an individual must graduate from an accredited surgical technology program. Accredited programs provide both didactic education and supervised clinical experience based on a core curriculum for surgical technology. Programs vary in length from 12 to 24 months for a diploma, certificate or associate’s degree.

Good Candidates For Surgical Technology
Dr. Robert T. Grant, Plastic Surgeon-in-Chief at N.Y. Presbyterian/Columbia University Medical Center and Weill Cornell Medical Center, believes that surgical technology offers a great opportunity for individuals who want to enter the surgical field but don’t want to spend many years and lots of money on post-graduate training. “It’s a growing field, and there will be lots of opportunities as health care continues to expand.”

“My favorite part of my job is making sure that patient safety and satisfaction are achieved,” Ferguson says. “Also, being able to assist the surgeon in such an important role is very satisfying.”

As a surgical assistant traveler, Hart must be able to function in all areas of the OR and among all age groups. “Going to new places, meeting new people, learning how things are done differently in different hospitals and ORs, and increasing my education within the medical field are all things that I really like about my job.”

What kind of individual might find a career as a surgical technologist rewarding? According to the AST, surgical technology might appeal to someone who wants to be on the move during the day, stay involved and highly focused on their job, learn new things, and be a meaningful, professional contributor to a team whose goal is to provide the best surgical care to patients day-in and day-out.

Individuals who desire the fast-paced action of providing surgical care in emergency situations often find a lot of satisfaction in the surgical technologist job. The common theme you often hear from CSTs is that they want to be up at the sterile field assisting the surgeon—that’s where the action is taking place, and it’s also where the challenges are: solving problems and meeting the needs of the surgeon.

To learn more about the role of surgical technologist in the OR and the CST designation, visit the AST’s website at



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