Surgical technologists, also called surgical technicians or operating room technicians, are members of the surgical team who work in the operating room with surgeons, nurses, anesthesiologists, and other personnel before, during, and after surgery. They ensure a safe and sterile environment. To prepare a patient for surgery, they may wash, shave, and disinfect the area where the incision will be made. They arrange the equipment, instruments, and supplies in the operating room according to the preference of the surgeons and nurses. During the operation, they adjust lights and other equipment as needed. They count sponges, needles, and instruments used during the operation, hand instruments and supplies to the surgeon, and hold retractors and cut sutures as directed. They maintain specified supplies of fluids (for example, saline, plasma, blood, and glucose), and may assist in administering these fluids. Following the operation, they may clean and restock the operating room and wash and sterilize the used equipment using germicides, autoclaves, and sterilizers, although in most larger hospitals these tasks are done by other central service personnel. There are approximately 83,700 surgical technologists employed in the United States.
History of Surgical Technologist Career
While the origins of surgery go back to prehistoric times, two scientific developments made modern surgery possible. The first was the discovery of anesthesia in the mid-19th century. Because the anesthesia eliminated the patient’s pain, surgeons were able to take their time during operations, enabling them to try more complex procedures.
The second important discovery was that of the causes of infection. Until Louis Pasteur’s discovery of germs and Joseph Lister’s development of aseptic surgery in the 19th century, so many people died of infection after operations that the value of surgery was extremely limited.
During World War II, the profession of surgical technology grew when there was a critical need for assistance in performing surgical procedures and a shortage of qualified personnel. Shortly after, formal educational programs were started to teach these medical professionals.
Throughout the last century, the nature of most surgical procedures, with all of their sophisticated techniques for monitoring and safeguarding the patient’s condition, has become so complex that more and more people are required to assist the surgeon or surgeons. While many of the tasks that are performed during the operation require highly trained professionals with many years of education, there are also simpler, more standardized tasks that require people with less complex training and skills. Over the years, such tasks have been taken care of by people referred to as orderlies, scrub nurses, and surgical orderlies.
Today, such people are referred to as surgical technologists, operating room technicians, or surgical technicians. For the most part, these medical professionals have received specialized training in a community college, vocational or technical school, or a hospital-sponsored program. They are eligible to earn certificates of competence, and, in general, enjoy a higher degree of professional status and recognition than did their predecessors.
The Job of Surgical Technologists
Surgical technologists are health professionals who work in the surgical suite with surgeons, anesthesiologists, registered nurses, and other surgical personnel delivering surgical patient care.
In general, the work responsibilities of surgical technologists may be divided into three phases: preoperative (before surgery), intraoperative (during surgery), and postoperative (after surgery). Surgical technologists may work as the scrub person, circulator, or surgical first assistant.
In the preoperative phase, surgical technologists prepare the operating room by selecting and opening sterile supplies such as drapes, sutures, sponges, electrosurgical devices, suction tubing, and surgical instruments. They assemble, adjust, and check nonsterile equipment to ensure that it is in proper working order. Surgical technologists also operate sterilizers, lights, suction machines, electrosurgical units, and diagnostic equipment. When patients arrive in the surgical suite, surgical technologists may assist in preparing them for surgery by providing physical and emotional support, checking charts, and observing vital signs. They properly position the patient on the operating table, assist in connecting and applying surgical equipment and monitoring devices, and prepare the incision site by cleansing the skin with an antiseptic solution.
During surgery, surgical technologists have primary responsibility for maintaining the sterile field. They constantly watch that all members of the team adhere to aseptic techniques so the patient does not develop a postoperative infection. As the scrub person, they most often function as the sterile member of the surgical team who passes instruments, sutures, and sponges during surgery. After “scrubbing,” which involves the thorough cleansing of the hands and forearms, they put on a sterile gown and gloves and prepare the sterile instruments and supplies that will be needed. After other members of the sterile team have scrubbed, they assist them with gowning and gloving and applying sterile drapes around the operative site.
Surgical technologists must anticipate the needs of surgeons during the procedure, passing instruments and providing sterile items in an efficient manner. Checking, mixing, and dispensing appropriate fluids and drugs in the sterile field are other common tasks. They share with the circulator the responsibility for accounting for sponges, needles, and instruments before, during, and after surgery. They may hold retractors or instruments, sponge or suction the operative site, or cut suture material as directed by the surgeon. They connect drains and tubing and receive and prepare specimens for subsequent pathologic analysis.
Surgical technologists most often function as the scrub person, but may function in the nonsterile role of circulator. The circulator does not wear a sterile gown and gloves, but is available to assist the surgical team. As a circulator, the surgical technologist obtains additional supplies or equipment, assists the anesthesiologist, keeps a written account of the surgical procedure, and assists the scrub person.
Surgical first assistants, who are technologists with additional education or training, provide aid in retracting tissue, controlling bleeding, and other technical functions that help surgeons during the procedure.
After surgery, surgical technologists are responsible for preparing and applying dressings, including plaster or synthetic casting materials, and for preparing the operating room for the next patient. They may provide staffing in postoperative recovery rooms where patients’ responses are carefully monitored in the critical phases following general anesthesia.
Some of these responsibilities vary, depending on the size of the hospital and department in which the surgical technologist works; they also vary based on geographic location and health care needs of the local community.
Surgical Technologist Career Requirements
During your high school years, you should take courses that develop your basic skills in mathematics, science, and English. You also should take all available courses in health and biology.
Surgical technology education is available through postsecondary programs offered by community and junior colleges, vocational and technical schools, the military, universities, and structured hospital programs in surgical technology. A high school diploma is required for entry into any of these programs.
