Surgical technology is an allied health profession. Surgical technologists are responsible for surgical instruments and other equipment in the surgical unit. They assist a variety of personnel in the surgical area, including surgeons and registered nurses.
Surgical technologists are also sometimes referred to as operating or surgical room technicians. The primary goal of the surgical technologist is to adequately prepare the operating room for a surgical procedure and to assist surgical professionals in performing their duties during the surgery. This preparation generally involves setting up the surgical instruments and equipment; it also includes the organization and placement of sterile linens and solutions. In addition, the surgical technologist gathers, adjusts, and assesses nonsterile equipment to verify that it is operational. The surgical technologist also helps patients with preparation for the surgical procedure by cleaning, shaving, and disinfecting the areas of the body where the surgery will take place. Surgical technologists move the patients into the operating room, where they help with the proper positioning of the patient on the operating table, having dressed the patient with sterile surgical clothing.
In the preoperative phase, surgical technologists often help with the important task of monitoring the vital signs of patients and checking patient charts. They also help other surgical personnel scrub and dress for the surgical procedure. During surgical procedures, technologists supply instruments and supplies to the surgeons and surgical assistants. This will involve counting needles, sponges, instruments, and supplies. It may also include holding retractors and cutting sutures. One of the most important duties of the technologist is to help with the collection, preparation, and disposal of specimens taken from the patient. Such specimens are usually taken to the laboratory for analysis. Other duties include applying dressings to the surgical site and maintaining equipment in the operating room, such as suction devices, lights, and sterilizers. They may also be involved in the management of blood and plasma. After surgery, the surgical technologist often takes the patient to a recovery room. Another role of the technologist is to clean the operating room after the surgery is complete, and the replenishment of surgical room supplies.
Most surgical technologists work in surgical units in hospitals, which are comfortable environments that are clean and well-lit. However, it is often necessary for the surgical technologist to stand for hours during lengthy surgical procedures. Surgical technologists, as well as other surgical personnel, are sometimes exposed to contagious disease, in addition to challenging situations involving bad odors and sights associated with serious disease. They wear traditional surgical gowns along with head coverings, masks, gloves, shoe covers, and protective eyewear. The majority of surgical technologists work a 40-hour week. This work week may involve some weekend, evening, and holiday shifts.
Education and training
Almost all surgical technologists receive their training in one of the following places: the military, hospitals, vocational schools, universities, or junior and community colleges. A formal body called the Commission on Accreditation of Allied Health Education Programs (CAAHEP) officially recognized and accredited 165 such programs as of 1998. Generally, a person must be a high-school graduate before being admitted to these programs. These programs vary in length from nine to 24 months. Those who graduate from these programs receive either a certificate, diploma, or associated degree. Those who have prior medical training, such as certain military personnel or licensed practical nurses, often train in the programs for a shorter duration.
The typical surgical technology program includes courses in anatomy, physiology, pharmacology, medical terminology, microbiology, surgery, and ethics. These programs also have a significant period of supervised hands-on clinical training. During the program, the student learns the proper techniques to ensure the care and safety of patients during surgical preparation and procedures. In addition, surgical technology students learn to handle a variety of equipment, supplies, solutions, and drugs. The surgical technologist must learn in detail the types and functions of a wide variety of surgical instruments. In addition to these more traditional surgical implements, a fully-trained modern surgical technologist must know about modern surgical technology and how it is used. This technology may include endoscopes, lasers, and power tools. For obvious reasons, surgical technology students receive extensive training in the use of the appropriate tools in various surgical situations.
There is a strong emphasis on proper sterilization techniques and the prevention of disease transmission before, during, and after surgical procedures. Significant discussion of disinfectant agents and their application to instrumentation, equipment, and supplies are also part of the curriculum. Surgical technologists also receive training in the principles of wound healing from the suturing process to the various stages of healing. Surgical technologists are also often trained to perform basic cardiopulmonary resuscitation (CPR) or basic life support (BLS). In addition to patients who are scheduled for surgery in advance, surgical technologists also help prepare patients who enter the hospital in emergency situations.
