What Is A Surgical Technologist?
Most people have never heard about a surgical technologist, and if they have, they think “they hand the tools to the surgeon”. Well, first they are instruments – not tools. Second, they do hand surgeons instruments, but there is so much more that a surgical tech does. Let’s talk about all of the things a surg tech does.
But first, what does it take to become a surg tech? An associate degree through an – accredited – surgical technology program allows you to sit for the certification exam. I will also share that not all healthcare facilities require certification or even completion of a program. I do not personally believe that is acceptable, however I will save that for another day! A good surgical technology program will prepare you to be a novice surgical tech upon graduation. You should gain clinical experience in a variety of specialties through the course of the program. Clinicals are typically done at a variety of hospitals, so you are also able to form an idea of where you want to work upon graduation. During your education you will also, of course, receive the didactic part which is extremely important. If you cannot grasp the rationales, you will struggle in your growth as a surgical tech. My biggest advice for program selection is to do your research, compare a few different programs, and always ensure the program is accredited. I have met far too many people who got started with a program that was not accredited, what a waste of time and money!
Accrediting body for surgical technology
Okay, so back to what a surgical tech actually does. Yes, a big portion of what a surg tech does is to pass instruments to the surgeon. That may sound simple, but it is far from simple! A good surg tech is constantly assessing what is going on in the procedure and anticipating what is going to happen next. In some procedures, seconds matter. If those seconds are wasted on the surgeon telling the surgical tech what he or she wants, the procedure could quickly turn south. Not all procedures have this sense of urgency- but I will let you in on a little secret... the surgeon wants to work with someone who knows what he or she wants and does not have to be told. Now, don’t get me wrong, everyone anticipates wrong sometimes! That’s okay! The surgeon will know you are trying your best to meet the patient’s needs by getting him what he or she needs quickly. A good surgical tech never has their hands empty during the procedure.
During the surgical procedure the surgical tech has many responsibilities aside from passing to the surgeon. A surgical tech needs to keep track of everything (with a “count”) that was opened to the sterile field. Yes, everything! For nearly every procedure there are many counted items. Sometimes it’s only the “sponges, sharps, and smalls” (I will go over that in a future post). Other times it’s the sponges, sharps, smalls, and instruments- AKA a “full count”. I love a full count- both as a surgical tech and a nurse. There is something about that flow that I just truly enjoy. Each hospital should have their own count policy that will go over the specifics on what the requirement is for counting, and you should be very familiar with that! I’ll mention this here, but cover it more later, but… if any member of the care team ever wants to count. You count. No questions asked. If you could not tell- counting is very important!
A surgical tech sets up the entire sterile field and ensures it remains sterile until the procedure is complete. In some facilities the surgical tech also performs the decontamination and sterilization of instrumentation- which is a HUGE factor in ensuring the best patient outcomes. This process is almost always overlooked, but it is insanely important. The sterile processing department is where this happens. But seriously, a sterile processing tech has a major role in each surgeries success, and they are very underappreciated- I’ll go much more into detail about all things SPD in the future. But if you know an SPD tech, tell them they are so appreciated!!
In some facilities the surgical techs are responsible for pulling cases as well. This means they gather all of the needed instrumentation and disposable supplies that are needed for the procedure. This can either be a small amount of “stuff” or a LOT of “stuff” dependent on what the case is! In my experience, my role hasn’t been to pull cases, but if we were finished with procedures and the SPD team still had cases for the next day to pull, we would help. So, a surgical tech pulls the case and sets the case up… who tears it down? If you guessed the surgical tech, you’re right! After the procedure is complete the surgical tech is responsible for getting everything where it needs to go. The instruments must be taken care of in a very specific way- more to come on that in the future. The immediate care of instruments is called “point of use” care. After that they are transported to the sterile processing team who works their magic to get the instruments ready for the next patient.
A surgical tech is there every step of the way during a surgical procedure. They get a front row seat to each procedure. A lot of surgeons love to teach, which means you get an up close and hands on anatomy lesson frequently, which is pretty cool! I’ve had a few surgeons draw out anatomy on the back table. If you show any interest in what they are teaching, you’ll usually get a pretty good explanation of just about anything! I’ve learned so much scrubbing procedures over the years and these “lessons” help you to be a better surgical tech and be able to anticipate just about anything. While most surgeons are interested in explaining things, there will always be some that do not want to teach or even answer the most basic questions in order to get through the case.
A surgical tech must have a very good surgical conscience. This essentially means having the guts to speak up if something isn’t quite right. Whether that’s a suspected contamination, a question of the procedure, etc. If you have doubt or concern about something you MUST speak up. They also must be an expert in sterility. A surgical tech must be able to move within the sterile field and keep it sterile! Oh, and guess what, a surgical tech also must ensure everyone else remains sterile as well! For example, students (other than surg tech students) in the OR typically have no awareness of what is sterile and what is not. A surgical tech must keep an out for any breech in asepsis through the entire procedure. If you’re the only one that sees it- call it out! If you are unsure if there was a break in asepsis or not… well it’s not worth the risk. Correct it. If you’ve ever been in an OR for a few hours, you’ve likely heard the term “when in doubt, throw it out”. If the integrity of something is questionable, don’t question it- just replace it! Not correcting something that COULD be a contamination could lead to a complication later- such as an SSI, or a surgical site infection. If someone calls you out personally on a contamination- don’t take it personal. They are just advocating for the patient and sometimes others are able to see things differently that you didn’t realize happened.
I hope this gave you a little bit of a glimpse about what a surgical tech does. There really is so much! It truly is an exciting and rewarding career where you will learn so much and be a vital member of the care team. If you’re curious about any part of the role of a surgical tech reach out! Not everybody is cut out to be a surgical tech, and that’s okay! If becoming a surgical tech is something that you are interested in but are not sure if it’s the right fit, I am more than happy to talk more with you about what it takes! I’ve met many people who went through school and started their career as a surgical tech just to decide it was not for them because they did not know enough about the role!