More than 400 of these programs are accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). The accredited programs vary from nine to twelve months for a diploma or certificate, to two years for an associate’s degree. You can expect to take courses in medical terminology, communications, anatomy, physiology, microbiology, pharmacology, medical ethics, and legal responsibilities. You gain a thorough knowledge of patient preparation and care, surgical procedures, surgical instruments and equipment, and principles of asepsis (how to prevent infection). In addition to classroom learning, you receive intensive supervised clinical experience in local hospitals, which is an important component of your education.
Certification or Licensing
Increasing numbers of hospitals are requiring certification as a condition of employment. Surgical technologists may earn a professional credential by passing a nationally administered certifying examination. To take the examination, you must be currently or previously certified or be a graduate of a CAAHEP-accredited program. The Liaison Council on Certification for the Surgical Technologist (LCC-ST), an independent affiliate of the Association of Surgical Technologists, is the certifying agency for the profession. Those who pass the exam and fulfill education and experience requirements are granted the designation of certified surgical technologist (CST). To renew the four-year certificate, the CST must earn continuing education credits or retake the certifying examination. The LCC-ST also offers an advanced credential for surgical first assistants; this exam awards the designation of CST certified first assistant (CST/ CFA). Another certification for surgical technologists can be obtained from the National Center for Competency Testing. To take the certification exam, candidates must either complete an accredited training program, attend a two-year hospital on-the-job training program, or have seven years of experience in the field. Upon passing the exam, surgical technologists obtain the designation of Tech in Surgery-Certified, TS-C (NCCT). This certification must be renewed every five years either through reexamination or continuing education.
Surgical technologists must possess an educational background in the medical sciences, a strong sense of responsibility, a concern for order, and an ability to integrate a number of tasks at the same time. You need good manual dexterity to handle awkward surgical instruments with speed and agility. In addition, you need physical stamina to stand through long surgical procedures.
Exploring Surgical Technologist Career
It is difficult to gain any direct experience on a part-time basis in surgical technology. The first opportunities for direct experience generally come in the clinical and laboratory phases of your educational programs. However, interested students can explore some aspects of this career in several ways. You or your teachers can arrange a visit to a hospital, clinic, or other surgical setting in order to learn about the work. You also can visit a school with a CAAHEP-accredited program. During such a visit, you can discuss career plans with the admissions counselor. In addition, volunteering at a local hospital or nursing home can give you insight into the health care environment and help you evaluate your aptitude to work in such a setting.
Most surgical technologists are employed in hospital operating rooms, clinics, and surgical centers. They also work in delivery rooms, cast rooms, emergency departments, ambulatory care areas, and central supply departments. Surgical technologists may also be employed directly by surgeons as private scrubs or as surgical first assistants.
Graduates of programs are often offered jobs in the same hospital in which they received their clinical training. Programs usually cooperate closely with hospitals in the area, which are usually eager to employ technologists educated in local programs. Available positions are also advertised in newspaper want ads.
With increased experience, surgical technologists can serve in management roles in surgical services departments and may work as central service managers, surgery schedulers, and materials managers. The role of surgical first assistant on the surgical team requires additional training and experience and is considered an advanced role.
Surgical technologists must function well in a number of diverse areas. Their competency with multiple skills is demonstrated by their employment in organ and tissue procurement/preservation, cardiac catheterization laboratories, medical sales and research, and medical-legal auditing for insurance companies. A number are instructors and directors of surgical technology programs.
Salaries vary greatly in different institutions and localities. According to the U.S. Department of Labor, the average salary for surgical technologists was $34,830 in 2005, and ranged from $24,530 to $48,710 a year (excluding overtime). Some technologists with experience earn much more. Most surgical technologists are required to be periodically on call—available to work on short notice in cases of emergency—and can earn overtime from such work. Graduates of educational programs usually receive salaries higher than technologists without formal education. In general, technologists working on the East Coast and West Coast earn more than surgical technologists in other parts of the country. Surgical first assistants and private scrubs employed directly by surgeons tend to earn more than surgical technologists employed by hospitals.
Surgical technologists naturally spend most of their time in the operating room. Operating rooms are cool, well lighted, orderly, and extremely clean. Technologists are often required to be on their feet for long intervals, during which their attention must be closely focused on the operation.
Members of the surgical team, including surgical technologists, wear sterile gowns, gloves, caps, masks, and eye protection. This surgical attire is meant not only to protect the patient from infection but also to protect the surgical team from any infection or blood-borne diseases that the patient may have. Surgery is usually performed during the day; however, hospitals, clinics, and other facilities require 24-hour-a-day coverage. Most surgical technologists work regular 40-hour weeks, although many are required to be periodically on call.
Surgical technologists must be able to work under great pressure in stressful situations. The need for surgery is often a matter of life and death, and one can never assume that procedures will go as planned. If operations do not go well, nerves may fray and tempers flare. Technologists must understand that this is the result of stressful conditions and should not take this anger personally.
In addition, surgical technologists should have a strong desire to help others. Surgery is performed on people, not machines. Patients literally entrust their lives to the surgical team, and they rely on them to treat them in a dignified and professional manner. Individuals with these characteristics find surgical technology a rewarding career in which they can make an important contribution to the health and well-being of their community.
Surgical Technologist Career Outlook
According to the U.S. Department of Labor, the field of surgical technology is projected to experience rapid job growth through 2014. Population growth, longevity, and improvement in medical and surgical procedures have all contributed to a growing demand for surgical services and hence for surgical technologists. As long as the rate at which people undergo surgery continues to increase, there will continue to be a need for this profession. Also, as surgical methods become increasingly complex, more surgical technologists will likely be needed.
An increasing number of surgical procedures are being performed in the offices of physicians and ambulatory surgical centers, requiring the skills of surgical technologists. As a result, employment for technologists in these non-hospital settings should grow much faster than the average.