Computed axial tomography—Noninvasive imaging in which planes of tissue are assessed by radiography combined with computer analysis.
Endoscope—A device that consists of a tube and an optical system that allows the observation of the inside of a hollow organ or cavity.
Magnetic resonance imaging—Noninvasive technique that allows the viewing of soft tissues in the body using a strong magnetic field.
Positron emission tomography—a noninvasive technique that allows the observing of blood and oxygen flow in tissues, particularly the brain, using positron-emitting radionuclides.
Surgical technologists also receive training in the various ways that diseases are diagnosed, such as radiography, computed axial tomography (CT), positron emission tomography, magnetic resonance imaging, and ultrasonography. These imaging techniques are generally used preoperatively, though some of these methods may be used in an operative setting.
Surgical technologists need to be able to handle a fairly high level of stress due to the typical conditions in an operating environment. They also need to be organized and conscientious. A high level of manual dexterity is also required in the manipulation of operating room supplies and instruments. They need to know the equipment, supplies, and procedures of the operating room to efficiently help the surgical team. There is no time to waste in this environment, and the surgical technologist should not have to be told how and what to do at every step. As with other health professionals, the surgical technologist needs to keep up with the latest developments within the field.
The Liaison Council on Certification for the Surgical Technologist certifies technologists as professionals. This body grants such certification after the person graduates from one of the accredited programs and passes a national certification examination. At this point, the individual can use the title Certified Surgical Technologist (CST). This certification has to be renewed every six years. The certification requires either passing an examination or taking continuing education courses. Generally, those who have obtained the CST designation have an advantage in the recruitment process.
Advanced education and training
There are a variety of ways for the surgical technologist to keep up with developments within the field. There are many continuing education courses available. One of the best ways for the technologist to advance within the field is to specialize in a particular type of surgical technology, for example, cardiothoracic surgery, neurosurgery, orthopedic surgery, or as circulating technologists. The circulating technologist is the only member of the surgical team that is not completely sterile. In this role the technologist helps with the patients or assists in the anesthesia. This person also retrieves and opens supplies for sterile members of the team. They may also interview the patient before surgery, keeping detailed notes about the surgery itself, and act as a resource of information about the patient during surgery. There are four levels of CST certification. Level 1 is one that has been certified in basic patient care concepts and has the training to perform as first scrub during basic surgeries. Level 2 has all of the abilities and training of those at level 1 and has circulating skills. Level 3 has the skills and knowledge of the first two levels and has some defined management position. Level 4 surgical technologists are called surgical first assistants. These technologists actually help with the surgery itself. First assistants typically have additional training. Another means for surgical technologists to advance is by getting into management positions, such as operating supply departments in hospitals. Practice standards have been developed to help surgical technologists in these roles.
The United States Department of Labor has forecast that the employment of surgical technologists will grow at a rate that is much faster than average through the year 2008. This reflects growth in the number of surgical procedures being performed currently. This number is growing because those born in the baby boom after World War II are reaching retirement age and many require surgical interventions. New surgical technologies will also be increasingly utilized, and this will require highly trained personnel. The majority of surgical technologists will continue to be employed by hospitals, but many will work in clinics and in the offices of physicians.
Caruthers, Bob L. and Paul Price, eds. Surgical Technology for the Surgical Technologist: A Positive Care Approach. Albany, NY: Delmar, 2001.
Occupational Outlook Handbook. Chicago, Ill: NTC/Contemporary, 2000.
Association of Surgical Technologists. 7108-C South Alton Way, Englewood, CO 80112. <http://www.ast.org>.
Liaison Council on Certification for the Surgical Technologist. 7790 East Arapahoe Rd, Suite 240, Englewood, CO 80112-1274.
Mark A. Mitchell